Community-based ivermectin therapy for onchocerciasis: comparison of three methods of dose assessment

• Published in: The American journal of tropical medicine and hygiene Vol. 65; no. 3; p. 184
• Main Authors: Shu, E N, Okonkwo, P O
• Format: Journal Article
• Language: English
• Published: United States 01-09-2001
• Subjects: Adult; Animals; Antinematodal Agents - administration & dosage; Antinematodal Agents - therapeutic use; Arm - anatomy & histology; Body Height - physiology; Body Weight - physiology; Dose-Response Relationship, Drug; Female; Humans; Ivermectin - administration & dosage; Ivermectin - therapeutic use; Male; Nigeria; Onchocerca - drug effects; Onchocerciasis - drug therapy; Nigeria
• ISSN: 0002-9637
• DOI: 10.4269/ajtmh.2001.65.184

A new method of assessment based on mid-upper arm circumference (MUAC) is described for dosage adjustment for community-based ivermectin distribution. We studied 878 subjects eligible for ivermectin dosing in Awhum, Nigeria. In a previous preliminary study of 40 persons, MUAC (in cm) correlated with weight (kg) in the first 20 male (r = 0.97, r2 = 0.95, P < 0.0001) and the first 20 female subjects (r = 0.94, r2 = 0.88, P < 0.0001). We therefore studied the use of height, physical appearance, and MUAC for calculating the dose of ivermectin. The MUAC-based schedule underdosed only 4.1% of the population. The methods based on height underdosed 3.3% and 21.1%, and assignment based on physical appearance underdosed 10.2% of the population studied. This MUAC-based method (13-15 cm, 0.5 tablet; 16-20 cm, 1.0 tablet; 21-27 cm, 1.5 tablets; > or = 28 cm, 2.0 tablets) is more convenient and corresponds closely to dosing by weight. An adaptation of this method with reference to other prevalent tropical diseases and their respective drugs is therefore advocated.