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Osei FA, Newton SKT, Nyanor I, Osei-Yeboah E, Amuzu EX, Mensah NK, Nyarko OO, Amanor E, Odoom SF, Abubakar SY, Dongyele M, Mohammed A, Asare O, Boadi S, Furu P, Meyrowitsch DW, Owusu-Dabo E. Awareness of and participation in mass drug administration programs used for onchocerciasis control in the Atwima Nwabiagya North District, Ghana. Glob Health Res Policy 2023; 8:47. [PMID: 37964321 PMCID: PMC10644529 DOI: 10.1186/s41256-023-00331-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 11/04/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Studies on Mass drug administration (MDA) in Ghana targeting various diseases, have mostly focused on factors that affect coverage and compliance to MDA with limited focus on evidence regarding awareness and community perception of the program. Therefore, this study sought to provide empirical evidence on the knowledge of onchocerciasis, and awareness of and participation in the MDA among community members. METHODS A community-based cross-sectional survey was conducted from August to October 2019 in communities within the Atwima Nwabiagya North District, Ghana. Data was collected from 2,008 respondents. Bivariate and multivariate logistic regression analyses were performed to measure the associations between socio-demographics, having heard of onchocerciasis and its prevention, and levels of awareness of the MDA program. RESULTS A total of 1268 respondents (63.2%) were aware of the MDA program. The majority ofMost respondents (74.4%) were of the view that the information given about the program was not enough and 45.4% of the respondents had no idea about the relevance of the MDA program. Respondents who had ever heard about onchocerciasis prevention and persons who had previously participated in the MDA program were more likely to be aware of the MDA program during implementation (AOR = 2.32; 95% CI 1.79-3.01 and AOR = 9.31; 95% CI 7.06-12.26, respectively). CONCLUSIONS We observed a significant association between being aware of MDA campaigns and knowledge of onchocerciasis and its preventive methods, and participation in previous MDA campaigns. We recommend intensification and improvement of prevention campaigns regarding the onchocerciasis MDA program as key to ensuring increased MDA program participation.
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Affiliation(s)
- Francis Adjei Osei
- Department of Global Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Sam Kofi Tekyi Newton
- Department of Global Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | | | | | | | | | | | | | | | - Mathias Dongyele
- Department of Global Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Aliyu Mohammed
- Department of Epidemiology and Biostatistics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Ofeibea Asare
- Career Development Centre, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Peter Furu
- Department of Public Health, Global Health Section, University of Copenhagen, Copenhagen, Denmark
| | - Dan Wolf Meyrowitsch
- Department of Public Health, Global Health Section, University of Copenhagen, Copenhagen, Denmark
| | - Ellis Owusu-Dabo
- Department of Global Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Otabil KB, Basáñez MG, Ankrah B, Opoku SA, Kyei DO, Hagan R, Ababio R, Bart-Plange EJ, Babae TN, Kudzordzi PC, Darko VA, Bamfo JG, Ameyaw J, Raji AS, Hadermann A, Schallig HDFH, Colebunders R. Persistence of onchocerciasis and associated dermatologic and ophthalmic pathologies after 27 years of ivermectin mass drug administration in the middle belt of Ghana. Trop Med Int Health 2023; 28:844-854. [PMID: 37846505 DOI: 10.1111/tmi.13937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
OBJECTIVES There is a pressing need to regularly evaluate the progress of onchocerciasis elimination programmes to timely identify and mitigate potential risks hindering the reaching of the 2030 targets proposed by the World Health Organization (WHO) in its roadmap on neglected tropical diseases (NTDs). We determined the prevalence of onchocerciasis and associated dermatological and ophthalmological manifestations in six endemic communities in the Bono Region of Ghana after 27 years of ivermectin mass treatment. METHODS In a cross-sectional study, 564 participants aged ≥5 years were enrolled (49.1% females), with a median age of 26 (range: 5-89) years. In 54% and 47%, skin-snip microscopy and Ov16 rapid diagnostic tests were performed, respectively. Skin disease was determined using the WHO Skin NTD App. Visual function assessments included tests of visual acuity. RESULTS The overall microfilarial prevalence was 12.5% (38/305) and Ov16 seroprevalence was 24.2% (64/265). Severe itching was recorded in 24.3%, acute papular onchodermatitis in 52.8%, chronic papular onchodermatitis in 12.5%, lichenified onchodermatitis in 0.7%, skin atrophy in 11.3%, depigmentation in 1.7% and palpable nodules in 5.3%. Of the 301 persons in which visual acuity was examined, 17% were visually impaired and 5.3% were blind and 47.3% presented with cataract. Chronic papular onchodermatitis, lichenified onchodermatitis, depigmentation and visual impairment were significantly associated with the presence of skin microfilariae and Ov16 seropositivity. CONCLUSIONS The persistence of Onchocerca volvulus infection and onchocerciasis-associated dermatological and ophthalmological pathologies after prolonged treatment is of concern. There is a need to include morbidity management in onchocerciasis elimination programmes and understand better patterns of treatment coverage, adherence and actual intake of ivermectin.
