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Onchocerciasis: Presentation And Treatment

A disease called Onchocerciasis, river blindness or craw craw is endemic to Bioko Island, Equatorial Guinea. The disease presents as a weakening// in affected individuals thus rendering them listless and not fit for work. This in turn adversely impacts the economy of this area. The disease is caused by the worm Onchocerca volvulus and is transmitted through the bite of the black fly, Simulium.

Enviromental conditions such as humidity, rapid water rivers and altitude of Bioko favour the development of this pathology, since this is the habitat of the fly acting as a vector. The parasite, in the form of larve, is inoculated to humans when the fly bites humans to obtain blood. Female parasites measure 30 to 50 cm and live 10 to 15 years, whereas male parasites measure 3 to 5 cm. Worms form tumours in infected indivuduals, and some of them are easily visible. Fecunded females emit daily 1,200 larves (microfilaria) measuring 150-360 micras, which are disseminated through the host’s skin, eyes and other organs. Affected individuals can host 50-200 million worms, especially distributed in skin and eyes, usually provoking blindness.

The work, carried out by the group of Hospital Clínic de Barcelona, was led by Dr. Jordi Mas of the Microbiology Unit of Hospital Clínic-Universitat de Barcelona, and Dr. Carlos Ascaso of the IDIBAPS Epidemiology and International Health Research Group. The objective of this study was to assess the impact of 8-year vertical distribution of Ivermectin, the only treatment available against onchocerciasis, among the rural population of 12 communities and two ethnical groups: the Bubis and the Fangs. The fact that the administered drug dose is only effective on larves, conditions the duration of this study. The study was carried out during 8 years, because this is precisely the maximum time of fertility of females, what guarantees the total elimination of the offspring.

This study, published in Tropical Medicine and
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