[Ivermectin and the reduction of the rate of infection of simuliids in a forest focus of human onchocerciasis].

Eight patients from a forest onchocercian area "Grandes rivières", in Ivory Coast, were treated with a single oral dose of ivermectin (12 mg). The density of dermic microfilariae was estimated at days 0, 7 and 180; the mean numbers of ingested microfilariae and of developing larvae in the vectors S. soubrense-S. sanctipauli, engorged on the treated patients were recorded. Comparisons were made with non treated patients, having a similar density of microfilariae than the 8 treated patients at day 7. Results confirm the reduction induced by ivermectin of the dermic microfilarial density and the resulting reduction of the infection of the simuliids. Furthermore 7 days after treatment, a new phenomenon is demonstrated: for a similar dermic microfilarial density, simuliids take up a number of microfilariae 100 times lower from treated than from untreated patients. To explain this phenomenon, it is suggested that ivermectin induces a change in the microfilarial distribution in the layers of the dermis. Six months after treatment, this low uptake of microfilariae by the vectors had disappeared, and the infection rate of the engorged similiids was much higher than at day 7 although the dermic microfilarial density was similar.