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Affiliation(s)
- Kenneth Bentum Otabil
- Consortium for Neglected Tropical Diseases and One Health, Department of Biological Science, School of Sciences, University of Energy and Natural Resources, Sunyani, Bono Region, Ghana
- Department of Biological Science, School of Sciences, University of Energy and Natural Resources, Sunyani, Bono Region, Ghana
- Global Health Institute, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - María-Gloria Basáñez
- Department of Infectious Disease Epidemiology, MRC Centre for Global Infectious Disease Analysis (MRC GIDA), and London Centre for Neglected Tropical Disease Research, School of Public Health, Imperial College London, London, UK
| | - Blessing Ankrah
- Consortium for Neglected Tropical Diseases and One Health, Department of Biological Science, School of Sciences, University of Energy and Natural Resources, Sunyani, Bono Region, Ghana
| | - Stephen Agyemang Opoku
- Department of Medical Laboratory Science, School of Sciences, University of Energy and Natural Resources, Sunyani, Bono Region, Ghana
| | - Dennis Ofori Kyei
- Department of Medical Laboratory Science, School of Sciences, University of Energy and Natural Resources, Sunyani, Bono Region, Ghana
| | - Rhoda Hagan
- Department of Medical Laboratory Science, School of Sciences, University of Energy and Natural Resources, Sunyani, Bono Region, Ghana
| | - Richmond Ababio
- Department of Medical Laboratory Science, School of Sciences, University of Energy and Natural Resources, Sunyani, Bono Region, Ghana
| | - Emmanuel John Bart-Plange
- Consortium for Neglected Tropical Diseases and One Health, Department of Biological Science, School of Sciences, University of Energy and Natural Resources, Sunyani, Bono Region, Ghana
| | - Theophilus Nti Babae
- Consortium for Neglected Tropical Diseases and One Health, Department of Biological Science, School of Sciences, University of Energy and Natural Resources, Sunyani, Bono Region, Ghana
| | - Prince-Charles Kudzordzi
- Consortium for Neglected Tropical Diseases and One Health, Department of Biological Science, School of Sciences, University of Energy and Natural Resources, Sunyani, Bono Region, Ghana
| | - Vera Achiaa Darko
- Consortium for Neglected Tropical Diseases and One Health, Department of Biological Science, School of Sciences, University of Energy and Natural Resources, Sunyani, Bono Region, Ghana
- STU Clinic, Sunyani Technical University, Sunyani, Bono Region, Ghana
| | | | | | - Abdul Sakibu Raji
- Department of Biological Science, School of Sciences, University of Energy and Natural Resources, Sunyani, Bono Region, Ghana
| | - Amber Hadermann
- Global Health Institute, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Henk D F H Schallig
- Department of Medical Microbiology, Experimental Parasitology Unit, Amsterdam University Medical Centres, Academic Medical Centre at the University of Amsterdam, Amsterdam, The Netherlands
| | - Robert Colebunders
- Global Health Institute, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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Moutongo Mouandza R, Mourou JR, Moutombi Ditombi B, Roger Sibi Matotou H, Ekomi B, Bouyou-Akotet MK, Mawili-Mboumba DP. Sociodemographics, Clinical Factors, and Biological Factors Associated with Loiasis in Endemic Onchocerciasis Areas in Southern Gabon. Am J Trop Med Hyg 2023; 109:850-857. [PMID: 37339766 PMCID: PMC10551092 DOI: 10.4269/ajtmh.22-0558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 04/22/2023] [Indexed: 06/22/2023] Open
Abstract
To implement the appropriate strategies for scale-up interventions to eliminate onchocerciasis without severe adverse events, clinical and biological factors associated with loiasis were analyzed in onchocerciasis-endemic areas. Blood was collected from volunteers after examination by a physician. Detection of microfilariae and measurement of Ov16 IgG4 were performed using direct microscopic examination of blood and onchocerciasis rapid test detection, respectively. Areas with sporadic, hypoendemic, and hyperendemic onchocerciasis endemicity were found. Participants with microfilaremia were considered microfilaremic, and those without microfilaremia were seen as amicrofilaremic. Of the 471 study participants, 40.5% (n = 191) had microfilariae. Among them, Mansonella spp. was the most common (78.2%, n = 147), followed by Loa loa (41.4%, n = 79). The association between the two species represented 18.3% (n = 35). The specific immunoglobulins of Onchocerca volvulus were detected in 24.2% of participants (n = 87/359). Overall prevalence of L. loa was 16.8%. Hypermicrofilaremia was found in 3% (N = 14), and one participant had more than 30,000 microfilaremiae per milliliter. The frequency of L. loa did not vary according to the level of onchocerciasis transmission. Pruritus was the most common clinical sign (60.5%, n = 285) reported, mainly in microfilaremic participants (72.2%, n = 138/191). The prevalence of L. loa microfilaria in the study population was below the threshold at risk for the occurrence of serious side effects due to ivermectin. Clinical manifestations frequently observed could be exacerbated by microfilaremia in areas where onchocerciasis transmission is high.
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Affiliation(s)
- Reinne Moutongo Mouandza
- Department of Parasitology-Mycology and Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, Libreville, Gabon
| | - Jean Romain Mourou
- Department of Parasitology-Mycology and Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, Libreville, Gabon
| | - Bridy Moutombi Ditombi
- Department of Parasitology-Mycology and Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, Libreville, Gabon
| | - Hadry Roger Sibi Matotou
- Department of Parasitology-Mycology and Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, Libreville, Gabon
| | - Bernadette Ekomi
- Department of Parasitology-Mycology and Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, Libreville, Gabon
| | - Marielle Karine Bouyou-Akotet
- Department of Parasitology-Mycology and Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, Libreville, Gabon
| | - Denise Patricia Mawili-Mboumba
- Department of Parasitology-Mycology and Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, Libreville, Gabon
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Otabil KB, Ankrah B, Bart-Plange EJ, Donkoh ES, Avarikame FA, Ofori-Appiah FO, Babae TN, Kudzordzi PC, Darko VA, Ameyaw J, Bamfo JG, Sakibu RA, Antwi-Berko D, Fodjo JNS, Basáñez MG, Schallig HDFH, Colebunders R. Prevalence of epilepsy in the onchocerciasis endemic middle belt of Ghana after 27 years of mass drug administration with ivermectin. Infect Dis Poverty 2023; 12:75. [PMID: 37587500 PMCID: PMC10433588 DOI: 10.1186/s40249-023-01117-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/29/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND In onchocerciasis-endemic areas with high ongoing Onchocerca volvulus transmission, a high prevalence of epilepsy has been reported. This study aimed to determine the prevalence and clinical characteristics of epilepsy in the Bono Region of Ghana following 27 years of implementation of ivermectin mass drug administration (MDA). METHODS Between October 2020 and August 2021, cross-sectional surveys were conducted in nine communities in the Tain District and Wenchi Municipality of the Bono Region of Ghana. In the first stage, a random door-to-door approach was used to screen the population for epilepsy using a pre-tested questionnaire. Persons suspected of having epilepsy were invited for a second-stage neurological examination for case verification. Community O. volvulus microfilarial infection status and Ov16 seropositivity were also determined. Ninety-five confidence intervals (95% CI) for prevalence values were calculated using the Wilson Score Interval. RESULTS Of the 971 participants, 500 (51.5%) were females, and the median age (interquartile range) was 26 (15‒43) years. Fourteen participants (1.4%, 95% CI: 1.0‒2.0) were diagnosed as having epilepsy with generalized seizures being the most frequent seizure type (85.7%, 12/14). The overall microfilarial prevalence of O. volvulus was 10.3% (November 2020) and 9.9% (August 2021); the Ov16 seroprevalence was 22.2% (June 2021). Only 63.2% took ivermectin in the last round of MDA distribution in March 2021. CONCLUSIONS The 1.4% prevalence of epilepsy in the Bono region is similar to the median epilepsy prevalence in sub-Saharan Africa. However, the persistent microfilarial prevalence and low ivermectin study coverage call for the Ghana Onchocerciasis Elimination Programme to step up its efforts to ensure that the gains achieved are consolidated and improved to achieve the elimination of onchocerciasis by 2030.
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Affiliation(s)
- Kenneth Bentum Otabil
- NeTroDis Research Group, Centre for Research in Applied Biology, School of Sciences, University of Energy and Natural Resources, Bono Region, Sunyani, Ghana.
- Department of Biological Science, School of Sciences, University of Energy and Natural Resources, Bono Region, Sunyani, Ghana.
