Travel medicine and infectious disease · 2026
Clinical characteristics and treatments of imported loiasis patients with microfilaraemia diagnosed in France, 2000-2022.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Declerck Charles, Kravetz Simon, Bouchaud Olivier, Dorchies Justine, Dupont Damien, Lefebvre Maeva, Pomares Christelle, Duvignaud Alexandre, Boullé Charlotte, Specklin Antoine, Leroy Jordan, Bonhomme Julie, Courtellemont Laura, Gerber Victor, Gangneux Jean-Pierre, Benelhadj Djelloul Assia, Maurille Charles, Hoffmann Claire, Robert Marie Gladys, Yera Hélène, Lefèvre Benjamin, L'Ollivier Coralie, Cateau Estelle, Gargala Gilles, Le Govic Yohann, Melenotte Cléa, Danneels Pierre, Donnars Anne, Grenouillet Frédéric, Gay Frédérick, Dubée Vincent
Аннотация
INTRODUCTION: Loiasis has been associated with increased morbidity and mortality, particularly in cases of high microfilarial density. Treatment depends on initial microfilaraemia (Mf) and relies on ivermectin (IVM), diethylcarbamazine (DEC) or albendazole (ALB), all associated with serious adverse events. Our objective was to describe the clinical characteristics, management and outcomes of patients diagnosed with loiasis and Mf in France.
METHODS: We conducted a multicenter retrospective study including patients with loiasis and Mf diagnosed and treated in France between 2000 and 2022, with at least one follow-up evaluation. We collected clinical and biological data, including Mf kinetics, for each treatment episode.
RESULTS: A total of 150 patients (181 treatment episodes) were included across 27 centers. Median age was 35 years, and most patients presented symptoms (75.3%). Median Mf was 500 mf/ml; for 74% of episodes, baseline Mf below 2000 mf/ml, while 8% had baseline Mf above 8000 mf/ml. Twelve different treatment schemes were identified, the most common being a single dose of IVM (39%). Adverse events occurred in 12% of episodes, including one fatal event. On last follow-up visit, 9.3% of patients still experienced symptoms, 24.7% exhibited persistent Mf, and 19.3% had persistent blood eosinophilia, patients treated with stand-alone IVM experienced worse outcomes (18%, 72% and 39%, respectively).
CONCLUSION: In France, loiasis treatment is inconsistent and frequently relies on inadequate options, including IVM monotherapy, which lacks therapeutic efficacy, and carries safety concerns. Our findings highlight real-world practices and indicates that better training is needed for practitioners treating patients with loiasis.
METHODS: We conducted a multicenter retrospective study including patients with loiasis and Mf diagnosed and treated in France between 2000 and 2022, with at least one follow-up evaluation. We collected clinical and biological data, including Mf kinetics, for each treatment episode.
RESULTS: A total of 150 patients (181 treatment episodes) were included across 27 centers. Median age was 35 years, and most patients presented symptoms (75.3%). Median Mf was 500 mf/ml; for 74% of episodes, baseline Mf below 2000 mf/ml, while 8% had baseline Mf above 8000 mf/ml. Twelve different treatment schemes were identified, the most common being a single dose of IVM (39%). Adverse events occurred in 12% of episodes, including one fatal event. On last follow-up visit, 9.3% of patients still experienced symptoms, 24.7% exhibited persistent Mf, and 19.3% had persistent blood eosinophilia, patients treated with stand-alone IVM experienced worse outcomes (18%, 72% and 39%, respectively).
CONCLUSION: In France, loiasis treatment is inconsistent and frequently relies on inadequate options, including IVM monotherapy, which lacks therapeutic efficacy, and carries safety concerns. Our findings highlight real-world practices and indicates that better training is needed for practitioners treating patients with loiasis.