BACKGROUND The progress of mass, community-directed, treatment with ivermectin (CDTI) for onchocerciasis control was disrupted by severe adverse effects (SAE) in the Democratic Republic of Congo (DRC). The study aimed at determining the frequency of post-CDTI SAE as well as factors associated with the occurrence of SAE. METHODS Our retrospective study relied on SAE collection cards, as archived by the DRC Ministry of Health, and compiled for people who benefited from ivermectin treatment then further developed SAE. The study included 945 post-CDTI SAE recorded in DRC between 2003 and 2017. These cases occurred in 15 projects out of 22 projects implemented in the country. All cards were reviewed and analysed. RESULTS Between the years 2003 and 2017, the total average population treated was around 15,552,588 among which 945 cases of SAE were registered in DR Congo, i.e. 6 cases of SAE for 100,000 persons treated per year. 55 deaths related to post-CDTI SAE were recorded, which represents 5.8% of all cases of SAE. Non-neurological SAE were dominated by severe headaches (74.8%), myalgia (64.0%) and arthralgia (62.7%). Neurological SAE were mainly coma (94.1%), motor deficit (75.4%) and palpebral subconjunctival haemorrhages (38.8%). Factors associated with the occurrence of SAE were: male, age over 18 years old, alcohol consumption, hemp intake and the presence of loiasis. The study also highlighted weaknesses of the National Program for Onchocerciasis Control (NPOC) in terms of awareness campaigns among the population. CONCLUSION Co-endemicity of loiasis and onchocerciasis is one of the key factors responsible for the occurrence of SAE following ivermectin treatment. Mobilization of resources necessary to the appropriate management of SAE and awareness of populations are essential to achieve onchocerciasis control in DRC.

中文翻译：

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刚果民主共和国社区伊维菌素治疗后严重不良反应的分析。


背景 在刚果民主共和国（DRC），以社区为导向的伊维菌素（CDTI）控制盘尾丝虫病的大规模治疗进展因严重不良反应（SAE）而中断。该研究旨在确定 CDTI 后 SAE 的发生频率以及与 SAE 发生相关的因素。方法 我们的回顾性研究依赖于刚果民主共和国卫生部存档的 SAE 收集卡，并为受益于伊维菌素治疗然后进一步发展为 SAE 的患者进行了编制。该研究包括 2003 年至 2017 年间刚果民主共和国记录的 945 起 CDTI 后 SAE。这些案例发生在该国实施的 22 个项目中的 15 个项目中。所有卡片均经过审查和分析。结果 2003 年至 2017 年间，刚果民主共和国平均接受治疗的总人口约为 15,552,588 人，其中登记了 945 例 SAE 病例，即每年 10 万人接受治疗，有 6 例 SAE 病例。记录了 55 例与 CDTI 后 SAE 相关的死亡，占所有 SAE 病例的 5.8%。非神经性 SAE 主要为严重头痛 (74.8%)、肌痛 (64.0%) 和关节痛 (62.7%)。神经系统SAE主要为昏迷（94.1%）、运动障碍（75.4%）和眼睑结膜下出血（38.8%）。与 SAE 发生相关的因素有：男性、年龄超过 18 岁、饮酒、大麻摄入和罗阿西斯的存在。该研究还强调了国家盘尾丝虫病控制计划（NPOC）在民众宣传活动方面的弱点。结论罗阿丝虫病和盘尾丝虫病共流行是伊维菌素治疗后发生SAE的关键因素之一。 调动适当管理 SAE 所需的资源和提高民众的认识对于刚果民主共和国实现盘尾丝虫病控制至关重要。