Proportions of symptoms at the inclusion Day 0.

BackgroundLoa (L.) loa hypermicrofilaraemia (≥ 8,000 mf/mL) increases the risk of severe adverse events during mass ivermectin administration for onchocerciasis control. Albendazole has been proposed as a potential alternative for reducing microfilaraemia prior to ivermectin administration.Methodology and principal findingsThis prospective study was conducted in northern Gabon from November 2021 to April 2022. Individuals infected with L. loa were screened and allocated to three groups: two treatment arms receiving 400 mg or 800 mg of albendazole daily for 30 days among hypermicrofilaraemic participants, and a group with microfilaraemia Conclusions/SignificanceDaily administration of 400 mg albendazole for 30 days effectively reduces microfilarial loads in patients with L. loa hypermicrofilaraemia and is well tolerated and safe. This pre-treatment regimen may reduce the risk of adverse events associated with ivermectin administration. Further research is needed to evaluate the long-term persistence of microfilarial suppression.