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Prevalence of strongyloides in Northern Thailand and treatment with ivermectin vs albendazole.

The stools of 697 cases were examined by agar plate technique at Tambon Makam Luang, Sun Pa Tong district, Chiang Mai; there were Strongyloides stercoralis 15.9%,Opisthorchis viverrini 5.1%, intestinal fluke 0.1%. Treatment with ivermectin 78 cases and albendazole 33 cases of strongyloidiasis gave cure rates at 98.7% and 78.7%, respectively. Alkaline phosphatase in some patients were increased at mild level after treatment. Side effects in ivermectin group were anorexia, nausia, diarrhea, diffuse itching and drowsiness; and in albendazole group were nausia and diarrhea. The efficacy of single dose and mild side effects suggest ivermectin as drug of choice for strongyloidiasis treatment.

Albendazole↗

Cross-fostering in combination with ivermectin therapy: a method to eradicate murine fur mites.

A colony of mutant mice with sickle cell anemia was infested with the fur mites Myocoptes musculinus and Myobia musculi. Pups of sickle-cell phenotype obtained by cesarean section prior to natural birth were of such poor vigor that none survived the combined insults of delivery by hysterectomy and cross-fostering. Consequently, surgical rederivation, the most reliable means of mite eradication, was not an option. Because furless mice are not susceptible to mite infestation and because neonates putatively remain free of mites until 4 to 5 days after birth, pups born by natural delivery were cross-fostered within 0 to 36 h to outbred lactating females treated once with ivermectin (2 mg/kg topically) at the time of transfer and housed in filter-top cages. Cross-fostering in conjunction with topical ivermectin administered to weaned mice one or more times at approximate 9-day intervals beginning on the day of weaning was successful in reliably eradicating mites. In addition, the 58% postnatal survivability of pups cross-fostered to dams given ivermectin was equivalent to that of natural-born pups that were reared by their untreated biological mothers.

Animal Husbandry↗

Double-dose ivermectin vs albendazole for the treatment of gnathostomiasis.

A comparative study was performed for the treatment of gnathostomiasis patients with ivermectin 0.2 mg/kg for 2 days in 15 patients vs albendazole 400 mg twice daily for 21 days in 14 patients. The ivermectin and albendazole gave cure rates of 100% and 78.5%, respectively, however the difference was not statistically significant between the two drugs (Fisher's exact, p=0.0996). One year after treatment, the patients who had no migratory swellings and a drop in ELISA titers or a negative immunoblot test were considered to be cured. The side effect of ivermectin for two days was dizziness. The side effects of albendazole were nausea, dizziness, and an increased alkaline phosphatase.

Albendazole↗

Effects of ivermectin and diethylcarbamazine on microfilariae and overall microfilaria production in bancroftian filariasis.

Ivermectin and diethylcarbamazine (DEC) are used in mass treatment programs for the elimination of lymphatic filariasis because of their strong effects on microfilaremia. However, the effects of treatment on adult worms and the degree of individual variation in efficacy are unclear. We analyzed series of microfilaria (Mf) counts from individuals treated with a single dose of 400 microg/kg ivermectin or 6 mg/kg DEC (N = 23 in each group; 1 year follow-up). For each individual, we estimated the microfilaricidal effect and the reduction in overall Mf production (e.g., caused by death or sterilization of worms, or inhibited Mf release from the female worm uterus). Ivermectin on average killed 96% of Mf and reduced Mf production by 82%. DEC killed 57% of Mf and reduced Mf production by 67%, with some individuals responding very poorly. The strong reduction in overall Mf production is good news for control of lymphatic filariasis, but the prospects of elimination will be diminished if part of the population systematically responds poorly to treatment.

Adult↗

The efficacy of a single-oral-dose administration of ivermectin and diethylcarbamazine on the treatment of feline Brugia malayi.

The combination of ivermectin and diethylcarbamazine (DEC) have been shown to be superior to either drug alone for the suppression of Brugia malayi in humans, but their efficacy against infection with B. malayi in cats has never been investigated. Fourteen asymptomatic microfilaremic (1-200 microfilariae/20 microl blood) cats received oral doses of ivermectin (400 microg/kg body weight) and DEC (6 mg/kg body weight) as a single treatment. A two-month post-treatment examination revealed that 87-100% of the microfilariae in each subject had been cleared, with two of the subjects being amicrofilaremic. A further reduction in microfilarial levels was observed until the final follow-up, at 8 months post-treatment, when the mean clearance rate was 99% and 12 out of the 14 subjects (86%) were amicrofilaremic. The combination of ivermectin and DEC demonstrated a microfilaricidal effect superior to that of either drug used alone, both in the initial rapid clearance of microfilariae, and in sustaining the effect for 8 months. This finding has important implications for the control of brugian lymphatic filariasis in the cat reservoir.

