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DOI: 10.1055/a-1999-1821
Loiasis – Eine extrem vernachlässigte Tropenerkrankung
Loiasis – An extremely neglected tropical disease
ZUSAMMENFASSUNG
Rund 10–15 Mio. Menschen in Zentral- und Westafrika sind mit der Filarie Loa loa infiziert. Obwohl die assoziierte Krankheitslast vergleichbar mit wichtigen Tropenkrankheiten wie der Schistosomiasis ist, gilt die Loaisis bisher als extrem vernachlässigte Tropenerkrankung. Parasitologisch wird differenziert zwischen der mikrofilariämen Loiasis, bei der die Mikrofilarien mittels Mikroskopie im Blutausstrich nachgewiesen werden, und der okkulten Loiasis, die nur bei entsprechender Exposition durch typische Symptome diagnostiziert werden kann. Pathognomonische Symptome sind die Wanderung des adulten Wurms in der Konjunktiva („afrikanischer Augenwurm“) sowie die transiente Calabar-Schwellung. Die Therapie der Loaisis stellt vor allem in Endemiegebieten oft eine große Herausforderung dar. Potenziell schwere Nebenwirkungen der verfügbaren Medikamente sowie das hohe Risiko einer Reinfektion führen meist dazu, dass L. loa-Patient*innen in den Endemiegebieten keine Therapie erhalten.
ABSTRACT
An estimated 10–15 Mio. people in Central and West Africa are infected with the filarial species Loa loa. Although the associated disease burden seems comparable to other important tropical diseases such as schistosomiasis, loiasis remains an extremely neglected tropical disease. The disease may be categorized as microfilaremic or occult loiasis based on parasitological investigation. The diagnosis of microfilaremic loaisis can be established by microscopic detection of microfilariae. Occult loiasis is diagnosed based on the presence of typical symptoms in the setting of relevant exposure. Pathognomonic signs are the migration of the adult worm through the conjunctiva and the transient Calabar swelling. The treatment of loaisis still represents a major challenge particularly in endemic areas. Potential life-threatening side effects of the medication in addition to the risk of reinfection often lead to the fact that L. loa patients do not receive treatment in endemic areas.
Publikationsverlauf
Artikel online veröffentlicht:
07. Februar 2023
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