- Global Health Institute, University of Antwerp, Antwerp, Belgium.
| | - Blessing Ankrah
- NeTroDis Research Group, Centre for Research in Applied Biology, School of Sciences, University of Energy and Natural Resources, Bono Region, Sunyani, Ghana
| | - Emmanuel John Bart-Plange
- NeTroDis Research Group, Centre for Research in Applied Biology, School of Sciences, University of Energy and Natural Resources, Bono Region, Sunyani, Ghana
- Department of Medical Laboratory Science, School of Sciences, University of Energy and Natural Resources, Bono Region, Sunyani, Ghana
| | - Emmanuel Sam Donkoh
- Department of Medical Laboratory Science, School of Sciences, University of Energy and Natural Resources, Bono Region, Sunyani, Ghana
| | - Fiona Amoabil Avarikame
- Department of Medical Laboratory Science, School of Sciences, University of Energy and Natural Resources, Bono Region, Sunyani, Ghana
| | - Fredrick Obeng Ofori-Appiah
- Department of Medical Laboratory Science, School of Sciences, University of Energy and Natural Resources, Bono Region, Sunyani, Ghana
| | - Theophilus Nti Babae
- NeTroDis Research Group, Centre for Research in Applied Biology, School of Sciences, University of Energy and Natural Resources, Bono Region, Sunyani, Ghana
| | - Prince-Charles Kudzordzi
- NeTroDis Research Group, Centre for Research in Applied Biology, School of Sciences, University of Energy and Natural Resources, Bono Region, Sunyani, Ghana
| | - Vera Achiaa Darko
- NeTroDis Research Group, Centre for Research in Applied Biology, School of Sciences, University of Energy and Natural Resources, Bono Region, Sunyani, Ghana
- STU Clinic, Sunyani Technical University, Bono Region, Sunyani, Ghana
| | - Joseph Ameyaw
- Happy Family Hospital, Bono East Region, Nkoranza, Ghana
| | | | - Raji Abdul Sakibu
- Department of Biological Science, School of Sciences, University of Energy and Natural Resources, Bono Region, Sunyani, Ghana
| | - Daniel Antwi-Berko
- Department of Medical Laboratory Science, School of Sciences, University of Energy and Natural Resources, Bono Region, Sunyani, Ghana
| | | | - María-Gloria Basáñez
- Department of Infectious Disease Epidemiology, MRC Centre for Global Infectious Disease Analysis (MRC GIDA), and London Centre for Neglected Tropical Disease Research, School of Public Health, Imperial College London, London, UK
| | - Henk D F H Schallig
- Department of Medical Microbiology, Experimental Parasitology Unit, Amsterdam University Medical Centres, Academic Medical Centre at the University of Amsterdam, Amsterdam, The Netherlands
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Gbogbo S, Amu H, Dowou RK, Ayanore MA. Management of onchocerciasis among adolescents in nkwanta north district of Ghana: Qualitative study of adolescents' perception, community and health system support. PLoS Negl Trop Dis 2023; 17:e0011577. [PMID: 37643153 PMCID: PMC10464985 DOI: 10.1371/journal.pntd.0011577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 08/07/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Onchocerciasis affects the quality of life to a greater extent among affected individuals. The World Health Organization (WHO)'s Onchocerciasis Control Program (OCP) has effectively reduced the prevalence of onchocerciasis by interrupting the transmission of the parasite and by mass population treatment in the regions at risk of the disease. Despite the successful reduction of the prevalence of onchocerciasis by WHO, the socioeconomic burden resulting from the disabilities caused by onchocerciasis are still immense. This study sought to explore the adolescents' perception regarding the management of onchocerciasis, community and health system support in Nkwanta North District of Ghana. METHOD This study adopted a qualitative phenomenological design and exploratory, descriptive qualitative approach. An in-depth interview guide was developed to collect data for the study. One-on-one interview was conducted. Data collected from 16 onchocerciasis adolescent patients were analysed thematically using ATLAS.ti v7.5.7. Quotes from the participants were presented verbatim to substantiate the themes realised. RESULTS Most of the 12 participants (75.0%) were aged 15-18 years old. It was noted that 6(37.50%) of participants were in Junior High School (JHS), while 4(25.0%) were in Senior High School (SHS). It was noted that community members have diverse understandings and perceptions of onchocerciasis, including beliefs that Onchocerciasis is a serious disease that can cause blindness; it is caused by the consumption of some types of food products or stressful work. Adolescents believed that onchocerciasis was caused by insect bite blood infection, poor environmental hygiene, sun or could have been inherited from parents. Ivermectin treatment was noted by adolescents to have helped relieve the symptoms of ochocerciasis they were experiencing. However, the adolescents indicated that they had experienced some side effects, including fever, headache, body itching, rushes, swollen body and blurred vision from the drug. CONCLUSION Inadequate education and communication about onchocerciasis resulted in diverse and erroneous meanings of onchocerciasis among community members. Our research recognises that community and health system supports is very important in the effective management of Onchocerciasis, contributing to the attainment of Sustainable Development Goal (SDG) 3.3, which is targeted at ending the epidemic of NTDs like onchocerciasis by 2030.
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Affiliation(s)
- Sitsofe Gbogbo
- Department of Population and Behavioural Sciences, School of Public Health, University of Health and Allied Science, Hohoe, Ghana
| | - Hubert Amu
- Department of Population and Behavioural Sciences, School of Public Health, University of Health and Allied Science, Hohoe, Ghana
| | - Robert Kokou Dowou
- Department of Epidemiology and Biostatistics, School of Public Health, University of Health and Allied Science, Hohoe, Ghana
| | - Martin Amogre Ayanore
- Health Policy Planning and Management, University of Health and Allied Science, Hohoe, Ghana
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Eyang-Assengone ER, Makouloutou-Nzassi P, Mbou-Boutambe C, Bangueboussa F, Atsame J, Boundenga L. Status of Onchocerciasis Elimination in Gabon and Challenges: A Systematic Review. Microorganisms 2023; 11:1946. [PMID: 37630506 PMCID: PMC10458829 DOI: 10.3390/microorganisms11081946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/19/2023] [Accepted: 07/26/2023] [Indexed: 08/27/2023] Open
Abstract
Control and treatment programs (CDTI) have been set up nationally in all endemic countries to overcome the impact of onchocerciasis on the affected populations. However, Gabon must still succeed in setting up real onchocerciasis control programs. Here, various database articles have been used to provide the scientific community with a summary document showing the mapping of this disease in Gabon. The articles dealing with onchocerciasis, animal reservoirs, surveillance, and elimination were analyzed. Results showed that little research has been performed. Most studies are concentrated in one region (The area of Lastourville). In addition, we observed that the distribution of the disease varies significantly across the country. Indeed, specific environments present a hyper-endemicity of the disease, while others are meso and hypo-endemic. So, we found some departments with a prevalence ranging from 0% to over 20%; within them, villages had infection levels comprising 10% to 60%, indicating potential hotspots. Vectors activities were studied in some areas. This paper showed the challenges encountered in the country to eliminate this disease. One solution is a deeper understanding of the disease's bioecology to establish effective health policies to eliminate onchocerciasis in Gabon effectively.
