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Onchocerciasis

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Neglected Tropical Diseases - Sub-Saharan Africa

Part of the book series: Neglected Tropical Diseases ((NTD))

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Abstract

Onchocerciasis, a dermic filariasis, is caused by the nematode Onchocerca volvulus. The disease is found in 30 African countries between latitudes 15° N and 14° S. About 37 million people are infected, 500,000 of whom are severely visually impaired. Worldwide, onchocerciasis is a very important infectious cause of blindness, being second only to trachoma in numbers of persons affected. Transmitted by a vector, Simulium damnosum, the adult parasite lives up to 14 years in humans producing millions of microfilaria which are responsible for the pathology of the disease. The disease presents as pruritus; onchodermatitis, including acute and chronic papular dermatitis; eye lesions of sclerosing keratitis and iridocyclitis; optic nerve disease; optic atrophy and choroidoretinitis; and in the worst case as blindness. There is evidence of protective immunity in onchocerciasis which could be at play in these lesions. Onchocerciasis is responsible for 1.49 million (disability-adjusted life years) DALYs annually, while troublesome itching accounts for 60 % of DALYs attributable to onchocerciasis. Individual diagnosis depends on symptomatology and parasitological tests, while community diagnosis is made through rapid epidemiological mapping which involves nodule palpation. Larviciding was used successfully for control in the West African Onchocerciasis Programme, while the African Programme for Onchocerciasis Control and Partners drive the control through community-directed treatment with ivermectin in the rest endemic African countries. Recent results which showed that the disease might have been eliminated in certain foci in Africa have informed the current paradigm change from control to the elimination of the disease. The prospects of elimination would imply extending operations beyond the currently covered areas, with the attendant management, financial, and logistic challenges. Some challenges of onchocerciasis control include (a) finding the optimum diagnostic tool, (b) how to minimize noncompliance with the drug treatment, (c) the best approach to obtain sustainability of the drug distribution program, (d) discovering an acceptable macrofilaricide which can either kill or sterilize the adult, (e) how to optimize treatment regime of possible antibiotic used to eliminate Wolbachia, and (f) how to discover early, any resistance to the current drug. All these require research which has always been central to the two control programs.

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Authors and Affiliations

  1. Insititute of Parasitology, McGill University and Lymphatic Filariasis Support Centre for Africa, CT 1380, Accra, Ghana

    Boakye A. Boatin

  2. Independent Condsultant, Main Post Office, Okpara Avenue, 3397, Enugu, Enugu State, Nigeria

    Uche Amazigo

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  1. Boakye A. Boatin
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  2. Uche Amazigo
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Correspondence to Boakye A. Boatin .

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  1. Ofc of Research, Innovation & Dev, University of Ghana, Accra, Ghana

    John Gyapong

  2. Lymphatic Filariasis Support Centre, University of Ghana, Accra, Ghana

    Boakye Boatin

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Boatin, B.A., Amazigo, U. (2016). Onchocerciasis. In: Gyapong, J., Boatin, B. (eds) Neglected Tropical Diseases - Sub-Saharan Africa. Neglected Tropical Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-25471-5_9

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