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 Table of Contents  
LETTER TO EDITOR
Year : 2016  |  Volume : 1  |  Issue : 1  |  Page : 31-32

Aiming to eliminate onchocerciasis from the African and Latin American nations: the World Health Organization


Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Kancheepuram, Tamil Nadu, India

Date of Web Publication14-Apr-2016

Correspondence Address:
Saurabh Rambiharilal Shrivastava
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, 3rd Floor, Ammapettai Village, Thiruporur - Guduvancherry Main Road, Sembakkam Post, Kancheepuram - 603 108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Shrivastava SR, Shrivastava PS, Jegadeesh R. Aiming to eliminate onchocerciasis from the African and Latin American nations: the World Health Organization. Environ Dis 2016;1:31-2

How to cite this URL:
Shrivastava SR, Shrivastava PS, Jegadeesh R. Aiming to eliminate onchocerciasis from the African and Latin American nations: the World Health Organization. Environ Dis [serial online] 2016 [cited 2022 Dec 7];1:31-2. Available from: http://www.environmentmed.org/text.asp?2016/1/1/31/180331

Dear Editor,

Human onchocerciasis is a neglected tropical parasitic disease caused by the filarial worm Onchocerca volvulus and is transmitted by the bites of black flies that breed in fast-flowing rivers and streams, mostly in villages where people are dependent on agriculture for their survival.[1] However, the recent estimates suggest that almost 99% of the infected individuals are from the African region while the remaining cases are from Yemen and some of the Latin American nations.[1] Further, another 120 million people are at the potential risk of acquisition of the infection in the affected regions.[1],[2]

Till date, only two nations Columbia and Ecuador have achieved the standards for the elimination of onchocerciasis.[1],[2] Acknowledging the success of elimination efforts, the World Health Organization (WHO) has set the target to eliminate the disease in Yemen, Latin America, and 12 African nations (viz. Benin, Kenya, Senegal, and Sierra Leone.) by the year 2020.[2],[3] However, owing to the extensive size of the affected population, geographical extent of the disease, poor socioeconomic status of the people, poor accessibility to health sector, limited utilization of health services, shortage of ivermectin drug, difficult to reach the affected areas (by the health workers), and due to the limitations in the various dimensions of the health infrastructure, the program managers are finding it extremely difficult to eliminate the disease from the African and Latin American nations.[1],[2],[3],[4],[5]

Despite implementation of nodulectomy and vector control measures, the desired results toward accomplishment of the elimination of onchocerciasis were not met.[2],[3] Moreover, it is very important to understand that there is no vaccine or medication to prevent the infection.[1] Thus, the current elimination strategy is to implement mass drug administration of ivermectin in the affected regions, with annual administration of the drug in the majority of the African nations and biannual administration in the American nations.[1]

Further, a set of guidelines have been released to help the program managers to reach to the decision of stopping large-scale treatment programs and thereby shift to the posttreatment surveillance activities for 3–5 years before the interruption of transmission is confirmed and hence its elimination.[2] In addition, guidelines have also been released to implement the steps required for the process of verification of elimination of transmission.[1],[2] To monitor the success of evaluation efforts in the affected regions, various diagnostic tests in vectors (like an entomological evaluation by polymerase chain reaction method, serological evaluation to detect the presence of immunoglobulin G4 antibodies, etc.), and in affected communities have been employed.[4],[5]

The diagnostic test plays a crucial role in providing adequate evidence to the policymakers to demonstrate the interruption in transmission for stopping mass drug administration, and at the end of posttreatment surveillance.[2],[4],[5] Furthermore, the WHO plans to launch an Expanded Special Project for Elimination of Neglected Tropical Diseases which will have strategies to simultaneously target five diseases (viz. onchocerciasis, filariasis, trachoma, schistosomiasis, and soil-transmitted helminthiases).[2]

To conclude, ensuring elimination of the human onchocerciasis is a crucial public health priority in the African nations and Latin America. It is high time that all the concerned stakeholders and international agencies should join their hands together and work in collaboration to accomplish the elimination goals.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
World Health Organization. Onchocerciasis – Fact Sheet No. 374; 2015. Available from: http://www.who.int/mediacentre/factsheets/fs374/en/. [Last accessed on 2016 Jan 26].  Back to cited text no. 1
    
2.
World Health Organization. Guidelines for stopping mass drug administration and verifying elimination of human onchocerciasis – Criteria and procedures. Geneva: WHO Press; 2016. p. 1-13.  Back to cited text no. 2
    
3.
Dunn C, Callahan K, Katabarwa M, Richards F, Hopkins D, Withers PC Jr., et al. The contributions of onchocerciasis control and elimination programs toward the achievement of the millennium development goals. PLoS Negl Trop Dis 2015;9:e0003703.  Back to cited text no. 3
    
4.
Vlaminck J, Fischer PU, Weil GJ. Diagnostic tools for onchocerciasis elimination programs. Trends Parasitol 2015;31:571-82.  Back to cited text no. 4
    
5.
Oguttu D, Byamukama E, Katholi CR, Habomugisha P, Nahabwe C, Ngabirano M, et al. Serosurveillance to monitor onchocerciasis elimination: The Ugandan experience. Am J Trop Med Hyg 2014;90:339-45.  Back to cited text no. 5
    




 

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