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PUBH-8165-1 Environmental Health

PUBH-8165-1 Environmental Health . TOPIC : Onchocerciasis Presented By: Christopher Arori Public Health Student Instructor: Dr. Shana Morrell April, 2009 Walden University. Learning Goals. After the presentation on onchocerciasis, the audience should be able to:

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PUBH-8165-1 Environmental Health

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  1. PUBH-8165-1 Environmental Health TOPIC: Onchocerciasis Presented By: Christopher Arori Public Health Student Instructor: Dr. Shana Morrell April, 2009 Walden University

  2. Learning Goals After the presentation on onchocerciasis, the audience should be able to: • Define the disease process • Know its significance • Identify the signs and symptoms of the disease • List risk factors associated with the illness • Identify people at risk • Describe the overall impact of the disease to society • Understand the effective control and prevention measures available • Understand the current and future outlook of the disease based on research

  3. Agenda • What is Onchocerciasis? • Its significance • What causes it? • Risk factors • People at risk • Social-Economic Impact • Control and Prevention Measures • Future Outlook • Key Goals of the Presentation • Information • To Manage and Implement Control Measures • Expected Learning Outcomes • Audience to be able to Share the Disease Information with their Communities • References

  4. Onchocerciasis Defined • Caused by a parasitic worm (Onchocerca vulvulus) • Spread to humans by the bite of an infected black fly (species of female Simulium flies) , after multiple bites (CDC, 2008). • Often times called river blindness • Occurs along fast flowing rivers and streams in Africa, Latin America, and Yemen (WHO,2009). References Center for Disease Control & Prevention (2008) World Health Organization, (2009 )

  5. Significance • Affects 17.7 million people worldwide • About 270,000 become blind • 500, 000 people have visual impairment • 99 % of those cases are in Africa • Social-economic underdevelopment results from such impairements • Fertile land is abandoned • Income generating capacity is compromised (CDC,2008) References Center for Disease Control and Prevention (2008)

  6. Signs and Symptoms • Skin rash • Eye lesions • Bumps under the skin • Chronic dermatitis, edema, chronic thickened skin (Lizard skin) • Disfigurement of the human body, • Eye lesions may progress to partial and full-prone blindness (CDC, 2008; WHO, 2009). References Center for Disease Control & Prevention (2008) World Health organization (2009)

  7. Risk Factors • Poor communication about the disease. • Lack of Ivermectin therapy and drug resistance to the medication (Achim, Sabine, Yeboah, Marcelle, Alexander, Sabine, & et al, 2009). • lack of interest in onchocerciasis prevention and research by local entities(Loewenberg, 2008). • Lack of specific information about the disease. • The presence of the vectors, black flies References Achim H., Sabine S., Yeboah M., Marcelle B., Alexander D., Sabine M., & “et al” (2009). Efficacy of 5-week doxycycline treatment on adult Onchocerca volvulus. Parasitological Research, 104 (2), 437-447 Loewenberg, S. (2008). Tanzania's fight against onchocerciasis. Lancet, 372 (9651), 1721-1722

  8. Social-Economic Impact • Socioeconomic underdevelopment • Fertile land is abandoned • Kids drop out of schools • Income generating capacity is compromised • Social stigma is persistent due to the disfigurement of human body (CDC, 2008) References Center for Disease Control & Prevention, 2008

  9. Prevention and Control Measures • Clearing forests along river basins/banks • Applying DDT sparingly • Aerial spraying, by using environmentally friendly larvicides such as Temephos and carbamates pyrethroids (organo-phosphorus insecticides). • Use of Medications such as Ivermectin (WHO, 2009) References World Health Organization, 2009

  10. Prevention and Control Measures • Lack of precise information about the dangers of the black fly bites (Dozier, Onwuliri, & Nwoke, 2004) • Application of DEET (30% proof) to all open areas • Utilizing long sleeves attire and trouser bottoms when in outdoors • Wearing a head net if necessary • Avoiding camping near fast flowing rivers in black fly invested areas References Dozier, I.N.S., Onwuliri, C.0.E., & Nwoke, B.E.B., (2004). Onchocerciasis in Imo state, Nigeria (2): the prevalence, intensity and distribution in the upper Imo river basin. International Journal of Environmental Health Research, 14 (5), 359-369 World Health Organization (2009) Center for Disease Control and Prevention (2008)

  11. Future outlook • Onchocerciasis, a parasitic condition along the river basins, will soon be eliminated. • One of the problems which can be seen is the issue of resistance to drugs and insecticides by the vectors (Humans &Insects). • Research needs to be conducted to figure out how to address the resistance problems • There is a need to develop potent medications to wipe out river blindness from the nations affected.

  12. Bibliography for further reading  Achim H.; Sabine S.; Yeboah M.; Marcelle B.; Alexander D.; Sabine M.& et al (2009). Efficacy of 5-week doxycycline treatment on adult Onchocerca volvulus. Parasitological Research, 104 (2), 437-447 Churcher, T.S. & Basáñez, M-G. (2009) Sampling strategies to detect anthelmintic resistance: the perspective of human onchocerciasis. Trends in Parasitological, 25 (1), 11-17 Dozie, I.N.S.; Onwuliri, C.O.E.; & Nwoke, B.E.B. (2004).Onchocerciasisin Imo state, Nigeria (2): the prevalence, intensity and distribution in the upper Imo river basin. International Journal of EnvironmentalHealth Research, 14 (5), 359-369  Hoerauf, A.; Specht, S.; Büttner, M.; Pfarr, K.; Mand, & “et al” (2008). Wolbachia endobacteria depletion by doxycycline as antifilarial therapy has macrofilaricidal activity in onchocerciasis: a randomized placebo-controlled study. Medical Microbiology & Immunology, 197 (3), 295-311  Loewenberg, S. (2008). Tanzania's fight against onchocerciasis. Lancet, 372 (9651), 1721-1722  McGeary, R.P.; Bennett, A.J.; Tran, Q.B.; Cosgrove, K.L.; & Ross, B.P. (2008).Suramin: Clinical Uses and Structure-Activity Relationships.Mini Reviews in Medicinal Chemistry, 8 (13), 1384-1394 Park, J.; Dickerson, T.J.; & Janda, K.D. (2008). Major sperm protein as a diagnostic antigen for onchocerciasis. Bioorganic & Medicinal Chemistry, 16 (15), 7206-7209  Prischich, F.; De Rinaldis, M.; Bruno, F.; Egeo, G.; Santori, C.; Zappaterreno, A. & et al (2008). High prevalence of epilepsy in a village in the Littoral Province of Cameroon. Epilepsy Research, 82 (2/3), 200-210  Sabine S.; Sabine M.; Yeboah M.; Peter K.; Dietrich B.; Achim H.(2008).Efficacy of 2- and 4-week rifampicin treatment on the Wolbachia of Onchocerca volvulus. Parasitological Research, 103 (6), 1303-1309  Stingl, P. (2009). Onchocerciasis: developments in diagnosis, treatment and control.International Journal of Dermatology, 48 (4), 393-396 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 & International Health, 13 (5), 689-696 The Center for Disease Control and prevention, (2008) World Health Organization, (2009)

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