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Affiliation(s)
- Elsa-Rush Eyang-Assengone
- Unité de Recherche en Ecologie de la Santé (URES), Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville BP 769, Gabon; (P.M.-N.); (C.M.-B.); (F.B.)
| | - Patrice Makouloutou-Nzassi
- Unité de Recherche en Ecologie de la Santé (URES), Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville BP 769, Gabon; (P.M.-N.); (C.M.-B.); (F.B.)
- Département de Biologie et Ecologie Animale, Institut de Recherche en Ecologie Tropicale (IRET/CENAREST), Libreville BP 13354, Gabon
| | - Clark Mbou-Boutambe
- Unité de Recherche en Ecologie de la Santé (URES), Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville BP 769, Gabon; (P.M.-N.); (C.M.-B.); (F.B.)
| | - Félicien Bangueboussa
- Unité de Recherche en Ecologie de la Santé (URES), Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville BP 769, Gabon; (P.M.-N.); (C.M.-B.); (F.B.)
| | - Julienne Atsame
- Programme de Lutte Contre les Maladies Parasitaires, Ministère de la Santé du Gabon, Libreville BP 2434, Gabon;
| | - Larson Boundenga
- Unité de Recherche en Ecologie de la Santé (URES), Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville BP 769, Gabon; (P.M.-N.); (C.M.-B.); (F.B.)
- Département d’anthropologie, Université de Durham, South Road, Durham DH1 3LE, UK
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Mawson AR. Understanding health disparities affecting people of West Central African descent in the United States: An evolutionary perspective. Evol Appl 2023; 16:963-978. [PMID: 37216026 PMCID: PMC10197229 DOI: 10.1111/eva.13549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/19/2023] [Accepted: 04/02/2023] [Indexed: 05/24/2023] Open
Abstract
Human populations adapting to diverse aspects of their environment such as climate and pathogens leave signatures of genetic variation. This principle may apply to people of West Central African descent in the United States, who are at increased risk of certain chronic conditions and diseases compared to their European counterparts. Less well known is that they are also at reduced risk of other diseases. While discriminatory practices in the United States continue to affect access to and the quality of healthcare, the health disparities affecting African Americans may also be due in part to evolutionary adaptations to the original environment of sub-Saharan Africa, which involved continuous exposure to the vectors of potentially lethal endemic tropical diseases. Evidence is presented that these organisms selectively absorb vitamin A from the host, and its use in parasite reproduction contributes to the signs and symptoms of the respective diseases. These evolutionary adaptations included (1) sequestering vitamin A away from the liver to other organs, to reduce accessibility to the invaders; and (2) reducing the metabolism and catabolism of vitamin A (vA), causing it to accumulate to subtoxic concentrations and weaken the organisms, thereby reducing the risk of severe disease. However, in the environment of North America, lacking vA-absorbing parasites and with a mainly dairy-based diet that is high in vA, this combination of factors is hypothesized to lead to the accumulation of vA and to increased sensitivity to vA as a toxin, which contribute to the health disparities affecting African Americans. vA toxicity is linked to numerous acute and chronic conditions via mitochondrial dysfunction and apoptosis. Subject to testing, the hypothesis suggests that the adoption of traditional or modified West Central African-style diets that are low in vA and high in vA-absorbing fiber hold promise for disease prevention and treatment, and as a population-based strategy for health maintenance and longevity.
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Affiliation(s)
- Anthony R. Mawson
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health SciencesJackson State UniversityJacksonMississippiUSA
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Chikezie FM, Opara KN, Ubulom PME, Yaro CA, Al-Akeel RK, Osei-Atweneboana MY, Alexiou A, Papadakis M, Batiha GES. Onchocerciasis transmission status in some endemic communities of Cross River State, Nigeria after two decades of mass drug administration with ivermectin. Sci Rep 2023; 13:5413. [PMID: 37012274 PMCID: PMC10070439 DOI: 10.1038/s41598-023-31446-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 03/11/2023] [Indexed: 04/05/2023] Open
Abstract
Onchocerciasis is a parasitic disease transmitted by black flies. Human onchocerciasis is a public health and socioeconomic problem in Nigeria. Its prevalence and morbidity have reduced over the years because of control efforts especially, Mass Drug Administration with ivermectin. The current goal is to eliminate the disease transmission by 2030. Understanding the changes in transmission patterns in Cross River State is critical to elimination of onchocerciasis in Nigeria. This study was designed to determine the transmission dynamics of onchocerciasis in Cross River State after over two decades of mass ivermectin distribution in endemic communities. Agbokim, Aningeje, Ekong Anaku and Orimekpang are four endemic communities from three Local Government Areas of the State selected for this study. Transmission indices such as infectivity rates, biting rates and transmission potentials, parity rates and diurnal biting activities were determined. A total of 15,520 adult female flies were caught on human baits, Agbokim (2831), Aningeje (6209), Ekong Anaku (4364) and Orimekpang (2116). A total of 9488 and 5695 flies were collected during the rainy and dry seasons respectively in the four communities studied. The differences in relative abundance among the communities were statistically significant (P < 0.001). Monthly and seasonal fly numbers varied significantly (P < 0.008). There were differences in diurnal biting activities of flies in this study at different hours of the day and different months. The peak monthly biting rates were 5993 (Agbokim, October), 13,134 (Aningeje, October), 8680 (Ekong Anaku, October) and 6120 (Orimekpang, September) bites/person/month while the lowest monthly biting rates were 400 (Agbokim, November), 2862 (Aningeje, August), 1405 (Ekong Anaku, January) and 0.0 (Orimekpang, November and December) bites/person/month. Differences in biting rates among the study communities were significant (P < 0.001). The peak monthly transmission potential in Aningeje was 160 infective bites/person/month in the month of February while the lowest (except for months with no transmission) was 42 infective bites/person/month in the month of April. All other study sites had no ongoing transmission in this study. Transmission studies showed that there is progress toward transmission interruption especially in 3 out of the four studied areas. Molecular O-150 poolscreen studies is required to confirm the true transmission situation in the areas.
