@article{95357,
  keywords = {Public Health, Environmental and Occupational Health, Infectious Diseases, ivermectin (IVM)},
  author = {Jittamala P and Monteiro W and Smit MR and Pedrique B and Specht S and Chaccour CJ and Dard C and Del Giudice P and Khieu V and Maruani A and Failoc-Rojas VE and Sáez-de-Ocariz M and Soriano-Arandes A and Piquero-Casals J and Faisant A and Brenier-Pinchart M and Wimmersberger D and Coulibaly JT and Keiser J and Boralevi F and Sokana O and Marks M and Engelman D and Romani L and Steer AC and von Seidlein L and White NJ and Harriss E and Stepniewska K and Humphreys GS and Kennon K and Guérin PJ and Kobylinski KC},
  editor = {Downs JA},
  title = {A systematic review and an individual patient data meta-analysis of ivermectin use in children weighing less than fifteen kilograms: Is it time to reconsider the current contraindication?},
  abstract = {<jats:sec id="sec001">
<jats:title>Background</jats:title>
<jats:p>Oral ivermectin is a safe broad spectrum anthelminthic used for treating several neglected tropical diseases (NTDs). Currently, ivermectin use is contraindicated in children weighing less than 15 kg, restricting access to this drug for the treatment of NTDs. Here we provide an updated systematic review of the literature and we conducted an individual-level patient data (IPD) meta-analysis describing the safety of ivermectin in children weighing less than 15 kg.</jats:p>
</jats:sec>
<jats:sec id="sec002">
<jats:title>Methodology/Principal findings</jats:title>
<jats:p>A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) for IPD guidelines by searching MEDLINE via PubMed, Web of Science, Ovid Embase, LILACS, Cochrane Database of Systematic Reviews, TOXLINE for all clinical trials, case series, case reports, and database entries for reports on the use of ivermectin in children weighing less than 15 kg that were published between 1 January 1980 to 25 October 2019. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO): CRD42017056515. A total of 3,730 publications were identified, 97 were selected for potential inclusion, but only 17 sources describing 15 studies met the minimum criteria which consisted of known weights of children less than 15 kg linked to possible adverse events, and provided comprehensive IPD. A total of 1,088 children weighing less than 15 kg were administered oral ivermectin for one of the following indications: scabies, mass drug administration for scabies control, crusted scabies, cutaneous larva migrans, myiasis, pthiriasis, strongyloidiasis, trichuriasis, and parasitic disease of unknown origin. Overall a total of 1.4% (15/1,088) of children experienced 18 adverse events all of which were mild and self-limiting. No serious adverse events were reported.</jats:p>
</jats:sec>
<jats:sec id="sec003">
<jats:title>Conclusions/Significance</jats:title>
<jats:p>Existing limited data suggest that oral ivermectin in children weighing less than 15 kilograms is safe. Data from well-designed clinical trials are needed to provide further assurance.</jats:p>
</jats:sec>},
  year = {2021},
  journal = {PLOS Neglected Tropical Diseases},
  volume = {15},
  pages = {e0009144},
  publisher = {Public Library of Science (PLoS)},
  issn = {1935-2735},
  url = {https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0009144&type=printable},
  doi = {10.1371/journal.pntd.0009144},
  language = {eng},
}