Onchodermatitis: Where Are We Now?

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.

Persistence of onchocerciasis and associated dermatologic and ophthalmic pathologies after 27 years of ivermectin mass drug administration in the middle belt of Ghana

“…Other manifestations (CPOD, LOD, DPM and NOD) were significantly associated with both mf and Ov16 positivity. These skin conditions are known to be key manifestations of onchocerciasis, with severe itch being the most frequent first sign of onchocercal skin disease (OSD) [40]. Our study findings are similar to those of a previous study in the Nkoranza North District of Ghana, where clinical manifestations of onchocerciasis persisted after more than two decades of ivermectin MDA [26].…”

“…OSD may have severe psychosocial and socio‐economic consequences [40]. In some endemic communities, people with OSD were seen as ‘unclean’ and often stigmatised due to fear of acquiring the infection, leading to ‘social ostracism’ [40]. OSD has also been associated with reduced productivity, difficulties in breastfeeding, poor school attendance, and reduced marriage prospects for affected teenage girls [40].…”

“…In some endemic communities, people with OSD were seen as ‘unclean’ and often stigmatised due to fear of acquiring the infection, leading to ‘social ostracism’ [40]. OSD has also been associated with reduced productivity, difficulties in breastfeeding, poor school attendance, and reduced marriage prospects for affected teenage girls [40]. In a study by Vlassof et al in Africa, it was identified that one‐third of residents with OSD had low self‐esteem and about 1%–2% of them had contemplated suicide due to their predicament [41].…”

“…OSD may have severe psychosocial and socio-economic consequences [40]. In some endemic communities, people with OSD were seen as 'unclean' and often stigmatised due to fear of acquiring the infection, leading to 'social ostracism' [40].…”

Factors influencing community acceptability of mass drug administration for the elimination of onchocerciasis in the Asante Akim South Municipal, Ghana

“…Onchocerciasis is one of the eleven neglected tropical diseases (NTDs) recently targeted by the World Health Organization (WHO) for elimination [ 1 ]. According to WHO, around 120 million people worldwide are at risk of onchocerciasis, among which 96% are in Africa [ 2 ].…”