Status of forest onchocerciasis in the Lower Cross River Basin, Nigeria: Change in clinical and parasitological indices after 6 years of ivermectin intervention

Opara, Kenneth Nnamdi; Fagbemi, Benjamin O.; Atting, I; Oyene, Ukam Ebe; Okenu, Daniel M. N.

doi:10.1016/j.puhe.2006.09.010

Cited by 5 publications

(10 citation statements)

References 6 publications

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“…The differences among the villages could be due to differences in their therapeutic coverage and compliance rate. This decrement in prevalence of the microfilaria was in agreement with a study conducted in the lower cross river basin of Nigeria [ 12 ], which had nearly a comparable therapeutic coverage with the current study area, had annual treatment schedule and also conducted after six years of intervention. Similar effects were also observed in Yanomami communities in the Brazilian Amazon [ 13 ], and other studies [ 14 ], [ 15 ] and [ 16 ].…”

Section: Discussionsupporting

confidence: 91%

“…Therefore a reduction in prevalence was expected. So, a study conducted in Nigeria[ 12 ] was considered for the assumption because, one, the prevalence at the baseline was 74% which was comparable to the prevalence in the study area at the baseline, second, the study was conducted after six years of the intervention again which was similar to the current study and the therapeutic coverage was almost comparable with the current study area, therefore like this study a 35.9% reduction from the pre intervention prevalence was assumed Threfore, P for this study was 48% (0.48).…”

Section: Methodsmentioning

confidence: 99%

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Impact of Six Years Community Directed Treatment with Ivermectin in the Control of Onchocerciasis, Western Ethiopia

et al. 2016

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BackgroundThe African Program for Onchocerciais Control (APOC) with a main strategy of community directed treatment with ivermectin (CDTI) was established with the aim of eliminating Onchocerciasis as a disease of public health and socio-economic importance. The study area was a hyper endemic area just before the implementation of CDTI. It has been implemented for six years in this district but yet not been evaluated. So, the objective of this study was to evaluate the impact of six years CDTI on parasitological and clinical indices of OnchocerciasisMethodsThis study employed a pre-post impact evaluation design. The minimum sample size for this study was 1318; the respondents were selected by multi-stage sampling technique. Data on socio-demographic characteristics using a semi-structured questionnaire, clinical examination for skin signs and symptoms of Onchocerciasis and two bloodless skin snips from each side of the gluteal fold were taken from the entire study participants. SPSS version 16.0 and Medcalc version 12.2.1.0 were used for analysis.ResultThe microfilaridermia reduced from the pre-intervention value of 74.8% to 40.7%, indicating a 45.6% reduction, mean intensity from 32.1(SD = 61.5) mf/mg skin snip to 18.7(SD = 28.7)indicating 41.75% reduction, CMFL from 19.6 mf/mg skin snip to 4.7 indicating 76% reduction. The result also showed that microfilaridermia and mean intensity decreased as the number of treatment taken increased. Pruritis, leopard skin, onchocercomata and hanging groin reduced by 54.4%, 61.3%, 77.7% and 88.5% respectively.ConclusionsThe implementation of CDTI significantly reduced the parasitological and clinical indices of Onchocerciasis, so, efforts should be made to improve the annual treatment coverage and sustainability of CDTI to drastically reduce the micro filarial load to the level the disease would no longer be a public health problem.

