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 five years. The global burden of onchodermatitis is progressively reducing and is no longer seen in children in many formerly endemic foci.
Highlights
Onchocerciasis, caused by infection with the filarial worm Onchocerca volvulus, is one of the eleven neglected tropical diseases (NTDs) recently targeted for elimination by the World Health Organization (WHO) [1]
The Global Burden of Disease (GBD) study 2013 estimated that onchocerciasis was the sixth highest cause of 227 NTD-related YLDs globally and it was ranked highly in the top 10 leading causes of 228 YLDs in Liberia, Cameroon and South Sudan
Baum et al [29] noted a long interval for some Ethiopian immigrants in Israel before they developed any sysmptoms and hypothesized that environmental factors resulting from immigration from a developing to an industrialised country triggered an immunological shift to strong T-helper (Th) 2 responses, in a similar manner that an increased prevalence in asthma had been noted in Ethiopian migrants several years after migrating to Israel
Summary
Onchocerciasis, caused by infection with the filarial worm Onchocerca volvulus, is one of the eleven neglected tropical diseases (NTDs) recently targeted for elimination by the World Health Organization (WHO) [1]. There has been significantly increased awareness of the skin manifestations associated with this disease and the main clinical manifestations of onchocerciasis in the twenty countries formerly covered by the African Programme for Onchocerciasis Control (APOC) were related to skin disease [4]. The WHO estimates that 198 million people are at risk of infection, though this number may increase as the mapping of areas of low transmission is finalised [5]. The Global Burden of Disease (GBD ) Study 2013 estimated a global prevalence of 17 million infected cases [6]. By improving the general health of individuals they contribute to improvements in worker productivity, gender equality and education and they actively contribute towards achieving several of the Millenium Development Goals [14]
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