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Onchocerciasis

Onchocerciasis . (River Blindness). Ada C. Quiñones , MPH student Walden University Pu6165-1 Instructor: Dr Rebecca Heick Summer,2010. The Scientist (2010) Online Image, August 7,2010 Retrieved from: www.thescientist.com. Goal.

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Onchocerciasis

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  1. Onchocerciasis (River Blindness) Ada C. Quiñones, MPH student Walden University Pu6165-1 Instructor: Dr Rebecca Heick Summer,2010 The Scientist (2010) Online Image, August 7,2010 Retrieved from: www.thescientist.com

  2. Goal The goal of this presentation is to convince different health organizations to work together in order to find effective methods for reducing the incidence and prevalence of River Blindness worldwide.

  3. The intended audience includes individuals from: • The Carter Center River Blindness Program • World Health Organization(WHO) • Centers for Disease Control and Prevention: Division of Parasitic Diseases (CDC) • The International Eyes Foundation Program • Mectizan Donation Programs • Lions Club International • General Public

  4. Objective • Educate the general public about Onchocerciasis (River Blindness) • Educate the public about potential health impact • Convince professionals of the need for public health interventions

  5. Introduction River Blindness is primarily an African disease, common in central Africa, especially in villages near rivers and streams. OCP/World Health Organization(1997) Online Image, August 7,2010 Retrieved from: https://apps.who.int/ocp/slides/index.htm Centers for Disease Control and Prevention[CDC]September, 2008). Onchocerciasis Retrieved from: http://www.cdc.gov/ncidod/dpd/parasites/onchocerciasis/factsht_onchocerciasis.htm#preventionsis/factshtonchocerciasis.htm#what

  6. Adult Black Fly (Simuliumyahense) with Onchocercavolvulus emerging from the insect's antenna. The parasite is responsible for the disease known as River Blindness in Africa. Image provided courtesy of the USDA under Public Domain. • http://serc.carleton.edu/microbelife/k12/microbes_within/resources.html Centers for Disease Control and Prevention[CDC]September, 2008). Onchocerciasis Retrieved from: http://www.cdc.gov/ncidod/dpd/parasites/onchocerciasis/factsht_onchocerciasis.htm#preventionsis/factshtonchocerciasis.htm#what These flies breed in fast-flowing streams and rivers, increasing the risk of infection to individuals living nearby, hence the common name of “ River Blindness".

  7. Geography Distribution • Thirty countries of Africa • Americas Ecuador Mexico Brazil Venezuela Colombia • Yemen Unite for Sight Inc. Online Image, August 7,2010 Retrieved from: www.uniteforsight.org Centers for Disease Control and Prevention[CDC]September, 2008). Onchocerciasis Retrieved from: http://www.cdc.gov/ncidod/dpd/parasites/onchocerciasis/factsht_onchocerciasis.htm#preventionsis/factshtonchocerciasis.htm#what

  8. Life cycle Centers for Disease Control and Prevention[[CDC](2008) Online Image, August 7,2010 Retrieved from: http://www.dpd.cdc.gov/dpdx

  9. Onchocercavolvulus Onchocercavolvulus was probably introduced to the Americas by African slaves . Humans appear to be the only natural definitive host. Adult worms move under the skin, where they become encapsulated by host reaction. OCP/World Health Organization(1997) Online Imagen, August 7,2010 Retrieved from:https://apps.who.int/ocp/slides/index.htm Robert, L.S., & Janovy ,J.(1996). Foundations of Parasitology (5th ed). USA: Wm.C. Brown publishers

  10. Symptoms • Infected persons may be without symptoms. • Those with symptoms will usually have one or more of the three manifestations: Skin rash Eye lesions Subcutaneous bumps under the skin • The most serious manifestation consists of lesions in the eye that can progress to blindness.(CDC,2008). Centers for Disease Control and Prevention[CDC] 2008). Onchocerciasis Retrieved from: http://www.cdc.gov/ncidod/dpd/parasites/onchocerciasis/factshtonchocerciasis.htm#what Robert, L.S., & Janovy ,J.(1996). Foundations of Parasitology (5th ed). USA: Wm.C. Brown publishers

