Community-based treatment of onchocerciasis with ivermectin in southwest Nigeria: dermatological response to a singledose therapy

Abstract

Onchocerciasis is a chronic tropical parasitic disease, with a wide range of cutaneous and ocular manifestations. It is a serious public health and socio-economic problem found in about 27 countries in sub-Saharan Africa, and in parts of Latin America and the Arabian Peninsula. It is estimated that over 80 million people arc at risk of infection; some 18 million infected and one million people visually impaired, of whom some 340,000 arc blind1. In Nigeria, 20 million people arc at risk of infection while 10,000 are already blind. It is estimated that 1 out of 3 onchocerciasis patients in the world is a Nigerian2. The two basic ecologically-related clinical and epidemiological varieties exist in Nigeria: the savannah and the rain-forest belt types of onchocerciasis. Dcrmatological manifestations include generalized or localized body itching, acutc papular onchodcrmatitis (APOD), chronic papular onchodermatitis (CPOD), lichcnified onchodcrmatitis (LOD), atrophy of the skin, depigmentation of the skin (leopard skin), and thickened and rough skin (lizard skin). Other lesions associated with onchocercal skin disease are subcutaneous nodules, Iymphadenopathv, hanging groin, and lymphocdcma3.