Loiasis is a vector-borne parasitic disease that has long been neglected due to its benign nature and its geographical distribution, which is restrict…

Millions of people are infested with parasitic worms without relief — but this may soon change

This study aimed to achieve consensus on the case definitions and clinical aspects of loiasis, a filarial parasite infection caused by Loa loa, in order to support the development of guidelines for di...

Loiasis remains one of the least prioritised filarial infections, yet its neglect undermines onchocerciasis elimination and limits progress toward global NTD goals. Recognising Loa loa as a neglected tropical disease would unlock resources, promote safe mass drug administration, and accelerate the World Health Organization’s 2030 targets.

This study aimed to achieve consensus on the case definitions and clinical aspects of loiasis, a filarial parasite infection caused by Loa loa, in order to support the development of guidelines for di...

Ivermectin is known to cause severe encephalopathies in subjects infected with loiasis, an endemic parasite in Sub-Saharan Africa (SSA). In addition, case reports have described ivermectin-related ser...

In a groundbreaking clinical trial published recently in Nature Communications, researchers have unveiled compelling evidence showcasing the safety and efficacy of levamisole regimens in treating loiasis—a parasitic infection that has long challenged medical professionals in endemic regions. This double-blind, randomized, placebo-controlled study is one of the most comprehensive assessments to date, meticulously comparing the therapeutic outcomes of 3-day and 5-day levamisole courses.

This study aimed to achieve consensus on the case definitions and clinical aspects of loiasis, a filarial parasite infection caused by Loa loa, in order to support the development of guidelines for diagnosis and clinical management and to provide harmonised definitions for future research and scientific communication. We applied the Delphi method. Statements on the definition of eyeworm, Calabar swelling, possible/probable/confirmed loiasis, occult loiasis, and the classification of loiasis clinical manifestations were submitted individually to a panel of 18 experts participating in the guideline development.

AbstractLoiasis, a filarial vector-borne disease, is common in rural West and Central Africa. Benzimidazole derivatives albendazole and mebendazole are recommended as alternative treatments due to their perceived safety in hypermicrofilaremic patients. There is growing evidence that benzimidazoles might also lead to Loa loa-associated encephalopathy. In this systematic review we analyzed all available evidence of benzimidazole-associated encephalopathy.Literature was systematically searched in PubMed, Google Scholar, and WHO-VigiBase®, including conference abstracts and consultation of experts.Six potential cases of benzimidazole-associated encephalopathy, including 2 fatalities, were identified among microfilaremic loiasis patients. Due to the limited global use of prolonged benzimidazole regimens for loiasis, the number of encephalopathy cases identified raises significant safety concerns, challenging the rationale of their use. Further research on mechanisms and safer alternative regimens is urgently needed.

AbstractLoiasis, a filarial vector-borne disease, is common in rural West and Central Africa. Benzimidazole derivatives albendazole and mebendazole are recommended as alternative treatments due to their perceived safety in hypermicrofilaraemic patients. There is growing evidence, that benzimidazoles might also lead to Loa loa-associated encephalopathy. In this systematic review we analysed all available evidence of benzimidazole-associated encephalopathy.Literature was systematically searched in PubMed, Google Scholar, and WHO-VigiBase®, including conference abstracts and consultation of experts.Six potential cases of benzimidazole-associated encephalopathy, including two fatalities, were identified among microfilaraemic loiasis patients. Due to the limited global use of prolonged benzimidazole regimens for loiasis, the number of encephalopathy cases identified raises significant safety concerns, challenging the rationale of their use. Further research on mechanisms and safer alternative regimens is urgently needed.

Loiasis, caused by the filarial nematode Loa loa, imposes a significant disease burden in endemic regions in West and Central Africa. Manifestations include adult worms in soft tissue (e.g., the conjunctiva of the eye) and microfilaria in peripheral blood, with clinical presentations ranging from asymptomatic infections to life-threatening organ involvement. Diagnosis remains challenging due to variable microfilaria counts, frequent amicrofilaremic occult infections, and unreliable serological tests. The untargeted plasma proteome reflects broad (patho-)physiological responses, providing valuable insights into the host and disease.MethodsApplying high-throughput plasma proteomics, we investigated the host responses of 274 patients with different L. loa disease states, including occult loiasis (n = 148), microfilaremia (n = 42), or both (n = 84), compared to 136 L. loa–negative controls. Differentially abundant proteins between L. loa–infected individuals and negative controls were validated using targeted proteomics.ResultsFive proteins (IGHG3, IGHG4, ACTBL2, LCP1, and IGLV9-49) were elevated in infected individuals compared to healthy controls. IGHG3, IGHG4, ACTB, and LCP1 increased from L. loa negative over individuals with history of eye worm migration to microfilaremic patients, indicating a comparatively pronounced proteomic host response to microfilaria in the blood. Sixty-three proteins differed depending on self-reported symptoms. The proteomic signatures enabled accurate classification of individuals with occult loiasis (area under the receiver operating characteristic curve [AUROC] = 0.73) and microfilaremia (AUROC = 0.84) by a random forest machine learning model.ConclusionsOverall, infection with Loa loa alters the host plasma proteome, exhibiting distinct host responses in different infection states and allowing for molecular disease classification of this highly neglected parasitic disease.