ABSTRACT
A cross-sectional study was carried out in four farming communities in
Aniocha North Local Government Area of Delta State of Nigeria, Idumuogo,
Ogodor, Anioma and Ubulubu – between November 2008 and March 2009.
The study was carried out to determine the current status of
Onchocerciasis in the communities, through the study of the clinical
manifestations of the disease and socio-economic effects on the sufferers, and
to connect on the ongoing control measures with ivermectin in the area.
A total of 450 subjects were selected for examination for clinical
manifestation of Onchocerciasis. 140 (31.1%) males, and 104 (23.1%) females
were found to be infected with one or two clinical manifestations. Although
infections were found in all age groups, it occurred mostly in older groups.
Various rates of clinical manifestation were recorded thus: leopard skin 106
(24%), Onchocercal nodules 32 (7.1%), Onchodermatitis 51 (11.3%), itching 50
(11.1%) and impaired vision 18 (4.0%) with Idumuogo and Ubulubu, having the
highest infections rates of 114 (25.3%) and 76 (16.9%) respectively. Males were
significantly more infected than females (X2 = 176.4, df = 24,
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CHAPTER ONE
INTRODUCTION
Onchocerciasis, also
known as “river blindness” is a disease caused by a nematode filarial worm. Onchocerca
volvulus, and is transmitted through the bites of an infected female
blackfly (Similium species). The manifestations of onchocerciasis
are predominantly dermal,
lymphatic and ocular in character. Dermal,
manifestation include pruritis, lesions (papules, macules, urticaria, oedema,
excoriatia pustules,
crusts, scaling ulceration, lichenification, pachydermia, Atrophy, pigmentary
change leopard skin and others) Nodules, lymphatic manifestations
are in form of lymphadenopathy, lyphoedema and Hanging groin.
Ocular damages affect
the conjunctiva, cornea, lens in form of cataract, Retina in form of pigment
epithelial atrophy, cotton wool spots and Haemorrhages choroid and optic nerves
in form of optic neuritis and optic atrophy (WHO, 1995).
Worldwide onchocerciasis
is second to trachoma as a leading cause of blindness of infectious origin
(Thylefors et al 1995). More than 100 million people worldwide are at
risk of infection, 18 million people are infected, 800,000 people are visually
impaired, 270,000 people are already blind, 3.3 million of the people
reside in Nigeria, where it is still regarded as a public health problem (WHO,
1995). Blindness which is the ultimate consequence of onchocerciasis renders
the productive segment of the community unproductive, and
dependent on others. Also most fertile lands have been abandoned because of this
disease, (Okolo et al, 2004).
Onchocerciasis
in Nigeria is transmitted solely by members of the Similium damnosum complex.
They are widespread in the savanna forest, savanna mosaic and rainforest
areas of Nigeria. S. damnosum, which breeds in large streams and rivers
in the woody and open country side,
has been known to be common in the rocky sections of the river Niger and its
tributaries (Eneanya and Nwaorgu, 2001). Maikaje et al (2008) also found S. damnosum breeding
along River Muvur and Uba, to habour infective Onchocerca volvulus
microfilarae. In Mubi North and Hong Local Government Areas of Adamawa State.
Okonkwo et al (1991) found S. damonsum breeding
along the Oji River of Enugu State. Nwoke et al (1998) also carried out
epidemiological studies of human onchocerciasis in rivers of Katsina Ala
(tributary of Benue) Anambra and Oji Rivers (tributaries of River Niger), the
Cross River and Imo River, the costal areas of Rivers, Akwa-Ibom and Cross River
States. The exposure of those rocks in the beds or side margins of these fast
flowing rivers as well as numerous trailing vegetation create favourable
breeding sites for Similium
damnosum complex. All these reports indicate that fast flowing river,
rivulets and streams, favours the breeding of blackfly.
A Rapid Epidemiological
Mapping of Onchocerciasis carried out in nine sentinel villages in Edo/Delta
(Okhoromi, Ugbokogbe, Oke, Ovao, Ekilor, Eko-Ibadan, Idumuogo, Agbor Alidinma
and Igbogili) recorded a prevalence
of 40.4% of microfilaria infection, 18.9% of nodules and 7.7% of leopard skin,
led to choosing Delta State as an endemic state with sufficiently
important public health problem to warrant community wide ivermectin treatment,
where the prevalence of microfilaria is greater than 40%, (WHO, 1991). Offor et al (1998)
trapped blackflies exposed on human legs between 0600 hours and 18 hours local
time in Okpanam (River Awai) and Ogwashuku (River Mgbiligba) of Delta State and blackflies
were likely forest S. yahense.
The aim of the present
study is to determine the current status of onchocerciasis in selected
communities in Aniocha North Local Government Area of Delta State.
The
specific objectives include:
1.
To define the prevalence of onchocercal nodules
in the communities
2.
To define the prevalence of dermatitis in the
communities.
3.
To define prevalence of leopard skin in the
communities and other clinical manifestations in the communities. It is hoped
that the result will provide useful information on the success of the ongoing
control programme with ivermectin in these areas.
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