{
  "schema_version": 1,
  "kind": "condition",
  "id": "loiasis",
  "name": "Loiasis (Loa Loa Infection)",
  "category": "chronic",
  "sources": "Filariasis - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK556012/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class AD24.07 - condition scope only, no dose · Egyptian National Drug Formulary - Antimicrobial 2023 (diethylcarbamazine monograph, p28)",
  "review_status": "reviewed",
  "verified_against": "Loiasis (Loa Loa Infection) - disease-level clinical article (loiasis-clinical.txt) · Egyptian National Drug Formulary - Antimicrobial 2023 (diethylcarbamazine monograph, p28)",
  "verified_date": "2026-08",
  "treatments": [
    {
      "id": 1130,
      "generic": "Diethylcarbamazine",
      "line": 1,
      "is_adjunct": false,
      "form": "oral.solid",
      "strength_mg": 100.0,
      "adult_dose": "8-10 mg/kg/day in 3 divided doses",
      "adult_duration": "21 days; repeat courses may be needed for cure",
      "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023 (diethylcarbamazine monograph, p28)",
      "rationale": "The formulary names treatment and prophylaxis of loiasis as this drug's indication and gives the CDC regimen of 8-10 mg/kg/day in three divided doses for 21 days, for adults and for children alike. The disease article cited on the card gives the same figure and adds the reason it cannot simply be prescribed: in a patient carrying a heavy microfilarial load the drug can cause encephalitis and shock, so the blood microfilarial count decides the approach before the first tablet.",
      "cautions": [
        "COUNT THE MICROFILARIAE BEFORE TREATING. The cited article gives 8,000 microfilariae/mL as the threshold: below it, this regimen; above it, albendazole 200 mg twice daily for 21 days first to bring the load down, with apheresis for very high loads. Some experts set the threshold lower, at 2,500/mL, and use ivermectin 150 mcg/kg between 2,500 and 20,000.",
        "CONTRAINDICATED IN ONCHOCERCIASIS - the formulary's only listed contraindication. Giving this drug to someone co-infected with river blindness triggers a severe inflammatory reaction.",
        "FOR A PATIENT WITH MICROFILARIA IN THE BLOOD the formulary offers a dose-escalating start instead: 50 mg once on day 1; 50 mg three times on day 2; 100 mg three times on day 3; then 9 mg/kg/day in 3 divided doses from day 4 to the end.",
        "Test for co-infection with onchocerciasis and with loiasis itself before treating anyone from an area where either is endemic. Both diethylcarbamazine and ivermectin can cause a fatal encephalopathy in loiasis.",
        "Prophylaxis, where exposure continues, is 300 mg once weekly."
      ],
      "peds_mgkg_low": 8.0,
      "peds_mgkg_high": 10.0,
      "peds_max_mg": null,
      "peds_basis": "day",
      "peds_unit": "mg",
      "peds_note": "Children and adolescents: 8-10 mg/kg/day in 3 divided doses for 21 days, the same rule as for adults.",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": [
        {
          "weight_kg": 10,
          "low_mg": 80,
          "high_mg": 100,
          "capped": false
        },
        {
          "weight_kg": 20,
          "low_mg": 160,
          "high_mg": 200,
          "capped": false
        },
        {
          "weight_kg": 30,
          "low_mg": 240,
          "high_mg": 300,
          "capped": false
        },
        {
          "weight_kg": 40,
          "low_mg": 320,
          "high_mg": 400,
          "capped": false
        }
      ],
      "brands": [],
      "condition_id": "loiasis"
    },
    {
      "id": 1131,
      "generic": "Referral & safety-netting (no drug therapy)",
      "line": 1,
      "is_adjunct": false,
      "form": null,
      "strength_mg": null,
      "adult_dose": "Filarial infection transmitted by the Chrysops fly of Central/West African forests, not found in Egypt. Relevant only in a patient with a matching travel history presenting with migrating (Calabar) swellings or a worm crossing the eye; treatment (diethylcarbamazine) can trigger severe reactions in heavily infected patients and needs specialist supervision.",
      "adult_duration": "Refer",
      "dose_source": "No dose - referral pathway, no medicine given in primary care",
      "rationale": "Filarial infection transmitted by the Chrysops fly of Central/West African forests, not found in Egypt. Relevant only in a patient with a matching travel history presenting with migrating (Calabar) swellings or a worm crossing the eye; treatment (diethylcarbamazine) can trigger severe reactions in heavily infected patients and needs specialist supervision.",
      "cautions": [
        "Not endemic in Egypt. Relevant to a returning traveller or an imported case; consider the travel history before anything else.",
        "The drug rows above are what the treating service gives. They are here so that the referral is an informed one and so the GP can recognise the regimen the patient comes back on - not as permission to start it without the referral.",
        "RED FLAG - Both DEC and ivermectin can cause potentially fatal encephalopathy in patients with loiasis.",
        "RED FLAG - A worm visibly crossing the conjunctiva, Calabar swellings after travel to Central or West Africa, or a very high microfilarial load before treatment, which carries a risk of encephalopathy with diethylcarbamazine and must be specialist-managed."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "Children follow the same pathway: recognise and refer. No primary-care medicine is implied.",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": null,
      "brands": [],
      "condition_id": "loiasis"
    }
  ]
}