1
|
Nyagang SM, Cumber SN, Cho JF, Keka EI, Nkfusai CN, Wepngong E, Tsoka-Gwegweni JM, Fokam EB. Prevalence of onchocerciasis, attitudes and practices and the treatment coverage after 15 years of mass drug administration with ivermectin in the Tombel Health District, Cameroon. Pan Afr Med J 2020; 35:107. [PMID: 32637005 PMCID: PMC7321683 DOI: 10.11604/pamj.2020.35.107.16036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 02/24/2020] [Indexed: 11/27/2022] Open
Abstract
Introduction Onchocerciasis is an infection caused by Onchocerca volvulus. It affects 37 million people of which 99% are in Africa. This study assessed the prevalence of onchocerciasis after 15 years of mass drug administration with ivermectin. Methods This was a population based cross sectional study. Questionnaires covering participants' identity and attitudes and practices of community respondents towards ivermectin were administered. The treatment coverage was obtained by review of records of mass drug administration from 1999 to 2015. The epidemiological evaluation of infection status was done by parasitological examination of skin snips and nodule palpation in individuals in five health areas of the district. Results A total of 400 participants were randomly selected. Of these, 56.0% were males, 62.0% single, 59.5% farmers and 98.0% Christians. Participants with good attitudes towards community directed treatment with ivermectin made up 80.5% while 47.8% of the participants had good practice. The highest treatment coverage achieved was 88.0% in 2010 while lowest was 57.0% in 2002. Less than 2% had microfilaria and 6.0% had nodules. There was no statistically significant difference in the prevalence of microfilaria with respect to age. There was a statistically significant difference in the distribution of nodules (χ2=73.6, p=0.001) among the different age groups. The greatest rate of infection (2.1%) was among farmers. Conclusion This study showed that the prevalence reduced compared to other prevalence studies in Cameroon. The study area was hypo-endemic for onchocerciasis.
Collapse
Affiliation(s)
- Sharon Mumah Nyagang
- Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Buea, Cameroon.,Cameroon Baptist Convention Health Services (CBCHS), Yaounde, Cameroon
| | - Samuel Nambile Cumber
- Office of the Dean, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.,Centre for Health Systems Research and Development, University of the Free State, Bloemfontein, South Africa.,School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Jerome Fru Cho
- Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Buea, Cameroon
| | - Elsie Indah Keka
- Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Buea, Cameroon
| | - Claude Ngwayu Nkfusai
- Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Buea, Cameroon.,Cameroon Baptist Convention Health Services (CBCHS), Yaounde, Cameroon
| | - Emerson Wepngong
- Cameroon Baptist Convention Health Services (CBCHS), Yaounde, Cameroon
| | | | - Eric Bertrand Fokam
- Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Buea, Cameroon
| |
Collapse
|
2
|
Noma M, Zouré HGM, Tekle AH, Enyong PAI, Nwoke BEB, Remme JHF. The geographic distribution of onchocerciasis in the 20 participating countries of the African Programme for Onchocerciasis Control: (1) priority areas for ivermectin treatment. Parasit Vectors 2014; 7:325. [PMID: 25053266 PMCID: PMC4223657 DOI: 10.1186/1756-3305-7-325] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 07/06/2014] [Indexed: 11/20/2022] Open
Abstract
Background The African Programme for Onchocerciasis Control (APOC) was created to control onchocerciasis as a public health problem in 20 African countries. Its main strategy is community directed treatment with ivermectin. In order to identify all high risk areas where ivermectin treatment was needed, APOC used Rapid Epidemiological Mapping of Onchocerciasis (REMO). REMO has now been virtually completed and we report the results in two articles. The present article reports the mapping of high risk areas where onchocerciasis was a public health problem. The companion article reports the results of a geostatistical analysis of the REMO data to map endemicity levels and estimate the number infected. Methods REMO consists of three stages: exclusion of areas that are unsuitable for the vector, selection of sample villages to be surveyed in each river basin, and examination of 30 to 50 adults for the presence of palpable onchocercal nodules in each selected village. The survey results and other relevant information were processed in a geographical information system. A panel of experts interpreted the data taking the river-based sampling into account and delineated high risk areas where the prevalence of nodules is greater than 20%. Results Unsuitable areas were identified in eight countries. In the remaining areas surveys were done in a total of 14,473 sample villages in which more than half a million people were examined. High-risk areas were identified in 18 APOC countries, ranging from small isolated foci to a vast contiguous endemic area of 2 million km2 running across seven countries. In five countries the high risk area covered more than 48% of the total surface area, and 31% to 48% of the population. It is estimated that 86 million people live in high risk areas in the APOC countries. Conclusions The REMO maps have played a significant role in onchocerciasis control in the 20 APOC countries. All high-risk areas where onchocerciasis used to be a serious public health problem have been clearly delineated. This led to the creation of community-directed treatment projects that by 2012 were providing annual ivermectin treatment to over 80 million people.
