Distinct loiasis infection states and associated clinical and hematological manifestations in patients from Gabon

PLoS Negl Trop Dis. 2022 Sep 19;16(9):e0010793. doi: 10.1371/journal.pntd.0010793. eCollection 2022 Sep.

Abstract

Background: Loiasis-a filarial disease endemic in Central and West Africa-is increasingly recognized as significant individual and public health concern. While the understanding of the disease characteristics remains limited, significant morbidity and excess mortality have been demonstrated. Here, we characterize clinical and hematological findings in a large cohort from Gabon.

Methods: Loiasis-related clinical manifestations and microfilaremia, hemoglobin and differential blood counts were recorded prospectively during a cross-sectional survey. For analysis, participants were categorized into distinct infection states by the diagnostic criteria of eye worm history and microfilaremia.

Results: Analysis of data from 1,232 individuals showed that occurrence of clinical and hematological findings differed significantly between the infection states. Eye worm positivity was associated with a wide range of clinical manifestations while microfilaremia by itself was not. Loa loa infection was associated with presence of eosinophilia and absolute eosinophil counts were associated with extent of microfilaremia (p-adj. = 0.012, ß-estimate:0.17[0.04-0.31]).

Conclusions: Loiasis is a complex disease, causing different disease manifestations in patients from endemic regions. The consequences for the affected individuals or populations as well as the pathophysiological consequences of correlating eosinophilia are largely unknown. High-quality research on loiasis should be fostered to improve patient care and understanding of the disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Cross-Sectional Studies
  • Gabon / epidemiology
  • Loa
  • Loiasis* / diagnosis
  • Loiasis* / epidemiology
  • Morbidity

Grants and funding

This work was supported by the Federal Ministry of Science, Research and Economy of Austria as part of the European and Developing Countries Clinical Trials Partnership 2 programme, which is supported by the European Union (Grant A12/B-2 to MR) and the German Center for Infection research (TI 07.001 to LV). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.