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Section: Discussionsupporting

confidence: 91%

Section: Methodsmentioning

confidence: 99%

Impact of Six Years Community Directed Treatment with Ivermectin in the Control of Onchocerciasis, Western Ethiopia

et al. 2016

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“…Another crucial factor could be lack of close monitoring of drug treatment and distribution by community -directed distributors (CDD) often occasioned by technical and logistic limitations in their ability to deliver interventions [1,2,5,18]. It has been equally suggested that poor compliance to treatment may not be unrelated to long treatment duration (10 -15 years), interval between doses (one year) that can easily be forgotten and thus missed, adverse events in ivermectin treatment often leading to rejection of treatments by communities [1, 3,6]. Reinvasion caused by limited treatment coverage area has also been implicated in low CDTI programme success [15,17,19].…”

Section: Communitymentioning

confidence: 99%

“…Other factors reported by respondents include dislike for the drugs (3.4%) and fear of ivermectin-related adverse reactions (9.3%) were in agreement with [15,16] that reported fear of adverse reaction as reason for noncompliance with intake of the drugs. Adverse events in ivermectin treatment have also been acknowledged to lead to rejection of treatments by communities [1, 3,6]. Thus this could limit treatment coverage and impact on possible reinvasion and perpetuate onchocerciasis endemic status of the study community.…”

Section: Major Themementioning

confidence: 99%

“…An estimated 25 million people were infected with about 1.3 million people visually impaired or blind as a result of the disease [1,2]. Nigeria is estimated to bear a significantly high burden of the disease with 32 endemic states including Cross River State [3,4]. In Cross River State, almost all the 18 local government areas (LGAs) are endemic for the disease and the prevalence was estimated to be 10% in 2012 [5], which may be gross underestimation given lack of credible population data.…”

Section: Introductionmentioning

confidence: 99%

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Perception, Awareness and Treatment Experiences about Onchocerciasis in a Rural Community in Cross River State, Nigeria: Implications for Control

Ejemot-Nwadiaro

E.ugobo

Nwachuku

et al. 2019

AJMAH

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Background: Onchocerciasis a disease of poverty continues to place huge health, economic and social burden on communities at risk. Understanding critical factors that impact on access to treatment, acceptance and overall control measures are pivotal to the march towards its elimination. Objective: To assess Onchocerciasis perception and treatment experiences in a rural community in Cross River State, Nigeria. Methodology: A cross-sectional descriptive study using mixed method was undertaken. Data were collected using pretested questionnaire and in-depth interview guide. Quantitative data were Ejemot-Nwadiaro et al.; AJMAH, 16(2): 1-14, 2019; Article no.AJMAH.50720 2 analysed using SPSS while the in-depth interviews were audio taped, transcribed verbatim and thematic analysis done. Findings were presented in frequencies, charts, percentages, tables and quotes. Tests of significance were determined using Chi-square ( 2 ) at significance level of 5%. Results: Ignorance, myths and negative perception about the cause of Onchocerciasisas pervade in 64 (31.2%) of the respondents that did not know that the bite of infected Blackfly is the cause. Some attributed the disease to curse from the gods (45.3%) and witchcraft (23.4%). This poor knowledge is associated with lower highest attained level of education (p =0.01). Non-availability of drugs (23.9%) and lack of knowledge on where to access ivermectin (9.8%) were the major challenges to ivermectin uptake. Inequity in treatment access was identified from the thematic analysis. Conclusion: Poor knowledge of the cause of the disease, non-availability of ivermectin and misconceptions about cause of onchocerciasis had negative influence on health-seeking behaviors, discriminatory practices and treatment coverage. By integrating contextual knowledge awareness creation about Onchocerciasis into the design of control strategies will facilitate the vantage march towards achieving elimination target. Original Research Article

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Learning from global public health experience: Something else to get lost in translation?

Mackie¹,

Sim²

2007

Public Health

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Status of forest onchocerciasis in the Lower Cross River Basin, Nigeria: Change in clinical and parasitological indices after 6 years of ivermectin intervention

Cited by 5 publications

References 6 publications

Impact of Six Years Community Directed Treatment with Ivermectin in the Control of Onchocerciasis, Western Ethiopia

Impact of Six Years Community Directed Treatment with Ivermectin in the Control of Onchocerciasis, Western Ethiopia

Perception, Awareness and Treatment Experiences about Onchocerciasis in a Rural Community in Cross River State, Nigeria: Implications for Control

Learning from global public health experience: Something else to get lost in translation?

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