Incidence of loiasis clinical manifestations in a rural area of the Republic of Congo: Results from a longitudinal prospective study (the MorLo project).

IF 3.4 2区医学 Q1 PARASITOLOGY

PLoS Neglected Tropical Diseases Pub Date : 2025-02-12 eCollection Date: 2025-02-01 DOI:10.1371/journal.pntd.0012868

Jérémy T Campillo, Biam-Miveck Pakat-Pambou, Bachiratou Sahm, Sébastien D S Pion, Marlhand C Hemilembolo, Elodie Lebredonchel, Michel Boussinesq, François Missamou, Cédric B Chesnais

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引用次数: 0

Abstract

Background: Loiasis is endemic in Central Africa. Despite evidence of clinical complications and increased mortality, it remains excluded from the list of neglected tropical diseases. The main manifestations are Calabar swellings (CS), Eyeworm (EW) and non-specific general symptoms such arthralgia and pruritus. We calculated incidence rates for clinical manifestations of loiasis from a 13-month study on clinical manifestations in 991 individuals living in Loa loa-endemic areas in the Republic of Congo.

Methodology: From September 2022 to September 2023, community health workers collected weekly symptoms from cohort participants. Detailed data on symptom duration, intensity, associated pruritus, and impact on sleep were recorded. Laboratory procedures included thick blood smear for L. loa microfilaremia measurement, creatininemia measurement and eosinophilia counts. We used multiple failure analysis and frailty models to calculate incidence rates of EW, CS, arthralgia, pruritus and absence from work (AfW) and to analyses factors associated with increased incidence of each symptom. The population-attributable fractions (PAFs) associated with loiasis were also calculated for pruritus, AfW and arthralgia.

Principal findings: Among the studied manifestations, arthralgia had the highest incidence rate at 555.2 cases per 1000 Person-Year (PY), followed by pruritus (332.3 cases/1000 PY), AfW (298.6/1000 PY), EW (266.4/1000 PY), and CS (213.8/1000 PY). Notably, the incidence rates of CS, pruritus, arthralgia, and AfW were statistically significantly higher in the subgroup of individuals who experienced at least one episode of EW during the follow-up period. EW occurrence is more frequent when microfilaremia is present. The PAFs of AfW, pruritus and arthralgia, associated with loiasis was 18.0% [07.3-27.6], 20.8% [11.6-29.1] and 12.1% [3.1-20.1], respectively.

Conclusion/significance: This is the first study to provide incidence rates for the clinical manifestations of loiasis. These estimates are crucial for assessing the burden of loiasis. The findings highlight the disease's impact on quality of life.

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刚果共和国农村地区风湿病临床表现的发病率：纵向前瞻性研究（MorLo项目）的结果。

背景：寄生虫病是中非的地方病。尽管有临床并发症和死亡率增加的证据，但它仍然被排除在被忽视的热带病清单之外。主要表现为Calabar肿胀（CS），眼虫（EW）和非特异性全身症状，如关节痛和瘙痒。我们通过对刚果共和国罗阿罗阿流行地区991名患者的临床表现进行为期13个月的研究，计算了罗阿罗阿病临床表现的发病率。方法：从2022年9月至2023年9月，社区卫生工作者每周收集队列参与者的症状。记录症状持续时间、强度、相关瘙痒和对睡眠影响的详细数据。实验室检查包括厚血涂片检测罗氏乳杆菌微丝虫病、肌酐血症和嗜酸性粒细胞计数。我们使用多重失效分析和脆弱性模型来计算EW、CS、关节痛、瘙痒和缺勤（AfW）的发生率，并分析与每种症状发生率增加相关的因素。还计算了瘙痒、AfW和关节痛与风疹相关的人群归因分数（PAFs）。主要发现：在研究的表现中，关节痛的发病率最高，为555.2例/1000人年（PY），其次是瘙痒（332.3例/1000 PY）， AfW (298.6/1000 PY), EW (266.4/1000 PY), CS （213.8/1000 PY）。值得注意的是，在随访期间至少经历过一次EW发作的个体亚组中，CS、瘙痒、关节痛和AfW的发生率具有统计学意义上的显著性升高。当存在微丝虫病时，EW的发生更为频繁。红斑相关AfW、瘙痒和关节痛的paf分别为18.0%[7.73 -27.6]、20.8%[11.6-29.1]和12.1%[3.1-20.1]。结论/意义：本研究首次提供了风疹临床表现的发病率。这些估计对于评估寄生虫病的负担至关重要。研究结果强调了这种疾病对生活质量的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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PLoS Neglected Tropical Diseases PARASITOLOGY-TROPICAL MEDICINE

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10.50%

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723

期刊介绍： PLOS Neglected Tropical Diseases publishes research devoted to the pathology, epidemiology, prevention, treatment and control of the neglected tropical diseases (NTDs), as well as relevant public policy. The NTDs are defined as a group of poverty-promoting chronic infectious diseases, which primarily occur in rural areas and poor urban areas of low-income and middle-income countries. Their impact on child health and development, pregnancy, and worker productivity, as well as their stigmatizing features limit economic stability. All aspects of these diseases are considered, including: Pathogenesis Clinical features Pharmacology and treatment Diagnosis Epidemiology Vector biology Vaccinology and prevention Demographic, ecological and social determinants Public health and policy aspects (including cost-effectiveness analyses).