Animals↗

Modeling targeted ivermectin treatment for controlling river blindness.

There is considerable host heterogeneity in exposure to onchocerciasis. We incorporate this heterogeneity into a model of onchocerciasis transmission that we use to evaluate intervention strategies targeting specific portions of the human population for treatment with ivermectin. Our model predicts that targeted allocation of ivermectin in a highly heterogeneous population will reduce the public health burden of onchocerciasis using 20-25% of the doses of untargeted allocation. Targeted allocation therefore poses significantly lower risk of adverse effects, while potentially delaying the emergence and spread of ivermectin resistance, relative to untargeted allocation.

Animals↗

Behavioural method to detect marginal neurotoxic effects of ivermectin in DA/Orl rats.

Ivermectin (22, 23-dihydroavermectin B 1) in subtoxic doses was administered subcutaneously to young adult DA rats. Prior to treatment the rats had been trained in a visual discrimination learning programme until their response pattern was stable. The behavioural response data were recorded during continued discrimination testing following the Ivermectin injection and compared with those of a control group. The results showed that the Ivermectin injection reduced the total number of lever presses and reinforcement collections. Further the treatment caused an increase in the total number of erroneous responses.

Animals↗

Effect of ivermectin on the development of serum antibody activity in rabbits infested with Psoroptes cuniculi (Acari: Psoroptidae).

Effect of ivermectin injected subcutaneously in a single dose on the serum specific antibody activity against. Psoroptes cuniculi antigens was studied on four heavily and three weakly P. cuniculi infested rabbits. It has been shown that ivermectin enhanced the production of the specific antibody, especially in weakly infested rabbits. The serum specific antibody activity in both heavily and weakly infested rabbits reached the peak levels on fifth after injection of ivermectin.

Animals↗

Efficacy of ivermectin administered via sustained-release bolus against gastrointestinal nematodes in cattle.

Twelve calves (mean weight, 175.5 kg) were used to confirm efficacy of ivermectin delivered from a prototype sustained-release bolus against naturally acquired gastrointestinal nematodes including early fourth-stage (inhibited) larvae of Ostertagia ostertagi. The calves were allocated by restricted randomization on weight to 1 of 2 groups: controls, to which a placebo bolus was given orally, and treated calves, to which a sustained-release bolus designed to deliver 8 mg of ivermectin/day at a steady rate was given orally. After treatment, the 2 groups were housed in separate pens with concrete flooring. Twenty-eight days after treatment, all calves were euthanatized and necropsied. The ivermectin-treated calves had no larval or adult Ostertagia spp and significantly (P less than 0.01) fewer adult Trichostrongylus axei and adult Cooperia (C oncophora, C punctata and C surnabada) than control calves. Efficacy of ivermectin was greater than 99% for Cooperia spp, and 100% for other parasites. Drug-related adverse reactions were not observed.

Animals↗

Migration and death of skin-dwelling Onchocerca volvulus microfilariae after treatment with ivermectin.

The effects of a single dose of ivermectin (122-200 micrograms/kg) on Onchocerca volvulus microfilariae (mf) in skin and lymph nodes were studied histologically in a qualitative and quantitative manner over seven days after treatment. Ivermectin caused mf to move from the subepidermal layer into the deeper layers of the dermis, subcutaneous fat and connective tissue, and the regional lymph nodes. No mf were seen migrating upwards through the epidermis. Dead mf were not seen before 24 hr and the numbers found dead in the dermis were far fewer than the total numbers in the skin before treatment. Inflammatory cellular reaction around dead mf in the tissues was usually minimal. The results suggest that most of the mf which disappear from the skin may be destroyed in the lymph nodes and that the histological reaction excited by mf dying under ivermectin is less violent than that after diethylcarbamazine.

Adult↗

Effects of ivermectin and fenbendazole in strategic treatment of gastrointestinal nematode infections in cattle.