Collapse
|
3
|
Dozie INS, Onwuliri COE, Nwoke BEB. Onchocerciasis in Imo State, Nigeria. Community knowledge and beliefs about transmission, treatment and prevention. Public Health 2004; 118:128-30. [PMID: 15037043 DOI: 10.1016/j.puhe.2003.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2002] [Revised: 07/15/2003] [Accepted: 09/01/2003] [Indexed: 11/26/2022]
Affiliation(s)
- I N S Dozie
- Medical and Public Health Microbiology Unit, Faculty of Medicine and Health Sciences, Imo State University Owerri, PMB 2000, Imo State, Nigeria.
| | | | | |
Collapse
|
4
|
Anosike JC, Onwuliri OE, Onwuliri VA. The prevalence, intensity and clinical manifestations of Onchocerca volvulus infection in Toro local government area of Bauchi State, Nigeria. Int J Hyg Environ Health 2001; 203:459-64. [PMID: 11556150 DOI: 10.1078/1438-4639-00052] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Between January and October 1994, a study of the prevalence, intensity and clinical manifestations of onchocerciasis in nine communities of Toro local government area of Bauchi State, Nigeria was undertaken using the skin-snip method. Of the 1117 inhabitants examined, 188 (16.8%) were positive for microfilariae of Onchocerca volvulus. The prevalence of onchocerciasis was significantly higher (P < 0.05) among males than females, in subjects 21 years of age and above than in those in the first two decades of life, in nomads, farmers, hunters and fishermen than smiths and traders. Intensity of infection was light, not exceeding a geometric mean of 5.3 microfilaria per 2 mm skin bite. Preponderance of positive cases below 20 years presented no chronic signs. Conversely, persons above 20 years had higher microfilaria counts which coincides with the period when most clinical signs manifest. Microfilarial-rate and -density in relation to age were closely associated (r = 0.75, P < 0.001). The need for a sustained mass distribution of Mectizan in these communities is highlighted.
Collapse
Affiliation(s)
- J C Anosike
- Applied Entomology and Parasitology Research Unit, Filariasis Control Project, Department of Zoology, University of Jos, P. M. B. 2084., Plateau State, Nigeria
| | | | | |
Collapse
|
5
|
Nwaorgu OC, Okeibunor JC. Onchocerciasis in pre-primary school children in Nigeria: lessons for onchocerciasis country control programme. Acta Trop 1999; 73:211-5. [PMID: 10546837 DOI: 10.1016/s0001-706x(99)00023-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
There is limited data on the prevalence of onchocerciasis in young children in Nigeria, partly because treatment with the effective drug Ivermectin has been contra-indicated in children less than 5. As the risk of complications of onchocerciasis is related to duration and intensity of infection, it would be beneficial to know the prevalence in young children for design of control programmes. A study was therefore undertaken to determine the prevalence of onchocerciasis in 642 children 0-4 years old in a rain forest endemic community in South East Nigeria. The overall onchocerciasis prevalence (positive skin snips) for children 0-4 years old in three Local Government Areas in Enugu State, Eastern Nigeria was 15.7% with no significant difference in infection rates between male and female children. There was no detectable infection in children less than 1 year old. Characteristic onchocercal rash was identified in 11.1% of the children and presence of typical onchocercal subcutaneous palpable nodules in 4.6%. Total prevalence for adults in the same population was found to be 26.9%. This indicates that in onchocerciasis endemic communities, everybody may be at risk of infection irrespective of age.
Collapse
Affiliation(s)
- O C Nwaorgu
- Department of Biological Science, Nnamdi Azikwe University, Awka, Nigeria
| | | |
Collapse
|
6
|
Akogun OB. Onchocerciasis in Taraba State, Nigeria: clinical-epidemiological study of at-risk males in Bakundi District. ZENTRALBLATT FUR BAKTERIOLOGIE : INTERNATIONAL JOURNAL OF MEDICAL MICROBIOLOGY 1999; 289:371-9. [PMID: 10467668 DOI: 10.1016/s0934-8840(99)80077-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
An epidemiological study of 1366 adult males from fourteen communities of Bakundi district of Taraba State, Nigeria was carried out to establish the prevalence and intensity of onchocerciasis. The findings of the study showed that 45.2% of subjects were infected. Ten communities had infection rates in excess of 30%. Lizard skin and leopard skin were seen in 3.5% and 2.0%, respectively, and increased with increasing age. Hanging groin (2.6%) and scrotal enlargement (8.6%) were also observed. There was a good correlation between the infection rate on one hand and the presence of nodules (r = 0.85, P < 0.05), hanging groin (r = 0.56, P < 0.05) and scrotal enlargement (r = 0.62, P < 0.05) on the other. There was also a significant correlation between the intensity of infection on the one hand and lizard skin (r = 0.67, P < 0.05), leopard skin (r = 0.88, P < 0.05) and hanging groin (r = 0.82, P < 0.05) on the other. Those who worked in the fields (such as hunters, farmers and fishermen) had higher infection than others because of frequent contact with the vector. Extensive surveys of all suspected river valleys must be carried out to identify all those communities which will benefit from ivermectin treatment.
