ABSTRACT
We conducted a cohort study on impact of effects of eight years of annual ivermectin mass treatment administered in eight villages in Imo State, Nigeria. Physical and visual acuity examinations carried out in 462 persons in 1995, prior to the launching of mass drug administration with ivermectin, were compared with re-examinations of 411 (89%) of these same individuals in 2002. We found that gross visual impairment decreased from 16% to 1%, nodule prevalence decreased from 59% to 18%, and papular dermatitis was reduced from 15% to 2%. No change was seen in leopard skin rates (14%). The only incident lesions were three subjects from a single community having the appearance of new nodules (e.g., nodules not identified in the 1995 examinations). Differences in community coverage did not appear to influence the benefit from treatment of individual residents.
Subject(s)
Ivermectin/therapeutic use , Onchocerciasis/drug therapy , Adult , Aged , Cohort Studies , Female , Humans , Longitudinal Studies , Male , Middle Aged , NigeriaABSTRACT
This paper describes a pilot initiative to incorporate lymphatic filariasis (LF) elimination and urinary schistosomiasis (SH) control into a mature onchocerciasis control program based on community-directed ivermectin treatment in central Nigeria. In the same districts having onchocerciasis we found LF (as determined by blood antigen testing in adult males) in 90% of 149 villages with a mean prevalence of 22.4% (range 0-67%). Similarly, SH, as determined by dipstick reagent testing for blood in urine from school children, was found in 91% of 176 villages with a mean orevalence in school age children of 24.4% (range 0-87%). Health education and treatment interventions for SH resulted in 52,480 cumulative praziquantel treatments, and 159,555 combined onchocerciasis and LF treatments (with ivermectin and albendazole) as of the end of 2000. Treatments for onchocerciasis and LF were separated by at least 1 week from treatments for SH. There was no negative impact on the coverage of the onchocerciasis program by the addition of LF and SH activities.