Four groups of 18 beef calves each were used to evaluate effects of different treatments on parasite control and weight gains. The investigation extended from November 1986 (weaning) to October 1987. Group-1 calves were treated with ivermectin (200 micrograms/kg of body weight, SC) at approximately 6-week intervals for a total of 8 treatments; group-2 calves were given the same dosage of ivermectin by the same route of administration as group-1 calves in November, March, and July; group-3 calves were given fenbendazole paste (5 mg/kg, PO) at the same times as group-2 calves; and group-4 calves served as untreated controls with provision for ivermectin salvage treatment. All groups grazed on individual pairs of larval-contaminated, 1.6-ha pastures. Highest (P less than 0.05) initial worm counts in fall tracer calves were found in group 3 (Ostertagia ostertagi and Trichostrongylus axei adults) and group 4 (O ostertagi and Haemonchus adults). Fecal egg counts of group-1 calves were low throughout the experiment and pasture larval counts remained negligible after July. Egg counts and larval counts of other groups remained higher into summer. Worm counts, including O ostertagi inhibited early fourth-stage larvae (EL4), were highest (P less than 0.05) in groups-3 and -4 spring tracer calves; numbers of O ostertagi EL4 were similarly high in groups 2, 3, and 4; and T axei counts were highest (P less than 0.05) in groups-3 and -4 yearlings slaughtered in spring. Liveweights of group-1 calves were greater (P less than 0.05) than in other groups from March 2 to October, and by July 2, group-2 calves had a liveweight advantage over group-4 calves. Group-3 calves had the lowest rate of gain from March to July and mean liveweight of the group was less (P less than 0.05) than in all other groups from April to October. Only minimal worm numbers were recovered from groups-1 or -2 calves in October. Large numbers of O ostertagi and T axei were recovered from group-4 calves and O ostertagi from group-3 calves. A few calves in groups 3 and 4, but particularly in group 4, were affected by type-II disease (chronic to acute gastritis caused by maturation and emergence of previously inhibited larvae) from August to October. Final mean liveweights in descending order were 365 kg in group 1, 328 kg in group 2, 316 kg in group 4, and 281 kg in group 3.

Animals↗

The efficacy of ivermectin against Strongyloides papillosus in cattle.

The efficacy of ivermectin was evaluated against Strongyloides papillosus in four controlled trials in cattle. Thirty-four animals were inoculated subcutaneously with S. papillosus 3rd stage larvae 14-24 days before treatment. At 7-14 days after treatment, calves were slaughtered and the number of adult S. papillosus present in the small intestine counted. Faecal egg counts were carried out before and after treatment. Seventeen control animals received a single subcutaneous injection of vehicle solution at a dose volume of 1 ml/50 kg body weight, and 17 calves were treated once with ivermectin at 200 mcg/kg b.w. using a 1% injectable solution (IVOMEC Injection Merck & Co., Inc.), subcutaneously. The control animals had a mean burden of 5,913 worms, while ivermectin significantly (p less than 0.01) reduced the number of adults S. papillosus by more than 99%. There was a greater than 99% reduction in the faecal egg count of treated animals at the last faecal examination compared with that pre-treatment.

Animals↗

Persistent activity of a single late-season treatment with ivermectin against gastrointestinal trichostrongyles and lungworm in young calves.

The present study was designed to assess the persistent efficacy of ivermectin against gastrointestinal trichostrongyles and lungworm (Dictyocaulus viviparus) when given late in the season to young calves naturally exposed to infection on permanent pasture. The results suggest that ivermectin prevents the re-establishment of Ostertagia spp. for 2 to 3 weeks, but Cooperia spp. for only 1 to 2 weeks. Re-establishment of lungworm is prevented for a period of at least 3 weeks. The results are discussed in the light of recent studies on the ivermectin effects on experimental or early-season natural infections.

Animals↗

Effect of chronic ivermectin treatment on GABA receptor function in ethanol withdrawal-seizure prone and resistant mice.

Ivermectin, a potent, effective anthelmintic, is easy to administer, has a broad spectrum of action and a wide safety margin. However, no testing has been done in hosts genetically selected for seizure susceptibility which may be more sensitive to the effects of ivermectin than other animals. This was done in the present experiments with seizure prone and seizure resistant mice infested with Syphacia obvelata (pinworm). These subjects were treated daily with oral ivermectin in their drinking water every other week for six weeks, for a total of 21 days. The treatment cleared the mice of the pinworm infestation, but did not alter the seizure susceptibility or binding parameters of [3H]flunitrazepam in either of the selected lines.

Animals↗

Sequential mesenteric arteriography in pony foals during repeated inoculations of Strongylus vulgaris and treatments with ivermectin.

