Diagnosis, management and prevention of loiasis: guideline of the German Society for Tropical Medicine, Travel Medicine, and Global Health (DTG).

Loiasis is a complex filarial infection endemic in Central Africa and parts of West Africa. Loa loa is transmitted by the deer fly Chrysops dimidiata and C. silacea. The clinical manifestation of the disease is highly variable ranging from asymptomatic infection, symptomatic disease, to life-threatening complications. The diagnosis of L. loa infection is challenging due to a significant proportion of occult infections and a lack of reliable point of care tests. While diethylcarbamazine is the gold standard for curative treatment in many non-endemic countries, its use is limited in endemic regions due to its propensity for severe adverse drug reactions that may occasionally lead to life threatening complications. Alternative treatment regimens have specific indications and limitations in the treatment of loiasis. In this guideline, issued by the German Society for Tropical Medicine, Travel Medicine, and Global Health, recommendations for the diagnosis, management, treatment, and prevention of loiasis are provided based on the currently available best evidence, and gaps in our understanding are highlighted.