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Affiliation(s)
- Friday Maduka Chikezie
- Department of Animal and Environmental Biology, University of Uyo, Uyo, Akwa Ibom State, Nigeria.
| | - Kenneth Nnamdi Opara
- Department of Animal and Environmental Biology, University of Uyo, Uyo, Akwa Ibom State, Nigeria
| | - Peace Mayen Edwin Ubulom
- Department of Animal and Environmental Biology, University of Uyo, Uyo, Akwa Ibom State, Nigeria
| | - Clement Ameh Yaro
- Department of Animal and Environmental Biology, University of Uyo, Uyo, Akwa Ibom State, Nigeria
| | - Rasha Khalifah Al-Akeel
- Department of Zoology, Faculty of Entomology and Parasitology, King Saud University, Riyadh, Saudi Arabia
| | | | - Athanasios Alexiou
- Department of Science and Engineering, Novel Global Community Educational Foundation, Hebersham, NSW, 2770, Australia
- AFNP Med, 1030, Wien, Austria
| | - Marios Papadakis
- Department of Surgery II, University Hospital Witten-Herdecke, Heusnerstrasse 40, University of Witten-Herdecke, 42283, Wuppertal, Germany.
| | - Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour, AlBeheira, 22511, Egypt
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Kumah E, Owusu P, Otchere G, Ankomah SE, Fusheini A, Kokuro C, Mensah-Acheampong F, Atta JA, Agyei SK. Factors influencing community acceptability of mass drug administration for the elimination of onchocerciasis in the Asante Akim South Municipal, Ghana. PLoS Negl Trop Dis 2023; 17:e0011251. [PMID: 37000840 PMCID: PMC10096254 DOI: 10.1371/journal.pntd.0011251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 04/12/2023] [Accepted: 03/17/2023] [Indexed: 04/03/2023] Open
Abstract
Introduction
Onchocerciasis is one of the eleven neglected tropical diseases (NTDs) recently targeted by the World Health Organization (WHO) for elimination. Mass drug administration (MDA) of ivermectin has become the main intervention for reducing the burden of onchocerciasis and controlling its transmission. However, despite the considerable gains in the fight against onchocerciasis in Ghana, the infection remains endemic in some communities. This study aimed to ascertain community members’ acceptability levels and factors associated with ivermectin MDA for the elimination of onchocerciasis in the Asante Akim South Municipal in the Ashanti Region of Ghana.
Methods
A cross-sectional, questionnaire-based study was conducted in six communities in the Asante Akim South Municipal from 7th May to 9th July, 2021. The study population comprised all persons aged 18 years and above who had lived in the study communities for more than three months prior to the study. The main outcome variable was the acceptability of ivermectin MDA by the community members. This was measured using a composite acceptability score adapted from the Intervention Rating Profile tool. The explanatory variables were the respondents’ socio-demographic characteristics, self-rated knowledge of onchocerciasis, perceived side effects of ivermectin, and self-reported level of education received on MDA activities.
Results
Out of 450 community members included in the study, 50.4% were male while 49.6% were female. The respondents’ mean age was 39.57±10.64 years. The mean acceptability score for ivermectin MDA was 20.52±2.91 (range, 9–36). Acceptability of ivermectin MDA was positively associated with gender, educational status, employment status, self-rated knowledge of onchocerciasis, and level of education received on MDA; and negatively associated with perceived side effect of ivermectin.
Conclusion
This study provides valuable information to inform policy decisions on planning and implementing MDA programs for the elimination of onchocerciasis in the study area and the country as a whole.
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Affiliation(s)
- Emmanuel Kumah
- Department of Health Administration and Education, Faculty of Science Education, University of Education, Winneba, Ghana
- * E-mail: ,
| | - Patrick Owusu
- Department of Public Health, Faculty of Health Sciences, Catholic University College of Ghana, Sunyani, Ghana
| | - Godfred Otchere
- Faculty of Humanities, Center for Medicine and Society, University of Freiburg, Freiburg, Germany
| | - Samuel E. Ankomah
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Adam Fusheini
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
- Center for Health Literacy and Rural Health Promotion, Accra, Ghana
| | - Collins Kokuro
- Department of Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Joseph Amankwah Atta
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Samuel Kofi Agyei
- Department of Physician Assistantship, Faculty of Health and Medical Sciences, Presbyterian University College of Ghana, Asante Akyem Campus, Agogo, Ghana
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Surakat OA, Babalola AS, Adeleke MA, Adeogun AO, Idowu OA, Sam-Wobo SO. Geospatial distribution and predictive modeling of onchocerciasis in Ogun State, Nigeria. PLoS One 2023; 18:e0281624. [PMID: 36857325 PMCID: PMC9977021 DOI: 10.1371/journal.pone.0281624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 01/27/2023] [Indexed: 03/02/2023] Open
Abstract
Onchocerciasis caused by infection with Onchocerca volvulus is a disease of public health importance and is highly associated with disability. As Nigeria is aiming at eliminating onchocerciasis by 2030, there is a need to develop newer tools to map disease prevalence and identify environmental factors driving disease prevalence, even in places that have not been previously targeted for preventive chemotherapy. This study produced predictive risk-maps of onchocerciasis in Ogun State. Georeferenced onchocerciasis infection data obtained from a cross-sectional survey at 32 locations between March and July 2015 together with remotely-sensed environmental data were analyzed using Ecological Niche Models (ENM). A total of 107 field occurrence points for O. volvulus infection were recorded. A total of 43 positive occurrence points were used for modelling. ENMs were used to estimate the current geographic distribution of O. volvulus in Ogun State. Maximum Entropy distribution modeling (MaxEnt) was used for predicting the potential suitable habitats, using a portion of the occurrence records. A total of 19 environmental variables were used to model the potential geographical distribution area under current climatic conditions. Empirical prevalence of 9.3% was recorded in this study. The geospatial distribution of infection revealed that all communities in Odeda Local Government Area (a peri-urban LGA) showed remarkably high prevalence compared with other LGAs. The predicted high-risk areas (probability > 0.8) of O. volvulus infection were all parts of Odeda, Abeokuta South, and Abeokuta North, southern part of Imeko-Afon, a large part of Yewa North, some parts of Ewekoro and Obafemi-Owode LGAs. The estimated prevalence for these regions were >60% (between 61% and 100%). As predicted, O. volvulus occurrence showed a positive association with variables reflecting precipitation in Ogun State. Our predictive risk-maps has provided useful information for the elimination of onchocerciais, by identifying priority areas for delivery of intervention in Ogun State, Nigeria.
