Still mesoendemic onchocerciasis in two Cameroonian community-directed treatment with ivermectin projects despite more than 15 years of mass treatment
Abstract Background After more than a decade of community-directed treatment with ivermectin (CDTI) in Centre and Littoral Regions of Cameroon, onchocerciasis endemicity was still high in some communities according to the 2011 epidemiological evaluations. Some corrective measures were undertaken to...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2016-11-01
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| Series: | Parasites & Vectors |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13071-016-1868-8 |
| _version_ | 1819043231850037248 |
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| author | Guy-Roger Kamga Fanny N. Dissak-Delon Hugues C. Nana-Djeunga Benjamin D. Biholong Stephen Mbigha-Ghogomu Jacob Souopgui Honorat G. M. Zoure Michel Boussinesq Joseph Kamgno Annie Robert |
| author_facet | Guy-Roger Kamga Fanny N. Dissak-Delon Hugues C. Nana-Djeunga Benjamin D. Biholong Stephen Mbigha-Ghogomu Jacob Souopgui Honorat G. M. Zoure Michel Boussinesq Joseph Kamgno Annie Robert |
| author_sort | Guy-Roger Kamga |
| collection | DOAJ |
| description | Abstract Background After more than a decade of community-directed treatment with ivermectin (CDTI) in Centre and Littoral Regions of Cameroon, onchocerciasis endemicity was still high in some communities according to the 2011 epidemiological evaluations. Some corrective measures were undertaken to improve the CDTI process and therefore reduce the burden of the disease. The objective of the present study was to assess the progress made towards the elimination of onchocerciasis in the Centre 1 and Littoral 2 CDTI projects where the worst performances were found in 2011. To this end, a cross-sectional survey was conducted in April 2015 in eight communities in two health districts (HD), Bafia in Centre 1 and Yabassi in Littoral 2, chosen because assessed at baseline and in 2011. All volunteers living for at least five years in the community, aged five years or more, underwent clinical and parasitological examinations. Individual compliance to ivermectin treatment was also assessed. Analyses of data were weighted proportionally to age and gender distribution in the population. Results In the Bafia and Yabassi HD, 514 and 242 individuals were examined with a mean age of 35.1 (standard deviation, SD: 20.7) and 44.6 (SD: 16.3) years, respectively. In the Bafia HD, the weighted prevalences varied from 24.4 to 57.0 % for microfilaridermia and from 3.6 to 37.4 % for nodule presence across the surveyed communities. The community microfilarial load (CMFL), expressed in microfilariae/skin snip (mf/ss), significantly dropped from 20.84–114.50 mf/ss in 1991 to 0.31–1.62 mf/ss in 2015 in all the surveyed communities. In the Yabassi HD, the weighted prevalences varied from 12.3 to 59.3 % for microfilaridermia and from 1.5 to 3.7 % for nodule presence across the surveyed communities, while a significant drop was observed in CMFL, from 20.40–28.50 mf/ss in 1999 to 0.48–1.74 mf/ss in 2015. The 2014 weighted therapeutic coverage of participants varied from 65.8 % (95 % CI: 58.4–73.2) in Yabassi HD, to 68.0 % (95 % CI: 63.3–72.7) in Bafia HD, with important variations among communities. Conclusions After more than 15 years of CDTI, onchocerciasis is still mesoendemic in the surveyed communities. Further studies targeting therapeutic coverage, socio-anthropological considerations of CDTI implementation and entomological studies would bring more insights to the persistence of the disease as observed in the present study. |
| first_indexed | 2024-12-21T09:53:30Z |
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| institution | Directory Open Access Journal |
| issn | 1756-3305 |
| language | English |
| last_indexed | 2024-12-21T09:53:30Z |
| publishDate | 2016-11-01 |
| publisher | BMC |
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| series | Parasites & Vectors |
