Imported loiasis in Italy: An analysis of 100 cases

Background: loiasis is a neglected filariasis, affecting millions of individuals living in the rainforest areas of West and Central Africa. Aim of this study was to compare clinical and parasitological manifestations of loiasis between subjects born in endemic areas and expatriates/travelers. Methods: we report clinical and parasitological manifestations of 100 patients with imported loiasis seen between 1993 and 2013 at the Center of Tropical Diseases, Negrar, Italy. Results: among the 100 patients, 30 were African immigrants, 70 were Europeans (59 long-term expatriates and 11 travelers). Thirty-five patients (19 Africans and 16 Europeans) had positive microfilaremia. Calabar swellings were twice as frequent in Europeans (90%) than in Africans (46.7%), while a history of "eyeworm" was recorded in a higher proportion of Africans (43.3%) than in Europeans (17.4%). The median duration of exposure in the non-endemic group was also fairly long (14.6 years). Different drug regimens were used for treatment. Conclusions: we suggest that the differences between Africans and Europeans are more likely to be related to genetic differences, rather than to chronicity. Moreover the management of imported loiasis needs standardization. (C) 2014 Elsevier Ltd. All rights reserved.