Filarial hydrocele is the most common chronic manifestation of lymphatic filariasis (LF) and poses a major public health burden to several filarial endemic countries. This review highlights the socio-economic impact of the disease, the role of the immune system in hydrocele development, current diagnostic approaches, and the control and management of filarial hydrocele. In the quest to facilitate the global effort to eliminate filarial hydrocele as a neglected tropical disease, a more comprehensive understanding of the mechanisms underlying the pathogenesis and development of the condition is important. In general, success has been achieved using annual treatment with ivermectin, but much remains to be done, particularly with late-stage infected individuals where surgery remains the only option. Studies have successfully demonstrated that inhibition of embryogenesis in adult female worms occurs after weeks of tetracycline treatment. Even more intriguing was the observation that the Wolbachia endosymbionts potently induce proinflammatory cytokines such as tumor necrosis factors (TNFs) and vascular endothelial growth factors (VEGFs), which are crucial for the development of filarial hydrocele. Furthermore, reports from human studies show that doxycycline treatment significantly ameliorates filarial hydrocele and markedly reverses early-stage filarial hydrocele. However, with the enormous challenges that face LF elimination such as global funding, logistics, civil wars, and drug resistance, a more relentless and collective approach from local governments as well as other stakeholders is needed to accelerate the fight against filarial hydrocele if the goal to eliminate it by 2020 is be to achieved.

Background -Glaucoma is an important eye disease that causes blindness with a frequency second only to blindness due to cataracts. Early detection of the condition is critical to preventing irreversible blindness in those affected. Objective -The purpose of this study was therefore to determine the prevalence of glaucoma in an eye clinic in Ghana, West Africa and help raise awareness of the situation on the ground. Methods and Results -The study is a retrospective study of the Out-Patient Department morbidity of glaucoma at the Emmavick Eye Clinic in Sunyani, Ghana spanning a period of 35 months. The study included patients visiting the clinic for the first time. The diagnostics tools used included tonometry, ophthalmoscopy (examination of optic disc) and perimetry. Out of a total of 5828 patients seen over the study period, 460 (7.89%) subjects presented with glaucoma. The prevalence of glaucoma in female Adults was 9.52% whilst that of male adults was 8.77%. The prevalence of glaucoma in children was 1.41%. Conclusion -The result of the present study affirms the fact that glaucoma is more prevalent in the adult population than in the younger population. This situation has a huge toll on the economy of developing countries like Ghana where there is need of much human resource to drive the advance toward highincome status. Mass education and screening is needed to identify affected individuals for early treatment and inform the populace about the insidious nature of glaucoma and its potential to irreversibly impair vision in affected individuals.

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.