Onchocerciasis When Initial Treatment Has Not Resolved Clinical Signs or Reduced Microfilariae

This protocol applies to patients with onchocerciasis who have completed a first-line antiparasitic course but in whom clinical signs persist or the microfilarial burden has not been adequately reduced.

Previous Line — Failure Condition

First-line treatment consisted of ivermectin as the drug of choice, or alternatively doxycycline where feasible. Escalation to this protocol is indicated when the goals of that line — resolution of clinical signs of onchocerciasis and reduction in the number of O. volvulus microfilariae — have not been achieved.

Next-Line Approach (Partial)

This protocol returns to ivermectin and incorporates a structured repeat-dose strategy for patients with persistent signs. The complete regimen, including the conditions that govern each step, is available in the full protocol below.

Instant Access to Structured Evidence-Based Regimens

References

Ivermectin PO is the drug of choice: 150 micrograms/kg single dose; a 2nd dose should be administered after 3 months if clinical signs persist.

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