| spelling | doaj.art-4e22fd27556745249f979d63721fc0292022-12-21T19:08:07ZengBMCParasites & Vectors1756-33052016-11-019111210.1186/s13071-016-1868-8Still mesoendemic onchocerciasis in two Cameroonian community-directed treatment with ivermectin projects despite more than 15 years of mass treatmentGuy-Roger Kamga0Fanny N. Dissak-Delon1Hugues C. Nana-Djeunga2Benjamin D. Biholong3Stephen Mbigha-Ghogomu4Jacob Souopgui5Honorat G. M. Zoure6Michel Boussinesq7Joseph Kamgno8Annie Robert9Ministry of Public HealthMinistry of Public HealthCentre for Research on Filariasis and other Tropical Diseases (CRFilMT)Ministry of Public HealthMolecular and Cell Biology Laboratory, Department of Biochemistry and Molecular Biology, University of BueaInstitute of Biology of Molecular Medicine, Université Libre de BruxellesWorld Health Organization, African Programme for Onchocerciasis Control (APOC)Institut de Recherche pour le Développement (IRD), IRD UMI 233 TransVIHMI – Université Montpellier – INSERM U1175Centre for Research on Filariasis and other Tropical Diseases (CRFilMT)Institut de Recherche Expérimentale et Clinique, Faculté de santé publique, Université catholique de LouvainAbstract Background After more than a decade of community-directed treatment with ivermectin (CDTI) in Centre and Littoral Regions of Cameroon, onchocerciasis endemicity was still high in some communities according to the 2011 epidemiological evaluations. Some corrective measures were undertaken to improve the CDTI process and therefore reduce the burden of the disease. The objective of the present study was to assess the progress made towards the elimination of onchocerciasis in the Centre 1 and Littoral 2 CDTI projects where the worst performances were found in 2011. To this end, a cross-sectional survey was conducted in April 2015 in eight communities in two health districts (HD), Bafia in Centre 1 and Yabassi in Littoral 2, chosen because assessed at baseline and in 2011. All volunteers living for at least five years in the community, aged five years or more, underwent clinical and parasitological examinations. Individual compliance to ivermectin treatment was also assessed. Analyses of data were weighted proportionally to age and gender distribution in the population. Results In the Bafia and Yabassi HD, 514 and 242 individuals were examined with a mean age of 35.1 (standard deviation, SD: 20.7) and 44.6 (SD: 16.3) years, respectively. In the Bafia HD, the weighted prevalences varied from 24.4 to 57.0 % for microfilaridermia and from 3.6 to 37.4 % for nodule presence across the surveyed communities. The community microfilarial load (CMFL), expressed in microfilariae/skin snip (mf/ss), significantly dropped from 20.84–114.50 mf/ss in 1991 to 0.31–1.62 mf/ss in 2015 in all the surveyed communities. In the Yabassi HD, the weighted prevalences varied from 12.3 to 59.3 % for microfilaridermia and from 1.5 to 3.7 % for nodule presence across the surveyed communities, while a significant drop was observed in CMFL, from 20.40–28.50 mf/ss in 1999 to 0.48–1.74 mf/ss in 2015. The 2014 weighted therapeutic coverage of participants varied from 65.8 % (95 % CI: 58.4–73.2) in Yabassi HD, to 68.0 % (95 % CI: 63.3–72.7) in Bafia HD, with important variations among communities. Conclusions After more than 15 years of CDTI, onchocerciasis is still mesoendemic in the surveyed communities. Further studies targeting therapeutic coverage, socio-anthropological considerations of CDTI implementation and entomological studies would bring more insights to the persistence of the disease as observed in the present study.http://link.springer.com/article/10.1186/s13071-016-1868-8OnchocerciasisIvermectinPersistenceEliminationBafiaYabassi |
| spellingShingle | Guy-Roger Kamga Fanny N. Dissak-Delon Hugues C. Nana-Djeunga Benjamin D. Biholong Stephen Mbigha-Ghogomu Jacob Souopgui Honorat G. M. Zoure Michel Boussinesq Joseph Kamgno Annie Robert Still mesoendemic onchocerciasis in two Cameroonian community-directed treatment with ivermectin projects despite more than 15 years of mass treatment Parasites & Vectors Onchocerciasis Ivermectin Persistence Elimination Bafia Yabassi |
| title | Still mesoendemic onchocerciasis in two Cameroonian community-directed treatment with ivermectin projects despite more than 15 years of mass treatment |
| title_full | Still mesoendemic onchocerciasis in two Cameroonian community-directed treatment with ivermectin projects despite more than 15 years of mass treatment |
| title_fullStr | Still mesoendemic onchocerciasis in two Cameroonian community-directed treatment with ivermectin projects despite more than 15 years of mass treatment |
| title_full_unstemmed | Still mesoendemic onchocerciasis in two Cameroonian community-directed treatment with ivermectin projects despite more than 15 years of mass treatment |
| title_short | Still mesoendemic onchocerciasis in two Cameroonian community-directed treatment with ivermectin projects despite more than 15 years of mass treatment |
| title_sort | still mesoendemic onchocerciasis in two cameroonian community directed treatment with ivermectin projects despite more than 15 years of mass treatment |
| topic | Onchocerciasis Ivermectin Persistence Elimination Bafia Yabassi |
| url | http://link.springer.com/article/10.1186/s13071-016-1868-8 |
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