Abstract

BackgroundOnchocerciasis is a neglected tropical disease which is still of immense major public health concern in several areas of Africa and the Americas. The disease manifests either as ocular or as dermal onchocerciasis with several symptoms including itching, nodules, skin thickening, visual impairment and blindness. Ivermectin has been an efficient microfilaricide against the causative agent of the disease (Onchocerca volvulus) but reports from some areas in Africa suggest the development of resistance to this drug. The aim of this study was to determine the prevalence of onchocerciasis and associated clinical conditions frequently associated with the disease in three endemic communities in Ghana which have been subjected to 18 to 20 rounds of mass drug administration of ivermectin. This was to help determine whether or not onchocerciasis persists in these communities.MethodsA cross-sectional study design was adopted. Three communities (Tanfiano, Senya and Kokompe) in the Nkoranza North District of Ghana where mass drug administration of ivermectin had been ongoing for more than two decades were selected for the study. The population was randomly sampled and 114 participants recruited for the study based on the eligibility criteria. The study participants were examined for the presence of parasites and clinical manifestations of onchocerciasis following established protocols.ResultsThe study showed that the prevalence of microfilaria in the Tanfiano, Senya, Kokompe communities were 13.2, 2.4, and 2.9%, with nodule prevalence being 5.3, 4.9 and 14.3% respectively. Females in the study communities had a higher prevalence of microfilaria carriers (5.17%) relative to males (2.44%), but this difference was not statistically significant (p = 0.2800, unpaired t test). The most frequent clinical manifestation observed in this study among all participants was dermatitis (25.4%), followed by visual impairment & nodules (7.9% each) and then by blindness (4.4%).ConclusionThe study showed that despite several years of mass drug administration with ivermectin, infection with onchocerciasis and the commonly associated clinical manifestations of the disease still persist in the study communities. This calls for a greater urgency for research and development aimed at discovering new or repurposed anti-filarial agents which will augment ivermectin if global onchocerciasis eradication targets are to be achieved.

Highlights

  • Onchocerciasis is a neglected tropical disease which is still of immense major public health concern in several areas of Africa and the Americas

  • The present study aimed to investigate the prevalence of onchocerciasis and clinical manifestations commonly associated with the disease in three communities in the middle belt of Ghana that are endemic for onchocerciasis and have been subjected to 18 to 20 rounds of mass drug administration programs (MDA)

  • The three communities were selected because no effective monitoring of the effectiveness of the MDA programmes in the communities had previously been performed in them, ivermectin MDA had been ongoing in these endemic communities for several years

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Summary

Introduction

The aim of this study was to determine the prevalence of onchocerciasis and associated clinical conditions frequently associated with the disease in three endemic communities in Ghana which have been subjected to 18 to 20 rounds of mass drug administration of ivermectin. About 90 million people are at risk of contracting the disease in endemic areas mainly in sub Saharan Africa, of which more than 37 million are estimated to be infected and 300,000 are permanently blind as a consequence of onchocerciasis [1]. These figures are generally accepted to be an underestimation of the true situation [2]. If many people are infected in a community, socioeconomic depression may result as fertile riverine areas are frequently abandoned for fear of the disease [1]

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