Abstract
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.
Highlights
Human Onchocerciasis is caused by the filarial parasitic nematode Onchocerca volvulus which is spread by black flies belonging to the genus Simulium[1]
The true extent of the disease has been estimated by Rapid Epidemiologic Mapping of Onchocerciasis (REMO) which estimated that 37 million people carry O. volvulus, with 90 million at risk in Africa [2]
A countrywide REMO carried out in 1997 and 2001 by African Program for Onchocerciais Control (APOC) revealed that Onchocerciasis was much more widespread in Ethiopia than previously estimated [3]
Summary
Human Onchocerciasis is caused by the filarial parasitic nematode Onchocerca volvulus which is spread by black flies belonging to the genus Simulium[1]. It has remained an important public health problem in Tropical Africa, Latin America, and Yemen. In a previous study conducted in four different villages of Anfilo District, Kelem Wollega Zone, Western Ethiopia or the current study area, the average prevalence of Onchocerciasis was 74.8%. 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.
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