  11. Clinical Presentation • Onchocercomas • Skin changes • Ocular envolment • Immune System Effect OCP/World Health Organization(1997) Online Imagen, August 7,2010 Retrieved from: https://apps.who.int/ocp/slides/index.htm OCP/World Health Organization(1997) Online Imagen, August 7,2010 Retrieved from: https://apps.who.int/ocp/slides/index.htm OCP/World Health Organization(1997) Online Imagen, August 7,2010 Retrieved from: https://apps.who.int/ocp/slides/index.htm Garcia, L.S.(2007). Diagnostic medical parasitology (5thed) .Washington, D.C: ASM Press

  12. Incidence and Prevalence • Onchocerciasis is the second leading cause of preventable blindness in the world. • More than 17.7 million people worldwide are infected, and 109 million people are at risk. • Visual impairments occur in 500,000 of these people, including 270,00 cases of blindness. • Over 90% of the disease occurs in Africa, with the rest occurring in six countries in Latin America, Yemen and the Arabian Peninsula . Centers for Disease Control and Prevention[CDC]September, 2008). Onchocerciasis Retrieved from: http://www.cdc.gov/ncidod/dpd/parasites/onchocerciasis/factsht_onchocerciasis.htm#preventionsis/factshtonchocerciasis.htm#what

  13. Mortality and Morbidity • Within the human body, the adult female worm (macrofilaria) produces thousands of baby or larval worms (microfilariae), which migrate in the skin and the eye and are the cause of morbidity.(WHO,2007). • While mortality rates for onchocerciasis are null, the personal costs, and social and economic burdens are high(WHO,2007).

  14. Socio-economic Impact • Hinders agriculture productivity • Generate massive economic losses • Imposes a disproportionate disease burden on poor rural communities • It creates stigma • Onchocerciasis causes and perpetuates poverty World Health Organization [WHO], (2010). Onchocerciasis. Retrieved from: http://www.who.int/topics/onchocerciasis/en/

  15. Prevention Black flies bite during the day. The best prevention is to avoid infective bites of the black fly by: • Using insecticides such as DEET • Wearing long sleeve shirts and pants. Centers for Disease Control and Prevention[CDC]September, 2008). Onchocerciasis Retrieved from: http://www.cdc.gov/ncidod/dpd/parasites/onchocerciasis/factsht_onchocerciasis.htm#preventionsis/factshtonchocerciasis.htm#what

  16. Diagnostics • Serologic testing for antibodies • Bloodless skin snips • PCR (Polymerase Chain Reaction) • Slit lamp examination • Mazzoti test Garcia, L.S.(2007). Diagnostic medical parasitology (5thed) .Washington, D.C: ASM Press

  17. Traveler Risk Risk of infection is greater in: • Adventure travelers • Missionaries, • Peace Corps volunteers Centers for Disease Control and Prevention[CDC]September, 2008). Onchocerciasis Retrieved from: http://www.cdc.gov/ncidod/dpd/parasites/onchocerciasis/factsht_onchocerciasis.htm#preventionsis/factshtonchocerciasis.htm#what

  18. Treatment • Surgical Removal • Ivermectin • Removal of enlarged regional lymph glands • DEC • Suramin • Amocarzine • Mebendazole and flubendanzole OCP/World Health Organization(1997) Online Imagen, August 7,2010 Retrieved from: https://apps.who.int/ocp/slides/index.htm Robert, L.S., & Janovy ,J.(1996). Foundations of Parasitology (5th ed). USA: Wm.C. Brown Centers for Disease Control and Prevention[CDC]September, 2008). Onchocerciasis Retrieved from: http://www.cdc.gov/ncidod/dpd/parasites/onchocerciasis/factsht_onchocerciasis.htm#preventionsis/factshtonchocerciasis.htm#what Garcia, L.S.(2007). Diagnostic medical parasitology (5thed) .Washington, D.C: ASM Press publishers

