IDA Roll Out

As mentioned elsewhere in the website, IDA is now being rolled out for LF elimination in a number of countries around the world. However, IDA is not approved for LF elimination programs in sub-Saharan African countries that are endemic for onchocerciasis or loiasis, because diethylcarbamazine (the “D” in IDA) can cause serious adverse events in persons with those conditions. Some 18 countries without loiasis are endemic for both LF and onchocerciasis. IDA is superior to the two drug regimen (ivermectin plus albendazole) that is used for LF elimination in those countries. Therefore, we are studying whether IDA is safe for use in patients with onchocerciasis after pre-treatment with ivermectin alone (which temporarily clears parasites from the skin and eyes). This strategy (ivermectin pretreatment followed by IDA, which we call “I/IDA”) has the potential to accelerate LF elimination in Africa. DOLF clinical trials will also test whether IDA is more effective than ivermectin alone for killing or sterilizing adult Onchocerca volvulus worms. Any significant improvement over ivermectin would represent a major breakthrough that could benefit the program to eliminate onchocerciasis in Africa.