Semiselective mesenteric arteriography was performed at regular intervals (inoculation weeks [IW] 0, 11, 18, and 24) in 9 of 10 pony foals raised to be free of parasites. Fifty infective larvae (L3) of Strongylus vulgaris were administered weekly for 4 weeks, then every 2 weeks through the 20th week. Three ponies were given ivermectin (oral paste, 0.2 mg/kg of body weight) treatment at IW 8, 16 and 24. Four ponies were inoculated, but did not receive ivermectin, and a third group of 2 ponies acted as uninoculated controls. Control ponies did not have gross or arteriographic lesions, whereas the inoculated untreated ponies had gross and progressive arteriographic lesions typical of verminous arteritis. Arteriographic lesions in the ivermectin-treated inoculated ponies were not as severe those in the untreated inoculated group, and there was either a partial resolution or a lack of progression of arteriographic lesions in all treated ponies. One untreated inoculated pony did not have progressive arterial lesions as did the 3 others in the group, and may develop resistance to the parasite.

Angiography↗

Effect of ivermectin on the vertical distribution of Onchocerca volvulus microfilariae in the skin.

A new technique for assessing vital and degenerative microfilariae (mf) in different skin layers of onchocerciasis patients is described. Vertical sections at least 5 mm deep were collected from the surgical nodulectomy wounds before and 2, 4 and 28 days after treatment with ivermectin and fixed in ethanol. Skin biopsies were punched horizontally with trephines and digested enzymatically with collagenase. In untreated biopsies 80% of the mf were located in the uppermost layer of 1 mm and only 1.2% were degenerated. After treatment with ivermectin the total number of mf was significantly reduced, and the distribution of living and remnant mf in the different skin layers had changed. The proportion of degenerated mf had increased markedly, but did not exceed 6% of the total pre-treatment mf level, i.e., the vast majority of the mf had actually disappeared from the skin. It is suggested that ivermectin reduces microfilarial motility slightly, and that mf are then attacked by adhering immunocompetent cells of the host and cleared by the lymphatic drainage.

Animals↗

Adverse reactions after large-scale treatment of onchocerciasis with ivermectin: combined results from eight community trials.

Eight community trials were carried out by the Onchocerciasis Control Programme in West Africa to determine the safety of the new microfilaricide ivermectin during large-scale treatment of onchocerciasis. The trial areas were located in eight different countries and varied greatly in endemicity level; a total of 50,929 persons were treated and monitored for 72 hours. Overall treatment coverage was 60% of the census population, the main reasons for non-treatment being the exclusion criteria. Of those treated, 9% reported with adverse reactions, 2.4% with moderate reactions, and 0.24% with severe reactions. Most reactions were reported during the first day of follow-up, the most frequent severe reaction being severe symptomatic postural hypotension (in 49 cases). Three cases of severe dyspnoea were life-threatening but their relationship with ivermectin treatment is uncertain. The incidence of adverse reactions was directly related to skin microfilarial load and was highest in the foci with the highest endemicity levels. Treatment resulted in 98% reductions in mean microfilarial loads at all endemicity levels. The benefit of treatment largely compensated for the discomfort due to adverse reactions, which were all transient and managed successfully. Ivermectin thus appears to be sufficiently safe for large-scale treatment but monitoring by resident nurses for at least 36 hours is recommended.

Africa, Western↗

Efficacy of ivermectin in hookworms as examined in Ancylostoma caninum infections.

Single oral doses of ivermectin were given to dogs with moderate or heavy infections of Ancylostoma caninum (egg counts ranging from 7,100 to 41,700 eggs/g feces) at 100, 50, 30, or 10 micrograms/kg body weight. Each of these dosages was effective in clearing the infection completely, so that numerous worms were passed in the feces on days 1-3, but no worm was recovered from the intestinal tract at necropsy on day 4 after treatment. In contrast, an average of 178 worms per dog was recovered at necropsy from the vehicle-treated control and the untreated animals. Albendazole, a known anti-hookworm agent, even in a dose of 400 mg, eliminated only 21-65% of the worms harbored by the infected animals. No untoward reaction to ivermectin or significant pathological change was noted in the experimental animals. In vitro experiments demonstrated that ivermectin: (1) was highly detrimental to actively motile adult worms in concentrations greater than 5.60 micrograms/ml; (2) was detrimental to eggs inside the uterine tissue of female worms in dosages at or greater than 10 micrograms/kg body weight; and (3) killed infected larvae in concentrations as low as 0.0025 micrograms/ml.

Albendazole↗