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Affiliation(s)
- Olabanji Ahmed Surakat
- Faculty of Basic and Applied Sciences, Department of Zoology, Osun State University, Osogbo, Nigeria
- * E-mail:
| | - Ayodele S. Babalola
- Department of Public Health and Epidemiology, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Monsuru A. Adeleke
- Faculty of Basic and Applied Sciences, Department of Zoology, Osun State University, Osogbo, Nigeria
| | - Adedapo O. Adeogun
- Department of Public Health and Epidemiology, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Olufunmilayo A. Idowu
- Department of Pure and Applied Zoology, Federal University of Agriculture, Abeokuta, Nigeria
| | - Sammy O. Sam-Wobo
- Department of Pure and Applied Zoology, Federal University of Agriculture, Abeokuta, Nigeria
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Nabi-Afjadi M, Mohebi F, Zalpoor H, Aziziyan F, Akbari A, Moradi-Sardareh H, Bahreini E, Moeini AM, Effatpanah H. A cellular and molecular biology-based update for ivermectin against COVID-19: is it effective or non-effective? Inflammopharmacology 2023; 31:21-35. [PMID: 36609716 PMCID: PMC9823263 DOI: 10.1007/s10787-022-01129-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 12/05/2022] [Indexed: 01/09/2023]
Abstract
Despite community vaccination against coronavirus disease 2019 (COVID-19) and reduced mortality, there are still challenges in treatment options for the disease. Due to the continuous mutation of SARS-CoV-2 virus and the emergence of new strains, diversity in the use of existing antiviral drugs to combat the epidemic has become a crucial therapeutic chance. As a broad-spectrum antiparasitic and antiviral drug, ivermectin has traditionally been used to treat many types of disease, including DNA and RNA viral infections. Even so, based on currently available data, it is still controversial that ivermectin can be used as one of the effective antiviral agents to treat severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or not. The aim of this study was to provide comprehensive information on ivermectin, including its safety and efficacy, as well as its adverse effects in the treatment of COVID-19.
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Affiliation(s)
- Mohsen Nabi-Afjadi
- Department of Biochemistry, Faculty of Biological Sciences, University of Tarbiat Modares, Tehran, Iran
| | - Fatemeh Mohebi
- Molecular Medicine Research Center, Hormozghan Health Institute, Hormozghan University of Medical Sciences, Bandar Abbas, Iran
| | - Hamidreza Zalpoor
- Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Fatemeh Aziziyan
- Department of Biochemistry, Faculty of Biological Sciences, University of Tarbiat Modares, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Abdullatif Akbari
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | | | - Elham Bahreini
- Department of Biochemistry, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Amir Mansour Moeini
- Department of Internal Medicine, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
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12
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Ojekunle OZ, Esan RO, Balogun MA, Ademolu KO, Adegoke KA, Taiwo AM. Ecological assessment of Black Fly (Simuliumdamnosum, Sensulato) breeding sites in two tributaries of Ogun river, Ogun state, Nigeria. ENVIRONMENTAL MONITORING AND ASSESSMENT 2022; 194:220. [PMID: 35201429 DOI: 10.1007/s10661-022-09770-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 01/07/2022] [Indexed: 06/14/2023]
Abstract
Onchocerciasis is a disease transmitted by blackfly vector of the genus Simuliumdamnosum complex having public and socio-economic consequences. The abundance of blackfly is directly linked to fluvial ecosystems in both tropical and non-tropical countries of the world. This study assessed the ecology of blackfly breeding sites in two tributaries of River Ogun located in Olokemeji and Lisa villages, Ogun State. A total of eighteen water samples were collected for physicochemical analysis during high rainfall (May, June and July), low rainfall (August, September and October) and dry season (November and December) with mean rainfall values of 163.17, 88.03 and 8.95 mm, respectively, in both tributaries. Physicochemical parameters such as temperature (oC), electrical conductivity (EC), pH, total solids (TS), dissolved oxygen (DO), biochemical oxygen demand (BOD), total suspended solids (TSS), hardness (H), sulphate (SO4), phosphate (PO4), alkalinity, acidity, nitrate (NO3) and total dissolved solids (TDS) were analysed using standard laboratory methods. Digestive enzymes were analysed using 1 g of frozen gut of Simulium larvae grounded with 20 ml of 0.067 g of potassium hydrogen and 20 ml of 0.1 M sodium reagent. A total of 766 and 482 samples of Simulium larvae were collected from Olokemeji and Lisa tributaries using Eppendorf tubes. The zooplanktons collected from Olokemeji and Lisa tributary were 904 and 802, while phytoplanktons collected from Olokemeji and Lisa tributary were 635 and 582 during the study period. Data obtained were analysed using both descriptive analysis and T-test. The results obtained for the physicochemical parameters were 28.7 °C, 137.5 µS/cm, 6.3, 248.1 mg/L, 58 mg/L, 108.8 mg/L, 90.8 mg/L, 2.24 mg/L, 2.24 mg/L, 30.76 mg/L, 42.35 mg/L, 1.99 mg/L, 2.07 mg/L and 2.55 mg/L for Temperature, EC, pH, TS, DO, BOD, TSS, H, SO4, PO4, alkalinity, acidity, NO3 and TDS, respectively. There were significant (p < 0.05) differences between the means of EC, pH, TS, TDS, TSS and hardness of Lisa tributary, and water samples were also viewed under an electron microscope for zooplanktons and phytoplanktons. The values of species diversity which were greater than 0.5 indicated that the species were abundant and evenly distributed. There were significant (p < 0.05) differences between the tributaries in all the digestive enzymes except amylase content. The regression analysis between TSS, nitrate, sulphate, phosphate, acidity, hardness, TS, pH and Simulium larvae abundance showed a positive correlation, R2 with values of 0.828, 0.994, 0.948, 0.933, 0.986, 0.997, 0.889 and 0.981, respectively. The R2 values between Simulium larvae abundance with phytoplanktons and rainfall have values of 0.868 at p < 0.01 and 0.911 at p < 0.05.
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Affiliation(s)
- Olusheyi Zaccheaus Ojekunle
- Department of Environmental Management and Toxicology, Federal University of Agriculture, Abeokuta, Ogun State, Nigeria
| | - Rotimi Olabode Esan
- Department of Environmental Management and Toxicology, Federal University of Agriculture, Abeokuta, Ogun State, Nigeria
| | - Mujeeb Adeyemi Balogun
- Department of Environmental Management and Toxicology, Federal University of Agriculture, Abeokuta, Ogun State, Nigeria
- Faculty of Science and Technology, University of the Basque Country, Basque, Spain
- College of Science and Technology, University of Bordeaux, Bordeaux, France
- Faculty of Sciences, University of Liège, Liège, Belgium
| | - Kehinde O Ademolu
- Department of Environmental Management and Toxicology, Federal University of Agriculture, Abeokuta, Ogun State, Nigeria
| | - Kayode Adesina Adegoke
- Department of Chemical Sciences, University of Johannesburg, Johannesburg, South Africa.
