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Co-infection with Onchocerca volvulus and Loa loa microfilariae in central Cameroon: are these two species interacting?

Published online by Cambridge University Press:  10 February 2006

S. D. S. PION ,
P. CLARKE ,
J. A. N. FILIPE ,
J. KAMGNO ,
J. GARDON ,
M.-G. BASÁÑEZ  and
M. BOUSSINESQ
S. D. S. PION
Affiliation:
Laboratoire mixte IRD (Institut de Recherche pour le Développement) – CPC (Centre Pasteur du Cameroun) d'Epidémiologie et de Santé publique, Centre Pasteur du Cameroun, BP 1274, Yaoundé, Cameroun Department of Infectious Disease Epidemiology, St Mary's campus, Norfolk Place, London W2 1PG, UK
P. CLARKE
Affiliation:
Infectious Disease Epidemiology Unit London School of Hygiene and Tropical Medicine Keppel Street, London WC1E 7HT, UK
J. A. N. FILIPE
Affiliation:
Department of Infectious Disease Epidemiology, St Mary's campus, Norfolk Place, London W2 1PG, UK
J. KAMGNO
Affiliation:
Laboratoire mixte IRD (Institut de Recherche pour le Développement) – CPC (Centre Pasteur du Cameroun) d'Epidémiologie et de Santé publique, Centre Pasteur du Cameroun, BP 1274, Yaoundé, Cameroun
J. GARDON
Affiliation:
Laboratoire mixte IRD (Institut de Recherche pour le Développement) – CPC (Centre Pasteur du Cameroun) d'Epidémiologie et de Santé publique, Centre Pasteur du Cameroun, BP 1274, Yaoundé, Cameroun Institut de Recherche pour le Développement, UR 24 Epidémiologie et Prévention, CP 9214 Obrajes, La Paz, Bolivia
M.-G. BASÁÑEZ
Affiliation:
Department of Infectious Disease Epidemiology, St Mary's campus, Norfolk Place, London W2 1PG, UK
M. BOUSSINESQ
Affiliation:
Laboratoire mixte IRD (Institut de Recherche pour le Développement) – CPC (Centre Pasteur du Cameroun) d'Epidémiologie et de Santé publique, Centre Pasteur du Cameroun, BP 1274, Yaoundé, Cameroun Institut de Recherche pour le Développement, Département Sociétés et Santé, 213 rue La Fayette, 75480 Paris Cedex 10, France
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Abstract

Ivermectin treatment may induce severe adverse reactions in some individuals heavily infected with Loa loa. This hampers the implementation of mass ivermectin treatment against onchocerciasis in areas where Onchocerca volvulus and L. loa are co-endemic. In order to identify factors, including co-infections, which may explain the presence of high L. loa microfilaraemia in some individuals, we analysed data collected in 19 villages of central Cameroon. Two standardized skin snips and 30 μl of blood were obtained from each of 3190 participants and the microfilarial (mf) loads of both O. volvulus and L. loa were quantified. The data were analysed using multivariate hierarchical models. Individual-level variables were: age, sex, mf presence, and mf load; village-related variables included the endemicity levels for each infection. The two species show a certain degree of ecological separation in the study area. However, for a given individual host, the presence of microfilariae of one species was positively associated with the presence of microfilariae of the other (OR=1·79, 95% CI [1·43–2·24]). Among individuals harbouring Loa microfilariae, there was a slight positive relationship between the L. loa and O. volvulus mf loads which corresponded to an 11% increase in L. loa mf load per 100 O. volvulus microfilariae. Co-infection with O. volvulus is not sufficient to explain the very high L. loa mf loads harboured by some individuals.

Keywords

Onchocerca volvulusLoa loamicrofilariaeco-infectionassociationCameroon
Type
Research Article
Information
Parasitology , Volume 132 , Issue 6 , June 2006 , pp. 843 - 854
Copyright
2006 Cambridge University Press

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