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CSU 145/2011: APOC IMPACT ON ONCHOCERCAL SKIN DISEASE

Friday, 22nd of April 2011

'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.'



The African Programme for Onchocerciasis Control: impact on onchocercal skin disease G. A. Ozoh1, M. E. Murdoch2 A-C. Bissek3, M. Hagan4, K. Ogbuagu5, M. Shamad6, E. I. Braide7, M. Boussinesq8, M. M. Noma9, I. E. Murdoch10, A. Sékétéli9, U. V. Amazigo9 Article first published online: 12 APR 2011 Abstract at http://onlinelibrary.wiley.com/doi/10.1111/j.1365-3156.2011.02783.x/abstract

Full text available to subscribers of Tropical Medicine & International Health Summary 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 6 years 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.