Active substances: Doxycycline
Background Onchocerciasis river blindness is a vector-borne, neglected tropical disease NTD, caused by the filarial parasite Onchocerca volvulus.
Physical manifestations include troublesome itching, skin rash, visual impairment and irreversible blindness.
Ivermectin is a microfilaricidal drug that kills the immature larval form of the parasite, microfilariae mf found in the skin, to prevent disease and transmission to the blackfly vector.
The persistence of onchocerciasis in South-West Cameroon highlights that a transition from control to elimination of this disease using CDTi is likely to be complicated by multiple factors.
Of major concern is the geographical overlap with the related filarial, Loa loa, which is a risk factor for incidence of severe neurological adverse events SAE, as well as more frequent non-neurological adverse events AE, post-CDTi.
Doxycycline DOX differs from IVM as it targets the filarial symbiont, Wolbachia, which sterilises adult worms residing in human tissues, preventing the production of mf seeding the skin and also significantly reduces adult lifespan to mediate macrofilaricidal activity within two years post-treatment.
Further benefit of depleting Wolbachia in existing skin mf is the inhibition of development to infectious stage larvae within the blackfly vector, thus more immediately impacting on transmission.
Doxycycline does not cause rapid microfilaricidal activity, and its target, Wolbachia, is not present in L. In a total of 26 persons had serological findings consistent with acute or previous infection.
Mode of transmission The disease is present all over the world, particularly in agricultural areas. Farmers with infected animals and veterinarians, slaughterhouse workers and laboratory staff have an elevated infection risk.
In addition to direct contact with infected animals and their afterbirth, airborne infection via aerosols or dust from contaminated areas is an important mode of transmission.
Especially in dry areas, such as the Mediterranean, outbreaks have been observed in the local population in periods with many animal partitions and strong winds. There is no evidence of human-to-human transmission.
Clinical picture Q-fever infection can be asymptomatic and frequently presents as a self-limiting febrile illness. The incubation period varies, but it is normally 2-3 weeks.
Patients with cardiac valve anomalies, arterial aneurysms, cancer or immunosuppression and pregnant women are particularly predisposed to chronic Q-fever.
Pregnant women infected with C. Diagnosis and treatment C. It only takes one bite from an infected mosquito to catch malaria. Use screened accommodation and keep windows and doors closed.