TY - JOUR
T1 - Persistence of onchocerciasis and associated dermatologic and ophthalmic pathologies after 27 years of ivermectin mass drug administration in the middle belt of Ghana
AU - Otabil, Kenneth Bentum
AU - Basáñez, María-Gloria
AU - Ankrah, Blessing
AU - Opoku, Stephen Agyemang
AU - Kyei, Dennis Ofori
AU - Hagan, Rhoda
AU - Ababio, Richmond
AU - Bart-Plange, Emmanuel John
AU - Babae, Theophilus Nti
AU - Kudzordzi, Prince-Charles
AU - Darko, Vera Achiaa
AU - Bamfo, Joseph G.
AU - Ameyaw, Joseph
AU - Raji, Abdul Sakibu
AU - Hadermann, Amber
AU - Schallig, Henk D. F. H.
AU - Colebunders, Robert
N1 - Funding Information:
We thank all the staff and students of the Department of Biological Science and the Centre for Research in Applied Biology at the University of Energy and Natural Resources in Ghana who provided support in one way or the other to ensure the successful implementation of this research. We also appreciate the efforts of the directors and staff of the Tain District, Wenchi Municipal Health Directorate and the Subinso Health Centre for their invaluable contributions towards the study. Our appreciation also goes to the chiefs and people of the study communities who partnered with us in this study. This research was partially supported by a small grant awarded to Kenneth Bentum Otabil by the Royal Society of Tropical Medicine and Hygiene/National Institute of Health Research, UK. María‐Gloria Basáñez acknowledges funding from the MRC Centre for Global Infectious Disease Analysis (MR/R015600/1), jointly funded by the UK Medical Research Council (MRC) and the UK Foreign, Commonwealth & Development Office (FCDO), under the MRC/FCDO Concordat agreement and is also part of the EDCTP2 programme supported by the European Union.
Funding Information:
We thank all the staff and students of the Department of Biological Science and the Centre for Research in Applied Biology at the University of Energy and Natural Resources in Ghana who provided support in one way or the other to ensure the successful implementation of this research. We also appreciate the efforts of the directors and staff of the Tain District, Wenchi Municipal Health Directorate and the Subinso Health Centre for their invaluable contributions towards the study. Our appreciation also goes to the chiefs and people of the study communities who partnered with us in this study. This research was partially supported by a small grant awarded to Kenneth Bentum Otabil by the Royal Society of Tropical Medicine and Hygiene/National Institute of Health Research, UK. María-Gloria Basáñez acknowledges funding from the MRC Centre for Global Infectious Disease Analysis (MR/R015600/1), jointly funded by the UK Medical Research Council (MRC) and the UK Foreign, Commonwealth & Development Office (FCDO), under the MRC/FCDO Concordat agreement and is also part of the EDCTP2 programme supported by the European Union.
Publisher Copyright:
© 2023 The Authors Tropical Medicine & International Health Published by John Wiley & Sons Ltd.
PY - 2023/11
Y1 - 2023/11
N2 - Objectives: There is a pressing need to regularly evaluate the progress of onchocerciasis elimination programmes to timely identify and mitigate potential risks hindering the reaching of the 2030 targets proposed by the World Health Organization (WHO) in its roadmap on neglected tropical diseases (NTDs). We determined the prevalence of onchocerciasis and associated dermatological and ophthalmological manifestations in six endemic communities in the Bono Region of Ghana after 27 years of ivermectin mass treatment. Methods: In a cross-sectional study, 564 participants aged ≥5 years were enrolled (49.1% females), with a median age of 26 (range: 5–89) years. In 54% and 47%, skin-snip microscopy and Ov16 rapid diagnostic tests were performed, respectively. Skin disease was determined using the WHO Skin NTD App. Visual function assessments included tests of visual acuity. Results: The overall microfilarial prevalence was 12.5% (38/305) and Ov16 seroprevalence was 24.2% (64/265). Severe itching was recorded in 24.3%, acute papular onchodermatitis in 52.8%, chronic papular onchodermatitis in 12.5%, lichenified onchodermatitis in 0.7%, skin atrophy in 11.3%, depigmentation in 1.7% and palpable nodules in 5.3%. Of the 301 persons in which visual acuity was examined, 17% were visually impaired and 5.3% were blind and 47.3% presented with cataract. Chronic papular onchodermatitis, lichenified onchodermatitis, depigmentation and visual impairment were significantly associated with the presence of skin microfilariae and Ov16 seropositivity. Conclusions: The persistence of Onchocerca volvulus infection and onchocerciasis-associated dermatological and ophthalmological pathologies after prolonged treatment is of concern. There is a need to include morbidity management in onchocerciasis elimination programmes and understand better patterns of treatment coverage, adherence and actual intake of ivermectin.
AB - Objectives: There is a pressing need to regularly evaluate the progress of onchocerciasis elimination programmes to timely identify and mitigate potential risks hindering the reaching of the 2030 targets proposed by the World Health Organization (WHO) in its roadmap on neglected tropical diseases (NTDs). We determined the prevalence of onchocerciasis and associated dermatological and ophthalmological manifestations in six endemic communities in the Bono Region of Ghana after 27 years of ivermectin mass treatment. Methods: In a cross-sectional study, 564 participants aged ≥5 years were enrolled (49.1% females), with a median age of 26 (range: 5–89) years. In 54% and 47%, skin-snip microscopy and Ov16 rapid diagnostic tests were performed, respectively. Skin disease was determined using the WHO Skin NTD App. Visual function assessments included tests of visual acuity. Results: The overall microfilarial prevalence was 12.5% (38/305) and Ov16 seroprevalence was 24.2% (64/265). Severe itching was recorded in 24.3%, acute papular onchodermatitis in 52.8%, chronic papular onchodermatitis in 12.5%, lichenified onchodermatitis in 0.7%, skin atrophy in 11.3%, depigmentation in 1.7% and palpable nodules in 5.3%. Of the 301 persons in which visual acuity was examined, 17% were visually impaired and 5.3% were blind and 47.3% presented with cataract. Chronic papular onchodermatitis, lichenified onchodermatitis, depigmentation and visual impairment were significantly associated with the presence of skin microfilariae and Ov16 seropositivity. Conclusions: The persistence of Onchocerca volvulus infection and onchocerciasis-associated dermatological and ophthalmological pathologies after prolonged treatment is of concern. There is a need to include morbidity management in onchocerciasis elimination programmes and understand better patterns of treatment coverage, adherence and actual intake of ivermectin.
KW - Ov16 seroprevalence
KW - microfilariae
KW - onchocercal skin disease
KW - onchocerciasis
KW - prevalence
KW - visual acuity
UR - https://www.scopus.com/pages/publications/85174312161
U2 - 10.1111/tmi.13937
DO - 10.1111/tmi.13937
M3 - Article
C2 - 37846505
SN - 1360-2276
VL - 28
SP - 844
EP - 854
JO - Tropical Medicine and International Health
JF - Tropical Medicine and International Health
IS - 11
ER -
SDG 3 Good Health and Well-being