The Loa Initiative of the BNITM-CERMEL collaboration aims to advance our understanding and knowledge about loiasis in an interdisciplinary and comprehensive way. To achieve this objective, a considerable number of projects with a diverse focus and a broad range of methodologies are conducted. A short overview of the currently ongoing projects is listed below:
Research
Interventional Clincal Trials
LoaCare
Treatment options for loiasis are currently limited by the very few drugs of any known efficacy and the risk of severe adverse reactions in patients with high microfilarial loads. Moreover, current treatment regimens usually do not differentiate between occult loiasis and microfilaraemic loiasis. Optimization of regimens for the safe treatment of occult loiasis could contribute to curing the disease and may reduce onwards transmission. This randomized controlled open-label clinical phase 3 trial will evaluate the efficacy, safety, and tolerability of different treatment regimens in individuals with occult loiasis for the reduction of Loa loa associated symptoms and signs in endemic regions of Gabon.
Funded by: GIZ
LoloMox
Moxidectin is a newly registered drug that is used for the control of onchocerciasis. It has been proven to be safe, well-tolerated and efficacious. However, so far there are only limited data available for its use against Loa loa. The aim of this clinical trial of moxidectin for the indication of loiasis is to establish a safe, well tolerated and efficacious drug for mass drug administration in adults residing in endemic regions.
Funded by: DZIF
LolOx
Oxfendazole has been shown to exhibit high adulticidal activity in preclinical models while exerting only modest effect on microfilariae. Thus, oxfendazole possesses ideal pharmacodynamic features for safe and efficacious causal treatment of loiasis in endemic regions. A phase I trial of oxfendazole has proven excellent tolerability, thus paving the way for this first clinical trial in the indication of loiasis.
The LolOx project aims to conduct a clinical phase II dose-escalation trial evaluating for the first time the safety, tolerability and efficacy of oxfendazole for the treatment of loiasis.
Funded by: DZIF
The eWHORM project aims to further assess the clinical usefulness of different dosage regimens of oxfendazole for the treatment of loiasis. This project is funded by Global Health – EDCTP3 and is conducted in collaboration with a large consortium of African and European partner institutions. Funded by: EDCTP et la Confédération suisse
Non-interventional Research Projects
Pathophysiology of loiasis
While we know of the loiasis associated morbidity and excess mortality from epidemiological studies, much of the pathophysiology of loiasis remains to be understood. This study aims to characterize potential pathophysiological pathways of loiasis by combining advanced diagnostics and epidemiological cohorts.
Diagnostics of loiasis
The laboratory diagnosis of loiasis remains a formidable challenge. Field deployable point of care tests with high diagnostic accuracy and the ability to quantify microfilaraemia reliably are much needed. We work with international partner institutions to advance current technologies and to develop new tools to improve our diagnostic toolbox.
Entomology of loiasis
The entomology of loiasis research has been much neglected over the past decades. Our understanding of the biology of Chrysops spp. remains limited and little progress in its control has been achieved. In collaboration with an entomological research group, the skills for entomological studies have been set up. Longitudinal monitoring has been established to better characterize the host-vector interplay in this high transmission region.
Socioeconomic projects
Besides its negative effects on human health, loiasis has an impact on the quality of life of affected communities beyond individual disease. Loiasis may also affect agricultural production and, more generally, constitute an important economic burden for rural populations. A team of health-economists has therefore set out to better understand the health-economic costs of loiasis in a high transmission region.
