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COVID-19: The Ivermectin African Enigma

Guerrero et al., Colombia Médica, doi:10.25100/cm.v51i4.4613
Oct 2020  
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Ivermectin for COVID-19
4th treatment shown to reduce risk in August 2020
 
*, now with p < 0.00000000001 from 104 studies, recognized in 23 countries.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,400+ studies for 79 treatments. c19ivm.org
Study of African Programme for Onchocerciasis Control (APOC) countries, which used ivermectin, with non-APOC countries in Africa, showing 28% lower mortality for APOC countries, relative risk RR = 0.72 [0.67-0.78]. See also1 and the author's response2.
Guerrero et al., 22 Oct 2020, peer-reviewed, 5 authors.
This PaperIvermectinAll
COVID-19: The Ivermectin African Enigma
Rodrigo Guerrero, Luis Eduardo Bravo, Edgar Muñoz, Elvia Karina Grillo Ardila, Esteban Guerrero
Colombia médica, doi:10.25100/cm.v51i4.4613
The low frequency of cases and deaths from the SARS-CoV-2 COVID-19 virus in some countries of Africa has called our attention about the unusual behavior of this disease. The ivermectin is considered a drug of choice for various parasitic and viral diseases and shown to have in vitro effects against SARS-CoV-2.
Conflict of Interest: Two of the authors of this paper are members of the Editorial Board of Colombia Medica Supplementary. Effect modifications using the stratified analyses according to APOC status and HDI index. In African regions with HDIs above the Z-score means, the predicted number of deaths and infections was lower in APOC countries; and in the regions with the lowest HDI score (Z-score <0), the number of deaths and infections was lower in the non-APOC countries.
References
Caly, Druce, Catton, Jans, Wagsta, The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro, Antivir Res, doi:10.1016/j.antiviral.2020.104787
Cepelowicz, Sherman, Fatteh, Voge, Sacks et al., ICON (Ivermectin in COvid Nineteen) study: Use of Ivermectin is Associated with Lower Mortality in Hospitalized Patients with COVID19, medRxiv, doi:10.1101/2020.06.06.20124461
Core, R: A language and environment for statistical computing
Hdr, Human Development Report 2019: beyond income, beyond averages, beyond today: Inequalities in human development in the 21st century. United Nations Development Program
Health Organization, Global programme to eliminate lymphatic filariasis: progress report, 2018, Weekly Epidemiological Record
Jans, Wagstaff, Ivermectin as a Broad-Spectrum Host-Directed Antiviral: The Real Deal? Cells
Liu, He, Zhuang, He, Li, Unexpected positive correlation between human development index and risk of infections and deaths of COVID-19 in Italy, One Heal, doi:10.1016/j.onehlt.2020.100174
Mbow, Lell, Jochems, Cisse, Mboup et al., COVID-19 in Africa: Dampening the storm?, Science
Norrestad, Number of coronavirus tests in Iceland since
Shahbazi, Khazaei, Socio-economic inequality in global incidence and mortality rates from coronavirus disease 2019: an ecological study, New Microbes New Infect, doi:10.1016/j.nmni.2020.100762
Sharp, Corp, Over 30 Years: The Mectizan ® Donation Program
Sharun, Dhama, Patel, Pathak, Tiwari et al., Ivermectin, a new candidate therapeutic against SARS-CoV-2/COVID-19, Ann Clin Microbiol Antimicrob, doi:10.1186/s12941-020-00368-w
Shouman, Prophylactic Ivermectin in COVID-19 Contacts, doi:10.1002/central/CN-02118717/full
Sodahlon, Mectizan Donation Program
Swargiary, Ivermectin as a promising RNA-dependent RNA polymerase inhibitor and a therapeutic drug against SARS-CoV2: Evidence from in silico studies, Research Square, doi:10.21203/rs.3.rs-73308/v1
Varghese, Kaukinen, Gläsker, Bespalov, Hanski et al., Discovery of berberine, abamectin and ivermectin as antivirals against chikungunya and other alphaviruses, Antiviral Res, doi:10.1016/j.antiviral.2015.12.012
Who/Apoc, The WHO African programme for onchocerciasis control final evaluation report
Worldometer, COVID-19 Coronavirus Pandemic