Collapse
Affiliation(s)
- O B Akogun
- Department of Biological Sciences, Federal University of Technology, Yola, Nigeria
| |
Collapse
|
7
|
Nwaorgu OC, Ohaegbula A, Onweluzo IE, Alo ET, Nweke LN, Agu ML, Emeh E. Results of a large scale onchocercosis survey in Enugu State, Nigeria. J Helminthol 1994; 68:155-9. [PMID: 7930458 DOI: 10.1017/s0022149x00013699] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The prevalence of onchocercosis was determined in three Local Government Areas (Ezeagu, Oji-River and Uzo-Uwani) in Enugu State, Eastern Nigeria between March 1989 and June 1990. Enugu State was shown to be mesoendemic for onchocercosis. A total of 7472 (26.9%) persons out of 27,831 examined were positive for skin microfilariae. There was no significant difference in infection rates between males (27.6%) and females (26.2%). Of the 118 villages surveyed only five had no inhabitant with skin microfilariae. There was a progressive increase of prevalence to the second decade of life, although 96.6% of cases with skin microfilariae had only a light infection. Onchocercomata prevalence was recorded as 27.3% which tallies with the prevalence of skin microfilariae at 26.9% hence onchocercomata prevalence may be used as a yardstick for predicting skin microfilariae prevalence.
Collapse
Affiliation(s)
- O C Nwaorgu
- Department of Parasitology and Entomology, Enugu State University of Technology, Nigeria
| | | | | | | | | | | | | |
Collapse
|
8
|
Ufomadu GO, Akpa AU, Ekejindu IM. Human onchocerciasis in the lower Jos Plateau, central Nigeria: the prevalence, geographical distribution and epidemiology in Akwanga and Lafia local government areas. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 1992; 86:637-47. [PMID: 1304706 DOI: 10.1080/00034983.1992.11812720] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
An investigation of human infection with Onchocerca volvulus and the resulting clinical disease was carried out for the Nigerian National Onchocerciasis Control Programme between July and August 1989 [corrected]. The survey covered 10.6% of the rural population in 41 savanna villages of central Nigeria. Of the 8451 self-selected individuals examined, 900 (10.6%) had skin microfilariae (Mf). There were differences between villages in both endemicity and intensity of infection, but in general the number of both Mf carriers and cases of clinical onchocerciasis increased with age. The disease in the Mf carriers showed as blindness (0.8%), onchocercal nodules (0.6%), leopard skin (1.6%) and pruritus (2.8%). Of 35 persons with lymphatic complications, 19 had hanging groin, 10 had elephantiasis and six had hydrocoele. Onchocerciasis was mesoendemic in the rocky northern escarpments, and became hypoendemic and sporadic in the southern uplands of sedimentary geological origin.
Collapse
Affiliation(s)
- G O Ufomadu
- Entomology and Parasitology Division, Nigeria Institute for Trypanosomiasis Research, Vom, Plateau State
| | | | | |
Collapse
|
9
|
Okonkwo P, Akpa A, Ihekwaba A, Nwagbo D, Umeh R, Adibua S, Ezike V, Ogbuokiri J. Studies on onchocerciasis in forest-savannah mosaic areas of Nigeria. I. Investigations in Gbaragu, Oji River. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 1991; 85:617-23. [PMID: 1811439 DOI: 10.1080/00034983.1991.11812617] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Reports on onchocerciasis in Nigeria have been scanty, despite the size of the country and of the problem. A survey of the prevalence and transmission of the disease in the south-eastern communities of Nigeria was commenced, with a year-long study of the vector and the clinical manifestations of the disease in a forest-savannah mosaic area on the Oji river. Microfilaraemia was found in 76% of the population, and nodules in 62%; there were no significant differences between male and female prevalence rates. Skin and ocular lesions of onchocerciasis, including 'Sowda', were common. Flies of the Simulium damnosum complex were found breeding along the entire length of the Oji river and tributaries. Biting occurred all the year round, but peaked in the months of March, April and May.
Collapse
Affiliation(s)
- P Okonkwo
- University of Nigeria Teaching Hospital, Enugu, Nigeria
| | | | | | | | | | | | | | | |
Collapse
|