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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. - PowerPoint PPT Presentation
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Onchocerciasis
Ada C. Quiñones, MPH studentWalden UniversityPu6165-1Instructor: Dr Rebecca HeickSummer,2010
(River Blindness)
The Scientist (2010)Online Image, August 7,2010Retrieved from: www.thescientist.com
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.
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
ObjectiveEducate the general public about
Onchocerciasis (River Blindness)
Educate the public about potential health impact
Convince professionals of the need for public health interventions
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 7,2010Retrieved 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#prevention
sis/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".
Adult Black Fly (Simulium yahense) with Onchocerca volvulus 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#prevention
sis/factshtonchocerciasis.htm#what
Geography DistributionThirty countries of AfricaAmericas
Ecuador Mexico Brazil Venezuela ColombiaYemen
Centers for Disease Control and Prevention[CDC]September, 2008). Onchocerciasis Retrieved from: http://www.cdc.gov/ncidod/dpd/parasites/onchocerciasis/factsht_onchocerciasis.htm#prevention
sis/factshtonchocerciasis.htm#what
Unite for Sight Inc.Online Image, August 7,2010Retrieved from: www.uniteforsight.org
Life cycle
Centers for Disease Control and Prevention[[CDC](2008)Online Image, August 7,2010Retrieved from: http://www.dpd.cdc.gov/dpdx
Onchocerca volvulusOnchocerca volvulus 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.
Robert, L.S., & Janovy ,J.(1996). Foundations of Parasitology (5th ed). USA: Wm.C. Brown publishers
OCP/World Health Organization(1997)Online Imagen, August 7,2010Retrieved from:https://apps.who.int/ocp/slides/index.htm
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
Clinical Presentation Onchocercomas Skin changes Ocular envolment Immune System Effect
Garcia, L.S.(2007). Diagnostic medical parasitology (5thed) .Washington, D.C: ASM Press
OCP/World Health Organization(1997)Online Imagen, August 7,2010Retrieved from: https://apps.who.int/ocp/slides/index.htm
OCP/World Health Organization(1997)Online Imagen, August 7,2010Retrieved from: https://apps.who.int/ocp/slides/index.htm
OCP/World Health Organization(1997)Online Imagen, August 7,2010Retrieved from: https://apps.who.int/ocp/slides/index.htm
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#prevention
sis/factshtonchocerciasis.htm#what
Mortality and MorbidityWithin 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).
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/
PreventionBlack flies bite during the day.
The best prevention is to avoid infective bites of the black fly by:
Using insecticides such as DEETWearing 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#prevention
sis/factshtonchocerciasis.htm#what
DiagnosticsSerologic testing for antibodiesBloodless skin snipsPCR (Polymerase Chain Reaction)Slit lamp examinationMazzoti test
Garcia, L.S.(2007). Diagnostic medical parasitology (5thed) .Washington, D.C: ASM Press
Traveler RiskRisk 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#prevention sis/factshtonchocerciasis.htm#what
TreatmentSurgical RemovalIvermectinRemoval of enlarged regional lymph glandsDECSuraminAmocarzineMebendazole and flubendanzole
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#prevention sis/factshtonchocerciasis.htm#what
Garcia, L.S.(2007). Diagnostic medical parasitology (5thed) .Washington, D.C: ASM Presspublishers
OCP/World Health Organization(1997)Online Imagen, August 7,2010Retrieved from: https://apps.who.int/ocp/slides/index.htm
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 magazine http://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
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.In Gárcia,L.S., Diagnostic Medical Parasitology (5thed.) (pp341-348). Washington, D.C: ASM Press/
Hall, L.R., & Pearlam,E. (1999). Pathogenesis of Onchorcercal keratitis (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
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/
Thank you