ArticleProceedings of the National Academy of Sciences of the United States of America2009
Identifying sub-optimal responses to ivermectin in the treatment of River Blindness.
Article in Proceedings of the National Academy of Sciences of the United States of America, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
45 citing papers in PubMed, 1 synthesis or guideline pooled it, 219 citations in OpenAlex.
- Therapeutic efficacy and macrofilaricidal activity of doxycycline for the treatment of river blindness.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2015Pooled it
- Trial
- Effect of a single dose of 8 mg moxidectin or 150 μg/kg ivermectin on O. volvulus skin microfilariae in a randomized trial: Differences between areas in the Democratic Republic of the Congo, Liberia and Ghana and impact of intensity of infection.PLoS neglected tropical diseases · 2022Trial
- Pharmacokinetics of oral moxidectin in individuals with Onchocerca volvulus infection.PLoS neglected tropical diseases · 2022Trial
- Comparison of Repeated Doses of Ivermectin Versus Ivermectin Plus Albendazole for the Treatment of Onchocerciasis: A Randomized, Open-label, Clinical Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Trial
- Doxycycline Leads to Sterility and Enhanced Killing of Female Onchocerca volvulus Worms in an Area With Persistent Microfilaridermia After Repeated Ivermectin Treatment: A Randomized, Placebo-Controlled, Double-Blind Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2015Trial
- A randomized, single-ascending-dose, ivermectin-controlled, double-blind study of moxidectin in Onchocerca volvulus infection.PLoS neglected tropical diseases · 2014Trial
- Modelling the impact of mass drug administration with ivermectin or moxidectin on human onchocerciasis when there is sub-optimal response of parasites to treatment.Research square · 2026Article
- High-resolution mapping of onchocerciasis risk in Ghana using spatial machine learning models.BMC infectious diseases · 2026Article
- Can mass drug administration of moxidectin accelerate onchocerciasis elimination in Africa?Philosophical transactions of the Royal Society of London. Series B, Biological sciences · 2023Article
- AssessingPathogens (Basel, Switzerland) · 2023Article
- Anthelmintic resistance in equine nematodes: Current status and emerging trends.International journal for parasitology. Drugs and drug resistance · 2022Review
- Crystal structure of an extracellular superoxide dismutase from Onchocerca volvulus and implications for parasite-specific drug development.Acta crystallographica. Section F, Structural biology communications · 2022Article
- Human filariasis-contributions of the Litomosoides sigmodontis and Acanthocheilonema viteae animal model.Parasitology research · 2021Review
- Impact of Annual versus Semiannual Mass Drug Administration with Ivermectin and Albendazole on Helminth Infections in Southeastern Liberia.The American journal of tropical medicine and hygiene · 2021Article
- Onchocerca ochengi male worms implanted in SCID mice and Gerbil: Relationship between microfilaridermia status of cows, nodular worm viability and fertility and worm survival in the rodents.Experimental parasitology · 2021Article
- Drugs that target early stages of Onchocerca volvulus: A revisited means to facilitate the elimination goals for onchocerciasis.PLoS neglected tropical diseases · 2021Article
- Ivermectin Treatment Response in Onchocerca Volvulus Infected Persons with Epilepsy: A Three-Country Short Cohort Study.Pathogens (Basel, Switzerland) · 2020Article
- Designing antifilarial drug trials using clinical trial simulators.Nature communications · 2020Article
- Reaching the last mile: main challenges relating to and recommendations to accelerate onchocerciasis elimination in Africa.Infectious diseases of poverty · 2019Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 6 institutions in 4 countries.
Funding
Abstract
Identification of drug resistance before it becomes a public health concern requires a clear distinction between what constitutes a normal and a suboptimal treatment response. A novel method of analyzing drug efficacy studies in human helminthiases is proposed and used to investigate recent claims of atypical responses to ivermectin in the treatment of River Blindness. The variability in the rate at which Onchocerca volvulus microfilariae repopulate host's skin following ivermectin treatment is quantified using an individual-based onchocerciasis mathematical model. The model estimates a single skin repopulation rate for every host sampled, allowing reports of suboptimal responses to be statistically compared with responses from populations with no prior exposure to ivermectin. Statistically faster rates of skin repopulation were observed in 3 Ghanaian villages (treated 12-17 times), despite the wide variability in repopulation rates observed in ivermectin-naïve populations. Another village previously thought to have high rates of skin repopulation was shown to be indistinguishable from the normal treatment response. The model is used to generate testable hypotheses to identify whether atypical rates of skin repopulation by microfilariae could result from low treatment coverage alone or provide evidence of decreased ivermectin efficacy. Further work linking phenotypic poor responses to treatment with parasite molecular genetics markers will be required to confirm drug resistance. Limitations of the skin-snipping method for estimating parasite load indicates that changes in the distribution of microfilarial repopulation rates, rather than their absolute values, maybe a more sensitive indicator of emerging ivermectin resistance.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.