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Information was obtained from ' 'https://www.worldometers.info/coronavirus/ database.&#x0D;\n' '\xa0Results After controlling for different factors including the Human Development Index, ' 'APOC countries, show statistically significant 28% lower mortality (0.72 IC 95% 0,67-0,78) ' 'and 8% lower rate of infection (0.92 IC95% 0,91-0,93) due to COVID-19.\xa0&#x0D;\n' '\xa0Conclusions:\xa0\xa0The incidence in mortality rates and the number of cases is ' 'significantly lower among the APOC countries compared to non-APOC countries. That a mass ' 'public health preventive campaign against COVID-19 may have taken place, inadvertently, in ' 'some African countries with massive community ivermectin use is an attractive hypothesis. 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Population , total - South Africa [Internet]. Vol. 19. ' '2020. p. 1-18. Available from: ' 'https://data.worldbank.org/indicator/SP.POP.TOTL?locations=ZA'}, { 'key': '49809', 'unstructured': 'R Core Team. R: A language and environment for statistical computing. ' '[Internet]. Vienna Austria; 2020. Available from: ' 'https://www.r-project.org/'}, { 'key': '49811', 'unstructured': 'HDR. Human Development Report 2019: beyond income, beyond averages, ' 'beyond today: Inequalities in human development in the 21st century ' '[Internet]. United Nations Development Program. 2019. Available from: ' 'http://hdr.undp.org/sites/default/files/hdr2019.pdf'}, { 'key': '49813', 'unstructured': 'Norrestad F. Number of coronavirus tests in Iceland 2020 [Internet]. Oct ' '20, 2020. Available from: ' 'https://www.statista.com/statistics/1106855/tested-and-confirmed-coronavirus-cases-in-iceland/'}, { 'key': '49815', 'unstructured': 'World Health Organization. WHO methods and data sources for ' 'country-level causes of death 2000-2016 [Internet]. World Health ' 'Organization. 2018. Available from: ' 'http://hdr.undp.org/sites/default/files/hdr2019.pdf'}, { 'key': '49817', 'unstructured': 'World Health Organization. WHO methods and data sources for ' 'country-level causes of death 2000-2015 [Internet]. 2017. Available ' 'from: ' 'http://www.ncbi.nlm.nih.gov/pubmed/25378742%5Cnhttp://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC4221770'}, { 'key': '49819', 'unstructured': 'Liu K, He M, Zhuang Z, He D, Li H. Unexpected positive correlation ' 'between human development index and risk of infections and deaths of ' 'COVID-19 in Italy. One Heal [Internet]. 2020;10(September):1-3. ' 'Available from: ' 'https://reader.elsevier.com/reader/sd/pii/S2352771420302755?token=4F114E6CAAC56546D45EF8E0C4D7CB1A18E05F165E3FE295C311ABA2F6E870ACA163E4689383E234F4DF48BEE87E6AD4'}, { 'key': '49821', 'doi-asserted-by': 'crossref', 'unstructured': 'Shahbazi F, Khazaei S. Socio-economic inequality in global incidence and ' 'mortality rates from coronavirus disease 2019: an ecological study. New ' 'Microbes New Infect [Internet]. 2020;38:100762. Available from: ' 'https://doi.org/10.1016/j.nmni.2020.100762', 'DOI': '10.1016/j.nmni.2020.100762'}, { 'key': '49822', 'doi-asserted-by': 'crossref', 'unstructured': 'Mbow M, Lell B, Jochems SP, Cisse B, Mboup S, Dewals BG, et al. COVID-19 ' 'in Africa: Dampening the storm? Science (80- ). 2020;369(6504):624-6. ' 'https://doi.org/10.1126/science.abd3902', 'DOI': '10.1126/science.abd3902'}, { 'key': '49824', 'doi-asserted-by': 'crossref', 'unstructured': 'Caly L, Druce JD, Catton MG, Jans DA, Wagsta KM. The FDA-approved drug ' 'ivermectin inhibits the replication of SARS-CoV-2 in vitro. Antivir Res ' 'J [Internet]. 2020;178-104787(March):1-4. Available from: ' 'https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7129059/pdf/main.pdf. ' 'https://doi.org/10.1016/j.antiviral.2020.104787', 'DOI': '10.1016/j.antiviral.2020.104787'}, { 'key': '49826', 'doi-asserted-by': 'crossref', 'unstructured': 'Swargiary A. Ivermectin as a promising RNA-dependent RNA polymerase ' 'inhibitor and a therapeutic drug against SARS-CoV2: Evidence from in ' 'silico studies [Internet]. 2020. Available from: ' 'https://www.researchsquare.com/article/rs-73308/v1. ' 'https://doi.org/10.21203/rs.3.rs-73308/v1', 'DOI': '10.21203/rs.3.rs-73308/v1'}, { 'key': '49828', 'doi-asserted-by': 'crossref', 'unstructured': 'Sharun K, Dhama K, Patel SK, Pathak M, Tiwari R, Singh BR, et al. ' 'Ivermectin, a new candidate therapeutic against SARS-CoV-2/COVID-19. Ann ' 'Clin Microbiol Antimicrob [Internet]. 2020;19(1):1-5. 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