Onchodermatitis: Where Are We Now?

Abstract

Onchocerciasis causes debilitating pruritus and rashes as well as visual impairment and blindness . Prior to control measures, eye disease was particularly prominent in savanna areas of sub-Saharan Africa whilst skin disease was more common across rainforest regions of tropical Africa. Mass drug distribution with ivermectin is changing the global scene of onchocerciasis. There has been successful progressive elimination in Central and Southern American countries and the World Health Organization has set a target for elimination in Africa of 2025. This literature review was conducted to examine progress regarding onchocercal skin disease. PubMed searches were performed using keywords "onchocerciasis", "onchodermatitis" and "onchocercal skin disease" over the past eight years. Articles in English, or with an English abstract, were assessed for relevance, including any pertinent references within the articles. Recent progress in awareness of, understanding and treatment of onchocercal skin disease is reviewed with particular emphasis on publications within the past 5 years. The global burden of onchodermatitis is progressively reducing and is no longer seen in children in many formerly endemic foci.

From river blindness to river epilepsy: Implications for onchocerciasis elimination programmes

“…Major progress has been made concerning the control of onchocerciasis, initially by the OCP (1974–2002) and subsequently by the African Programme for Onchocerciasis Control (APOC, 1995–2015) and the Onchocerciasis Elimination Program for the Americas (OEPA, 1993–ongoing) [14]. New cases of blindness and severe skin disease are rare except in conflict zones, where instability has had a detrimental impact on programmes’ performance, and in areas of difficult access [15]. CDTI has indeed been very successful in many areas, and since 2010, the paradigm of onchocerciasis control has shifted to that of elimination [16].…”

Review of the National Program for Onchocerciasis Control in the Democratic Republic of the Congo

“…APOC reported that the DRC is a global reservoir of onchocerciasis [28] in which almost 38 million people are at risk [11], of whom approximately 13 million were affected in 2013; the number of people blinded was estimated at 70 thousand [17,28,29,30]. The most recently available data in the 2016 study Global Burden of Disease (GBD) estimated a global prevalence of 14.65 million [2] people, including 12.22 million suffering from the skin disease and 1.03 million cases of sight loss due to onchocerciasis [2]. Onchocerciasis is the third most common cause of blindness in the DRC after cataracts and glaucoma [11].…”

“…Onchocerciasis, also known as river blindness, volvulosis, or Robles disease, is a cutaneous filariasis [1], caused by the filarial nematode Onchocerca volvulus [2]. The worm infests the skin and eyes and is transmitted from an infected individual to a healthy individual via the bite of an infected black fly, belonging to the Simuliidae family [3].…”

<p>Onchocerciasis Elimination: Progress and Challenges</p>

“…32 These guidelines are expected to be revised by WHO in 2020, but it is clear that progress towards onchocerciasis elimination effort would benefit enormously by newer, more sensitive and specific diagnostic tests to verify that transmission of infection has been suppressed or interrupted. 71 volvulus in all elimination programs. 32 The serological threshold for stopping MDA is an Ov16 antibody prevalence of <0.1% among children aged 5-9 years (inclusive) who act as sentinels for recent infection.…”