Loa loa—does it deserve to be neglected?

Wolfram Gottfried Metzger, Benjamin Mordmüller

Index: Lancet Infect. Dis. 14(4) , 353-7, (2014)

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Abstract

More than 10 million people in western and central Africa are estimated to be infected with Loa loa filarial nematodes. Like most other infectious diseases, L loa filariasis (loiasis) covers a wide range of symptoms. Severe complications have been reported; however, most observations are anecdotal, typically in travellers. The widespread use of filaricidal drugs within eradication programmes of Onchocerca volvulus and Wuchereria bancrofti led to the observation that concomitant L loa infection increases the risk of severe treatment-associated, life-threatening complications. Initiatives were therefore launched to map the risk of loiasis. Insight about the epidemiology of L loa has advanced notably; however, its effect on the individual as well as on the community level has not been well studied. In the absence of appropriate studies, L loa is commonly judged a harmless nematode, and loiasis as a separate entity does not belong to the list of neglected tropical diseases to be controlled or eradicated in worldwide campaigns. We advocate reorientation of research efforts towards a patient-centric view of loiasis and, as a first step, to establish the disease burden in disability-adjusted life-years of this chronic infection, and to answer the question of whether loiasis should be included in future control programmes.