Ozoh G.A., Murdoch M.E., Bissek A.-C., Hagan M., Ogbuagu K., Shamad M., Braide E.I., Boussinesq M., Noma M.M., Murdoch I.E., Sékétéli A., Amazigo U.V.
Department of Dermatology, University of Nigeria Teaching Hospital, Ituku Ozala, Nigeria; Department of Dermatology, Watford General Hospital, Watford, United Kingdom; Faculte de Medecine et des Sciences Biomedicales, Universite de Yaoundé, Cameroon; Eye
Ozoh, G.A., Department of Dermatology, University of Nigeria Teaching Hospital, Ituku Ozala, Nigeria; Murdoch, M.E., Department of Dermatology, Watford General Hospital, Watford, United Kingdom; Bissek, A.-C., Faculte de Medecine et des Sciences Biomedicales, Universite de Yaoundé, Cameroon; Hagan, M., Eye Care Unit, Ghana Health Services, Accra, Ghana; Ogbuagu, K., Commodity Security Branch, Technical Division, UNFPA Headquarters, New York, NY, United States; Shamad, M., Department of Dermatology, College of Medicine, University of Juba, Khartoum, Sudan; Braide, E.I., Department of Biological Sciences, University of Calabar, Calabar, Nigeria; Boussinesq, M., UMI 233, Institut de Recherche pour le Developpement, Montpellier, France; Noma, M.M., WHO/APOC, Ouagadougou, Burkina Faso; Murdoch, I.E., Institute of Ophthalmology, London, United Kingdom; Sékétéli, A., WHO/APOC, Ouagadougou, Burkina Faso; Amazigo, U.V., WHO/APOC, Ouagadougou, Burkina Faso
Objectives To assess the long-term impact of the African Programme for Onchocerciasis Control on itching and onchocercal skin disease (OSD). Methods Seven study sites in Cameroon, Sudan, Nigeria and Uganda participated. Two cross-sectional surveys were conducted of communities meso- and hyper-endemic for onchocerciasis before and after 5 or 6years of community-directed treatment with ivermectin (CDTI). Individuals were asked about any general health symptoms including itching and underwent full cutaneous examinations. Onchocercal skin lesions were documented according to a standard classification. Results Five thousand one hundred and ninety three people were examined in phase I and 5,180 people in phase II. The presence of onchocercal nodules was a strongly significant (P<0·001) risk factor for all forms of onchocercal skin disease: APOD (OR 1·66); CPOD (OR 2·84); LOD (OR 2·68); reactive skin lesions (OR 2·38) and depigmentation (OR 3·36). The effect of community-directed treatment with ivermectin was profound. At phase II, there were significant (P<0·001) reductions in the odds of itching (OR 0·32), APOD (OR 0·28); CPOD (OR 0·34); reactive skin lesions (OR 0·33); depigmentation (OR 0·31) and nodules (OR 0·37). Reduction in the odds of LOD was also significant (OR 0.54, P<0.03). Conclusions This first multi-country report of the long-term impact of CDTI reveals a substantial reduction in itching and OSD. APOC operations are having a major effect in improving skin health in poor rural populations in Africa. © 2011 Blackwell Publishing Ltd.