Ivermectin for onchocercal eye disease (river blindness) (Review)

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T A B L E O F C O N T E N T S HEADER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 ABSTRACT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 PLAIN LANGUAGE SUMMARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 SUMMARY OF FINDINGS FOR THE MAIN COMPARISON . . . . . . . . . . . . . . . . . . . 2 BACKGROUND . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 OBJECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 METHODS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 RESULTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Figure 1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Figure 2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 ADDITIONAL SUMMARY OF FINDINGS . . . . . . . . . . . . . . . . . . . . . . . . . . 21 DISCUSSION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 AUTHORS’ CONCLUSIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 ACKNOWLEDGEMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 REFERENCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 CHARACTERISTICS OF STUDIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 DATA AND ANALYSES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 APPENDICES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 WHAT’S NEW . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 HISTORY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 CONTRIBUTIONS OF AUTHORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 DECLARATIONS OF INTEREST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 SOURCES OF SUPPORT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 DIFFERENCES BETWEEN PROTOCOL AND REVIEW . . . . . . . . . . . . . . . . . . . . . 39 INDEX TERMS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 Ivermectin for onchocercal eye disease (river blindness) (Review) Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. i
[Intervention Review] Ivermectin for onchocercal eye disease (river blindness) Henry OD Ejere 1 , Ellen Schwartz 2 , Richard Wormald 3 , Jennifer R Evans 3 1 Phoebe Inpatient Medicine Specialists, Phoebe Putney Memorial Hospital, Albany, Georgia, USA. 2 Institute of Ophthalmology, London, UK. 3 Cochrane Eyes and Vision Group, ICEH, London School of Hygiene & Tropical Medicine, London, UK Contact address: Henry OD Ejere, Phoebe Inpatient Medicine Specialists, Phoebe Putney Memorial Hospital, 425 W. Third Avenue, Suite 500, Albany, Georgia, GA 31701, USA. hodejere2000@yahoo.com. Editorial group: Cochrane Eyes and Vision Group. Publication status and date: New search for studies and content updated (no change to conclusions), published in Issue 4, 2009. Review content assessed as up-to-date: 5 August 2009. Citation: Ejere HOD, Schwartz E, Wormald R, Evans JR. Ivermectin for onchocercal eye disease (river blindness). Cochrane Database of Systematic Reviews 2001, Issue 2. Art. No.: CD002219. DOI: 10.1002/14651858.CD002219. Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. Background A B S T R A C T It is believed that ivermectin (a microfilaricide) could prevent blindness due to onchocerciasis. However, when given to everyone in communities where onchocerciasis is common, the effects of ivermectin on lesions affecting the eye are uncertain and data on whether the drug prevents visual loss are unclear. Objectives The aim of this review was to assess the effectiveness of ivermectin in preventing visual impairment and visual field loss in onchocercal eye disease. The secondary aim was to assess the effects of ivermectin on lesions affecting the eye in onchocerciasis. Search strategy We searched the Cochrane Central Register of Controlled Trials (CENTRAL), which contains the Cochrane Eyes and Vision Group Trials Register, in The Cochrane Library (Issue 3 2009), MEDLINE (January 1950 to August 2009), EMBASE (January 1980 to August 2009), the WHO International Trials Registry (August 2009), the reference lists of identified trials and the Science Citation Index. We also contacted investigators, experts in the field and pharmaceutical companies to identify additional trials. There were no language or date restrictions in the search for trials. The electronic databases were last searched on 6 August 2009. Selection criteria We included randomised controlled trials with at least one year follow up comparing ivermectin to placebo or no treatment. Participants in the trials were people normally resident in endemic onchocercal communities with or without one or more characteristic signs of ocular onchocerciasis. Data collection and analysis Two authors independently extracted data and assessed trial quality. We contacted study authors for additional information. Trials varied in design and setting so no meta-analysis was performed. Ivermectin for onchocercal eye disease (river blindness) (Review) Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 1
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Page 37 and 38: Characteristics of excluded studies
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Ivermectin for onchocercal eye disease (river blindness) (Review)

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