Treatment of Symptomatic Loiasis with Microfilarial Load ≥8,000 Microfilariae per mL of Blood
Clinical Scenario
This protocol is for patients with symptomatic loiasis whose blood microfilarial count reaches or exceeds 8,000 microfilariae per mL — a clinically significant threshold that must be addressed before standard definitive treatment can safely begin.
Management Approach
The primary step is reducing the microfilarial burden below the 8,000 per mL threshold. The protocol describes two distinct options for achieving this: one involves a procedure available at specialised centres, the other is a specific oral medication course, with re-measurement required to confirm the target is met.
Target: microfilarial load < 8,000/mL
References
- Symptomatic loiasis, with MF/mL ≥8,000
- In those patients with microfilarial loads ≥8,000 microfilariae per mL, apheresis can be used in specialized centers to reduce the load below the 8,000 threshold prior to beginning treatment.
- There are some data available that suggest treating the patient with albendazole, 200mg twice daily for 21 days, may reduce the microfilarial load to acceptable levels.
- Re-measurement of levels after albendazole treatment would be required prior to treatment with DEC.
View source ↗