| | - Adewale Matthew Taiwo
- Department of Environmental Management and Toxicology, Federal University of Agriculture, Abeokuta, Ogun State, Nigeria
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13
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Otache AE, Ezenwosu IL, Ossai EN, Aniwada EC, Nwobi EA, Uzochukwu BSC. Health-related quality of life and associated factors among Onchocerciasis patients in southeast Nigeria: A cross-sectional comparative study. PLoS Negl Trop Dis 2022; 16:e0010182. [PMID: 35139077 PMCID: PMC8827426 DOI: 10.1371/journal.pntd.0010182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 01/19/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Onchocerciasis, a neglected tropical disease of public health importance, causes chronic morbidity and severe disability that may impact on health-related quality of life (HRQoL) of the infected people. This study assessed the HRQoL and associated factors among onchocerciasis patients in southeast Nigeria. METHODS This was a community-based cross-sectional comparative study. Using a multistage sampling technique, 340 onchocerciasis patients were selected and matched for age and gender with the healthy population in the same neighbourhood. The respondents were interviewed using the short-form-36 (SF-36) questionnaire to determine their HRQoL. WHO Disability Assessment Schedule 2.0 tool (WHODAS 2.0) was used to assess disability in persons with onchocerciasis. Means were compared with independent student t-test while Chi-square test was used to compare proportions. Also, correlation analysis and logistic regression were used in the analyses. RESULTS A significantly lower proportion of people living with onchocerciasis had a good quality of life when compared with the healthy subjects (69.4% vs 93.5%, p<0.001). Also, an inverse relationship was seen between disability and quality of life in the onchocerciasis group (r = -0.647, p<0.001). Predictors of poor quality of life among respondents with onchocerciasis were: respondents aged ≥48 years (AOR = 2.5, 95% CI: 1.4-5.0), those with some disability associated with onchocerciasis (AOR = 3.33, 95%CI: 1.4-5.0) and respondents who perceived themselves as a burden to people (AOR = 10, 95%CI: 2.5-20). CONCLUSION Onchocerciasis impacted negatively on HRQoL of persons with onchocerciasis when compared with the healthy population. The quality of life of persons affected with onchocerciasis reduces with increasing disability. There is the need to increase community awareness on onchocerciasis to ensure early diagnosis and prompt treatment as this will reduce disability among those affected with the disease thus enhancing their HRQoL.
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Affiliation(s)
- Adah E. Otache
- Department of Community Medicine, University of Nigeria Teaching Hospital, Enugu State, Nigeria
| | - Ifeyinwa L. Ezenwosu
- Department of Community Medicine, University of Nigeria Teaching Hospital, Enugu State, Nigeria
| | - Edmund N. Ossai
- Department of Community Medicine, College of Health Sciences, Ebonyi State University, Abakaliki, Nigeria
| | - Elias C. Aniwada
- Department of Community Medicine, University of Nigeria Teaching Hospital, Enugu State, Nigeria
| | - Emmanuel A. Nwobi
- Department of Community Medicine, University of Nigeria Teaching Hospital, Enugu State, Nigeria
| | - Benjamin SC. Uzochukwu
- Department of Community Medicine, University of Nigeria Teaching Hospital, Enugu State, Nigeria
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14
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Mushi V. Implementation Challenges of Community Directed Treatment with Ivermectin Program for Control of Onchocerciasis in Ulanga, Tanzania. East Afr Health Res J 2022; 5:123-128. [PMID: 35036836 PMCID: PMC8751475 DOI: 10.24248/eahrj.v5i2.661] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 11/01/2021] [Indexed: 11/22/2022] Open
Abstract
Background: Community drug distributors (CDDs) have a crucial role in distributing ivermectin for onchocerciasis control and prevention. Their roles, experiences and challenges faced in the implementation of community-directed treatment with ivermectin (CDTI) programme could potentially affect coverage, consequently leading to persistent transmission. Therefore, this study aimed to explore the experience and the roles which CDDs plays in implementation of community directed treatment with ivermectin program for onchocerciasis control in Ulanga, Tanzania. Methods: A cross-sectional study design was used to collect qualitative data in 2018 in Ulanga district, Tanzania. Five community drug distributors were purposively selected for in-depth interviews. Thematic framework approach for qualitative data analysis was used to generate codes, categories and themes. Results: Out of the five community drug distributors interviewed, two had experience of 15 to 20 years on implementation of the community directed treatment with ivermectin programme while the remaining community drug distributors had experience of less than 10 years. The main challenges faced by CDDs in the implementation of the CDTI programme include; the geographical location of the hamlets (hard to reach hamlets), long distances between houses, low compliance of community members to medication due to fear of side effects experienced before and mistrust of methods of dose calculation, short time of drug distribution and absence of people from their households as the exercise was conducted when community members were involved in agricultural activities. Conclusions: The challenges faced in the implementation of the CDTI programme could negatively affect the distribution and coverage of ivermectin treatment in the Ulanga district. It's now an opportune time to address the challenges that CDDs are facing in the implementation of the CDTI programme to ensure effective control of onchocerciasis in the district.
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Affiliation(s)
- Vivian Mushi
- Department of Parasitology and Medical Entomology, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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15
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Antischistosomal, antionchocercal and antitrypanosomal potentials of some Ghanaian traditional medicines and their constituents. PLoS Negl Trop Dis 2020; 14:e0008919. [PMID: 33382717 PMCID: PMC7810346 DOI: 10.1371/journal.pntd.0008919] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 10/26/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Ghana is endemic for some neglected tropical diseases (NTDs) including schistosomiasis, onchocerciasis and lymphatic filariasis. The major intervention for these diseases is mass drug administration of a few repeatedly recycled drugs which is a cause for major concern due to reduced efficacy of the drugs and the emergence of drug resistance. Evidently, new treatments are needed urgently. Medicinal plants, on the other hand, have a reputable history as important sources of potent therapeutic agents in the treatment of various diseases among African populations, Ghana inclusively, and provide very useful starting points for the discovery of much-needed new or alternative drugs. METHODOLOGY/PRINCIPAL FINDINGS In this study, extracts of fifteen traditional medicines used for treating various NTDs in local communities were screened in vitro for efficacy against schistosomiasis, onchocerciasis and African trypanosomiasis. Two extracts, NTD-B4-DCM and NTD-B7-DCM, prepared from traditional medicines used to treat schistosomiasis, displayed the highest activity (IC50 = 30.5 μg/mL and 30.8 μg/mL, respectively) against Schistosoma mansoni adult worms. NTD-B2-DCM, also obtained from an antischistosomal remedy, was the most active against female and male adult Onchocera ochengi worms (IC50 = 76.2 μg/mL and 76.7 μg/mL, respectively). Antitrypanosomal assay of the extracts against Trypanosoma brucei brucei gave the most promising results (IC50 = 5.63 μg/mL to 18.71 μg/mL). Incidentally, NTD-B4-DCM and NTD-B2-DCM, also exhibited the greatest antitrypanosomal activities (IC50 = 5.63 μg/mL and 7.12 μg/mL, respectively). Following the favourable outcome of the antitrypanosomal screening, this assay was selected for bioactivity-guided fractionation. NTD-B4-DCM, the most active extract, was fractionated and subsequent isolation of bioactive constituents led to an eupatoriochromene-rich oil (42.6%) which was 1.3-fold (IC50 <0.0977 μg/mL) more active than the standard antitrypanosomal drug, diminazene aceturate (IC50 = 0.13 μg/mL). CONCLUSION/SIGNIFICANCE These findings justify the use of traditional medicines and demonstrate their prospects towards NTDs drug discovery.
