Retrospective study of the 31 onchocerciasis-endemic countries using the community-directed treatment with ivermectin (CDTI) and the 22 non-endemic countries in Africa, showing significantly lower mortality per capita in the countries using ivermectin.
49 studies are RCTs, which show efficacy with
p=0.00000038.
This study is excluded in the after exclusion results of meta
analysis:
not a typical trial, analysis of African countries that used or did not use ivermectin prophylaxis for parasitic infections.
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risk of death, 88.2% lower, RR 0.12, p = 0.002, relative mean mortality per million.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Tanioka et al., 26 Mar 2021, retrospective, ecological study, multiple countries, preprint, 3 authors, dosage 200μg/kg, dose varied, typically 150-200μg/kg.
Why COVID-19 is not so spread in Africa: How does Ivermectin affect it?
Hisaya Tanioka, Sayaka Tanioka, Kimitaka Kaga
doi:10.1101/2021.03.26.21254377
Background: Scientists have so far been unable to determine the reason for the low number of COVID-19 cases in Africa. Objective: To evaluate the impact of ivermectin interventions for onchocerciasis on the morbidity, mortality, recovery, and fatality rates caused by COVID-19.
Method: A retrospective statistical analysis study of the impact of ivermectin against COVID-19 between the 31 onchocerciasis-endemic countries using the community-directed treatment with ivermectin (CDTI) and the non-endemic 22 countries in Africa. The morbidity, mortality, recovery rate, and fatality rate caused by COVID-19 were calculated from the WHO situation report in Africa. We investigated the onchocerciasis endemic 31 countries and the non-endemic 22 countries. Statistical comparisons used by the Welch test of them in the two groups were made.
Results: The morbidity and mortality were statistically significantly less in the 31 countries using CDTI. The recovery and fatality rates were not statistically significant difference. The average life expectancy was statistically significantly higher in the non-endemic countries.
Conclusions: The morbidity and mortality in the onchocerciasis endemic countries are lesser than those in the non-endemic ones. The community-directed onchocerciasis treatment with ivermectin is the most reasonable explanation for the decrease in morbidity and fatality rate in Africa. In areas where ivermectin is distributed to and used by the entire population, it leads to a significant reduction in mortality.
H.T. and S.T. analyzed the data and wrote the first draft. All authors provided critical revisions. All authors contributed equally to this study and approved the submitted manuscript.
References
Ahmed, Karim, Ross, A five-day course of ivermectin for the treatment of COVID-19 may reduce the duration of illness, Int J Infect Dis,
doi:10.1016/j.ijid.2020.11.191Mehta, Mytton, Mullins, SARS-CoV-2 (COVID-19): What Do We Know About Children? A Systematic Review, Clin Infect Dis,
doi:10.1093/cid/ciaa556