  19. Additional Resource • Higher Institute of Health of Bengo http://www.portalangop.co.ao/motix/en_us/noticias/saude/2010/5/25/Bengo-hosts- seminar-fight-against-river-blindness,7ace8f84-fb33-464b-a0ca-5745d6202bb7.html • The Carter Center River Blindness program http://www.cartercenter.org/health/river_blindness/index.html • World Health Organization (WHO) http://www.who.int/topics/onchocerciasis/en/ • Breakthroughs magazinehttp://nature.berkeley.edu/breakthroughs/break_feature1_su08.php • Lions club international http://www.lionsclubs.org/EN/lci-foundation/our- programs/sightfirst/initiatives/lcif-gr-river-blindness.php • The international eyes foundation program http://www.iefusa.org/riverblind.shtml • MAP International http://www.map.org/site/PageServer?pagename=SP_Uganda_River_Blindness • Mectizan Donation Program http://www.merck.com/corporate-responsibility/access/access-developing-emerging/mectizan-donation-riverblindness/ • Centers for Disease Control and Prevention[ http://www.cdc.gov/ncidod/dpd/parasites/onchocerciasis/factshtonchocerciasis.htm#what

  20. Reference • Centers for Disease Control and Prevention[[CDC].(2008). Onchocerciasis Retrieved from: http://www.cdc.gov/ncidod/dpd/parasites/onchocerciasis/factshtonchocerciasis.htm# what • Basáñez, M.G., Sébastien, D.S.,Churcher, T.S., Breitling L.P., Little,M.P., Boussinesq, M. (2006). River Blindness: A success story under threat? Plos Medicine,3(9), 1454-1460 • Boatin,B.A., & Richard F.O Jr. (2006). Control of Onchocerciasis. Advance in Parasitology 61. 349-394. • Gárcia, L.S.(2007). Filarial nematodes.InGárcia,L.S., Diagnostic Medical Parasitology (5thed.) (pp341-348). Washington, D.C: ASM Press/ • Hall, L.R., & Pearlam,E. (1999). Pathogenesis of Onchorcercalkeratitis (River Blindness). Clinical Microbiology Reviews,12 (3), 445-453. • Moller, D. W.(2005).Rodents and Insects. In Moeller,D.W. Environmental Health (3rd ed.). (pp 258).Boston: Harvard University Press. • Murray, P.R., Baron, E.J., Jorgensen, J.H., Landry, M.J., & Pealler, M.A.(2007).Manual of Clinical Microbiology, D. C: ASM Press • Rea, P.A., Zhang,V., & Baras, Y.S. (2010) .Ivermectin and River Blindness. American Scientist,98. 294-303

  21. Reference • Robert, L.S., & Janovy ,J.(1996). Nematodes:Filaroidea, In Robert, L.S., & Janovy, J., Foundations of Parasitology (5th ed).(pp. 452-456). USA: Wm.C. Brown publishers • Terranova, M., Padovese, V., Klaus, S., and Morrone, A.(2007). Onchocerciasis in Tigray. International Society of Dermatology, 46, 39-41 • Thylefors, B., Alleman, M. M.,& Twum-Danso, N.A.Y. (2008). Operational lessons from 20 years of the Mectizan donation program for the control of Onchocerciasis. Tropical Medicine and international health, 13(5), 689- 696 • Wagbatsoma, V.A., & Okojie, O.H. (May, 2004). Psychosocial effects of river blindness in a rural community in Nigeria. The Journal of the Royal Society for the Promotion of Health 124 ,134-136, • World Health Organization [WHO], (1979). Environmental Health Criteria 9: DDT and its derivates. • World Health Organization [WHO], (2010). Onchocerciasis. Retrieved from: http://www.who.int/topics/onchocerciasis/en/

  22. Thank you

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