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Gebrezgabiher G, Mekonnen Z, Yewhalaw D, Hailu A. Status of parasitological indicators and morbidity burden of onchocerciasis after years of successive implementation of mass distribution of ivermectin in selected communities of Yeki and Asosa districts, Ethiopia. BMC Public Health 2020; 20:1233. [PMID: 32787813 PMCID: PMC7425055 DOI: 10.1186/s12889-020-09344-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 08/04/2020] [Indexed: 11/23/2022] Open
Abstract
Background Control and elimination of onchocerciasis requires regular follow-up and evaluation of community directed treatment with ivermectin (CDTi) program implementation. This research was aimed to assess the epidemiological status of onchocerciasis in disease endemic communities of Asosa and Yeki districts of Ethiopia after 5 and 15 years of successive CDTi respectively, and to evaluate the decline in infection and morbidity burden. Methods A community-based cross-sectional study was conducted from August 2017 to January 2018 (i.e. within 2–7 months since the last treatment) using interview, physical and parasitological examinations. Pre-CDTi epidemiological data were obtained from studies conducted prior to the launch of CDTi. Results A total of 3002 individuals (1567 from Asosa and 1435 from Yeki) were included. No infection was detected from Yeki. In Asosa, the prevalence of infection was 1.6%. The geometric mean intensity of infection was 0.02 mf/mg of skin snip. The prevalence rates of dermatitis, depigmentation, nodule, and atrophy in Yeki were 33(2.3%), 57(4%), 37(2.6%) and 11(0.7%), respectively. The prevalence rates of papular dermatitis, depigmentation, palpable nodule, atrophy, and blindness in Asosa were 94(6%), 38(2.4%), 30(1.9%), 28(1.8%) and 2(0.1%), respectively. Five years of CDTi had significantly reduced prevalence and intensity of infection by 91.8% (p < 0.001) and 99.7% (p < 0.001), respectively. Moreover, CDTi reduced prevalence of papular dermatitis by 95.9% (p < 0.001), palpable nodule by 90.5% (p < 0.001), and atrophy by 30% (p = 0.6) in Yeki. Similarly, CDTi reduced prevalence of papular dermatitis by 88.6% (p < 0.001), depigmentation by 90.3% (p < 0.001), atrophy by 89.5% (p < 0.001), and blindness by 90% (p < 0.001) in Asosa. Conclusions Fifteen years of successive CDTi had brought the infection from high to zero in Yeki. However, thorough entomological and serological data need to be generated to ascertain whether complete interruption of parasite transmission has been attained, and for considerations of an evidence-based CDTi cessation. Five years of CDTi in Asosa has significantly reduced the infection and morbidity of onchocerciasis to very low level. We, hereby, recommend biannual CDTi to continue in Asosa and its surroundings until the infection transmission is fully interrupted.
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Affiliation(s)
- Gebremedhin Gebrezgabiher
- College of Veterinary Medicine, Samara University, P.O. Box 132, Samara, Ethiopia. .,School of Medical Laboratory Sciences, Institute of Health Sciences, Jimma University, Jimma, Ethiopia.
| | - Zeleke Mekonnen
- School of Medical Laboratory Sciences, Institute of Health Sciences, Jimma University, Jimma, Ethiopia
| | - Delenasaw Yewhalaw
- School of Medical Laboratory Sciences, Institute of Health Sciences, Jimma University, Jimma, Ethiopia.,Tropical and Infectious Diseases Research Center, Jimma University, Jimma, Ethiopia
| | - Asrat Hailu
- Department of Microbiology, Immunology, and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Otabil KB, Gyasi SF, Awuah E, Obeng-Ofori D, Tenkorang SB, Kessie JA, Schallig HDFH. Biting rates and relative abundance of Simulium flies under different climatic conditions in an onchocerciasis endemic community in Ghana. Parasit Vectors 2020; 13:229. [PMID: 32375902 PMCID: PMC7204027 DOI: 10.1186/s13071-020-04102-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 04/27/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Knowledge of the relative abundance and biting rates of riverine blackflies (vectors of onchocerciasis) is essential as these entomological indices affect transmission of the disease. However, transmission patterns vary from one ecological zone to another and this may be due to differences in species of blackfly vectors and the climatic conditions in the area. This study investigated the effects of climate variability on the relative abundance and biting rates of blackflies in the Tanfiano community (Nkoranza North District, Bono East Region, Ghana). Such information will help to direct policy on effective timing of the annual mass drug administration of ivermectin in the area. METHODS The study employed human landing collections and locally built Esperanza window traps to collect blackflies from March 2018 to February 2019. The relative abundance and biting rates of the Simulium vectors as well as the monthly climatic conditions of the study area were monitored. Correlation analysis and Poisson regression were used to establish the relationships between the variables. RESULTS The relative abundance and biting rates of the Simulium vectors were highest in the drier months of March, April and August, characterized by high temperatures, low humidity, longer hours of sunshine and stronger winds. The rainy months of May, June and July, characterized by low temperatures, high humidity, few hours of sunshine and weaker winds, had relatively low blackfly abundance and biting activity. Correlation analysis showed that only temperature was significantly, positively correlated with the relative abundance of blackflies (r = 0.617, n = 12, P = 0.033) and monthly biting rates (r = 0.612, n = 12, P = 0.034). A model to predict relative abundance and monthly biting rates using climatological variables was developed. CONCLUSIONS This study demonstrated that Simulium species in the study area preferred higher temperature, lower humidity and rainfall, more hours of sunshine and relatively stronger winds for survival. It is thus recommended that for the study district and others with similar climatological characteristics, mass drug administration of ivermectin should take place in April and September when the abundance of vectors has begun to decline after peaking.
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Affiliation(s)
- Kenneth Bentum Otabil
- Department of Basic and Applied Biology, School of Sciences, University of Energy and Natural Resources, Sunyani, BA, Ghana. .,Experimental Parasitology Unit, Department of Medical Microbiology, Academic Medical Centre, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
| | - Samuel Fosu Gyasi
- Department of Basic and Applied Biology, School of Sciences, University of Energy and Natural Resources, Sunyani, BA, Ghana
| | - Esi Awuah
- Department of Civil Engineering, Kwame Nkrumah University of Science and Technology, Kumasi, AR, Ghana
| | - Daniels Obeng-Ofori
- Office of the Vice Chancellor, Catholic University College of Ghana, Sunyani, BA, Ghana
| | - Seth Boateng Tenkorang
- Faculty of Health and Allied Sciences, Koforidua Technical University, Koforidua, ER, Ghana
| | - Justice Amenyo Kessie
- Department of Mathematics and Statistics, University of Energy and Natural Resources, Sunyani, BA, Ghana
| | - Henk D F H Schallig
- Experimental Parasitology Unit, Department of Medical Microbiology, Academic Medical Centre, Amsterdam University Medical Centers, Amsterdam, The Netherlands
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