Linked Life Data

10160375

Source:http://linkedlifedata.com/resource/pubmed/id/10160375

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
3
pubmed:dateCreated
1996-10-18
pubmed:abstractText
We have investigated various aspects related to managing wide-scale ivermectin distribution schemes within randomized controlled trials in communities where onchocerciasis is endemic. Multiple logistic regression analysis of determinants of compliance to five doses of ivermectin in 589 people in Sierra Leone showed independent significant associations with leopard skin depigmentation, the severity of side effects of treatment, fulfilling the exclusion criteria for treatment, and long-term residence in the community. These results are useful for tailoring health promotion messages in Sierra Leone, but the associations may differ in other West African societies. In Nigeria 1847 people were interviewed about various subjective responses, including itching. None of these showed clear improvement after three years of ivermectin treatment. Positive comments about treatment were generally non-specific and similar in the placebo and ivermectin groups. Negative comments were usually related to adverse reactions, especially itching and rash, and were more common after ivermectin. The lack of any benefit attributable to ivermectin that is discernible to its recipients may make it difficult to maintain the high compliance rates needed for long periods if mass dosing programmes are to have a lasting impact on onchocerciasis. In addition, no consistent effects of ivermectin were found by measuring visual acuity, height, weight or haematocrit in comparison with placebo. This may indicate that evidence of clinical impact is very slow to develop and is hard to measure using simple objective methods after only three doses of treatment. At present it seems that parasitological, entomological and detailed ophthalmological or dermatological methods are required to demonstrate the impact of ivermectin treatment in the medium-term.
pubmed:keyword
http://linkedlifedata.com/resource/pubmed/keyword/Africa, http://linkedlifedata.com/resource/pubmed/keyword/Africa South Of The Sahara, http://linkedlifedata.com/resource/pubmed/keyword/Behavior, http://linkedlifedata.com/resource/pubmed/keyword/Biology, http://linkedlifedata.com/resource/pubmed/keyword/Dermatological Effects, http://linkedlifedata.com/resource/pubmed/keyword/Developing Countries, http://linkedlifedata.com/resource/pubmed/keyword/Double-blind Studies, http://linkedlifedata.com/resource/pubmed/keyword/Drugs--side effects, http://linkedlifedata.com/resource/pubmed/keyword/English Speaking Africa, http://linkedlifedata.com/resource/pubmed/keyword/Health, http://linkedlifedata.com/resource/pubmed/keyword/NIGERIA, http://linkedlifedata.com/resource/pubmed/keyword/Ophthalmological Effects, http://linkedlifedata.com/resource/pubmed/keyword/PUBLIC HEALTH, http://linkedlifedata.com/resource/pubmed/keyword/Parasite Control, http://linkedlifedata.com/resource/pubmed/keyword/Physiology, http://linkedlifedata.com/resource/pubmed/keyword/Research Methodology, http://linkedlifedata.com/resource/pubmed/keyword/Sierra Leone, http://linkedlifedata.com/resource/pubmed/keyword/Studies, http://linkedlifedata.com/resource/pubmed/keyword/Treatment--side effects, http://linkedlifedata.com/resource/pubmed/keyword/User Compliance--determinants, http://linkedlifedata.com/resource/pubmed/keyword/Western Africa
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
H
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Sep
pubmed:issn
0268-1080
pubmed:author
pubmed:issnType
Print
pubmed:volume
11
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
299-307
pubmed:dateRevised
2007-11-15
pubmed:otherAbstract
PIP: In Sierra Leone, a double-blind placebo-controlled trial of 5, 6-monthly doses of ivermectin was conducted in 6 communities with hyperendemic onchocerciasis to determine compliance rates of ivermectin. The researchers had earlier found a significantly higher compliance rate with ivermectin than placebo (64% vs. 57% at 3rd treatment round). They then analyzed data from the 589 persons receiving ivermectin to identify determinants of increased and decreased subsequent compliance to ivermectin treatment. They also administered a questionnaire in a double-blind fashion to 1847 people attending the 4th treatment round in communities mesoendemic for onchocerciasis in Kaduna State in Nigeria. They aimed to focus on subjective responses to ivermectin treatment (e.g., itching). In Sierra Leone, the multiple logistic regression analysis revealed significant associations between complete compliance with ivermectin and leopard skin depigmentation (odds ratio [OR] = 1.56; p = 0.04), the severity of side effects of treatment (OR = 1.68, p = 0.001), fulfilling the exclusion criteria for treatment (OR = 2.26; p = 0.01), and long-term residence in the community (12 years) (OR = 0.54; p = 0.003). In Nigeria, none of the subjective responses to ivermectin treatment (which revolved around eye pain, body pains, itching, dizziness, chronic bad vision, and severity) clearly improved after 3 years of treatment. The ivermectin group tended to have the same non-specific positive comments about treatment (e.g., made healthy) as the placebo group. Negative comments, which usually related to adverse reactions, were more common in the ivermectin group. Ivermectin did not have consistent effects on visual acuity, height, weight, or hematocrit when compared with the placebo. The findings from Sierra Leone but not those in Nigeria can be used to develop health promotion messages. Those from Nigeria suggest that it would be difficult to maintain the high compliance rates needed for long periods if mass dosing programs are to have a long-term impact on onchocerciasis.
pubmed:meshHeading
pubmed:year
1996
pubmed:articleTitle
Maintaining compliance to ivermectin in communities in two West African countries.
pubmed:affiliation
London School of Hygiene and Tropical Medicine, UK.
pubmed:publicationType
Journal Article, Research Support, Non-U.S. Gov't