African Journal of Pharmacy and Pharmacology Vol. 2 (4). pp. 077-082, June, 2008 Available online http://www.academicjournals.org/ajpp ISSN 1996-0816 ©2008 Academic Journals Full Length Research Paper Does alcohol consumption increase the risk of severe adverse events to ivermectin treatment? Takougang I. 1 *, Ngogang J. 2 , Sihom F. 1 , Ntep M. 3 , Kamgno J. 3 , Eyamba A. 4 , Zouré H. 5 , Noma M. 5 and Amazigo U. V. 5 1 Department of Public Health, Faculty of Medicine and Biomedical Sciences; University of Yaoundé 1, P. O. Box 1364 Yaoundé, Cameroon. 2 Department of Physiological Sciences, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, P. O. Box 1364 Yaoundé, Cameroon. 3 National Programme for Onchocerciasis Control, Ministry of Public Health, Yaoundé, Cameroon. 4 Carter Center/Global 2000, Yaoundé, Cameroon. 5 African Programme for Onchocerciasis Control, BP 155 Ouagadougou, Burkina Faso. Accepted June 2, 2008 The present investigation is a case-control study designed to assess the level of association between alcohol consumption and the occurrence of severe adverse reaction (SAE) following ivermectin consumption. Thirty-six (36) cases of SAE occurred in the health districts of Bankim, Nanga Eboko, Obala, Okola and Sa’a. Case and control (43) individuals were submitted to a questionnaire related to their alcohol consumption 24 before and 24 to 48 h following ivermectin intake. An in-depth interview of siblings and local health worker was conducted to assess alcohol consumption around Mectizan intake. The degree of alcohol use was assessed using the level of serum transaminases and the alcohol use disorder identification test (AUDIT). The alcoholic beverages of the study communities were conventional such as beer, whisky, or locally made. Locally produced beverages included “arki” (“Odontol”, “Hah”, ...) and palm wine. The bark, sap or fruit of plants adjuvant are known to contain alkaloids and tannins which are potent neurotropic substances. The likelihood of developing SAE among cases and controls did not differ significantly with history of consumption of alcoholic beverages. Nor did it differ for other indicators of chronic alcohol consumption. Key words: Alcohol consumption, onchocerciasis, audit, serious adverse events, encephalopathy. INTRODUCTION Human onchocerciasis is a public health problem and an obstacle to socioeconomic development in endemic coun- tries of Africa, Arabian Peninsula and South America (WHO, 1995). The community-directed treatment with ivermectin (CDTI) is the main strategy adopted by the Afri- can Programme for Onchocerciasis control (APOC). Seve- re adverse events (SAEs) have been associated with mass treatment with ivermectin in areas where Loa loa and onchocerciasis are co-endemic (Duke, 2003; Twum-Danso, 2003). This has caused wide spread concern on the sus- *Corresponding author: E-mail: itakougang@yahoo.com. Tel.: 00 237 99 65 28 08 (mobile). tainability of CDTI (Amazigo et al., 2002; Addiss et al., 2003). The pathogenesis of Loa loa encephalopathy is not fully understood, but the primary determinant is the level of Loa loa microfilaraemia (Gardon et al., 1997; Boussinesq et al., 1998; Gardon et al., 1999; Boussinesq et al., 2001) and the inflammatory pathogenesis related to the dying worms (McGarry et al., 2003). Field obser- vations have pointed out the effect of alcohol as a co- factor in the determination of SAE, but the information available is conflictive. Food and alcohol are known to alter ivermectin bio-availability (Baraka et al., 1996). The contra-indication of alcohol consumption around Mectizan intake as indicated by Merck and Co., Inc. have safety concerns, but may unnecessarily deter some people from taking ivermectin (The Mectizan Expert Committee, 2000). Shu et al. (2000) failed to establish any enhanced occurrence of side effects in patients who consumed