Onchocerciasis control in Ghana (1974–2016)

Abstract

Background The control of onchocerciasis in Ghana started in 1974 under the auspices of the Onchocerciasis Control Programme (OCP). Between 1974 and 2002, a combination of approaches including vector control, mobile community ivermectin treatment, and community-directed treatment with ivermectin (CDTI) were employed. From 1997, CDTI became the main control strategy employed by the Ghana OCP (GOCP). This review was undertaken to assess the impact of the control interventions on onchocerciasis in Ghana between 1974 and 2016, since which time the focus has changed from control to elimination. Methods In this paper, we review programme data from 1974 to 2016 to assess the impact of control activities on prevalence indicators of onchocerciasis. This review includes an evaluation of CDTI implementation, microfilaria (Mf) prevalence assessments and rapid epidemiological mapping of onchocerciasis results. Results This review indicates that the control of onchocerciasis in Ghana has been very successful, with a significant decrease in the prevalence of infection from 69.13% [95% confidence interval) CI 60.24–78.01] in 1975 to 0.72% (95% CI 0.19–1.26) in 2015. Similarly, the mean community Mf load decreased from 14.48 MF/skin snip in 1975 to 0.07 MF/skin snip (95% CI 0.00–0.19) in 2015. Between 1997 and 2016, the therapeutic coverage increased from 58.50 to 83.80%, with nearly 100 million ivermectin tablets distributed. Conclusions Despite the significant reduction in the prevalence of onchocerciasis in Ghana, there are still communities with MF prevalence above 1%. As the focus of the GOCP has changed from the control of onchocerciasis to its elimination, both guidance and financial support are required to ensure that the latter goal is met.

Occurrence of Onchocerciasis infection after decades of mass drug administration in the Western North Region of Ghana: The case of Sefwi Akontombra district

“…Despite more than 40 years of concerted control efforts leading to signi cant reduction in onchocerciasis MF prevalence, the disease which has potentially severe impacts on the eyes and skin still remains endemic in some districts in Ghana as reported recently by Biritwum et al, [10]. This present study is the rst in determining the impact of MDA on the prevalence of onchocerciasis and its associated clinical manifestations in Sefwi Akontombra, a mesoendemic district in Ghana.…”

“…100 million IVM tablets distributed between 1997 and 2016. The review also revealed that the nodule and MF prevalence in the Western Region as at 2008 was 2.89% and 3.57% respectively [10].…”

“…A recent review on onchocerciasis control in Ghana (1974-2016) by Biritwum et al, showed that there has been a signi cant decrease in the prevalence of the infection from 69.13% in 1975 to 0.72% in 2015 [10].…”

“…100 million IVM tablets distributed between 1997 and 2016. The review also revealed that the nodule and MF prevalence in the Western Region as at 2008 was 2.89% and 3.57% respectively [10].However, data on the current prevalence of onchocerciasis in the Western North region (formerly part of Western region) since the inception of MDA to ght against the infection is scanty, obsolete and not robust. Also, there has not been any reported data on the prevalence of onchocerciasis in the Sefwi Akontombra district (formerly under the Sefwi Wiawso district) since its creation and subsequently an evaluation of the impact of MDA in eliminating the infection from the district.…”

Demographic patterns of human antibody levels to Simulium damnosum s.l. saliva in onchocerciasis-endemic areas: An indicator of exposure to vector bites

“…Villages were selected on the criteria that (a) there was evidence of exposure to S. damnosum s. l. vector bites [30,42], (b) they were under current ivermectin treatment as part of the national onchocerciasis control programme [43], (c) the villages comprised >200 residents, and (d) the villages represented variable ABRs based on previous records [30,42]. Five villages were selected; due to the proximity of two of the villages, these were grouped into a single cluster (Asubende and Senyase (ASU/SEN) resulting in four village clusters.…”