Volume 70, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


We conducted a cohort study on impact of effects of eight years of annual ivermectin mass treatment administered in eight villages in Imo State, Nigeria. Physical and visual acuity examinations carried out in 462 persons in 1995, prior to the launching of mass drug administration with ivermectin, were compared with re-examinations of 411 (89%) of these same individuals in 2002. We found that gross visual impairment decreased from 16% to 1%, nodule prevalence decreased from 59% to 18%, and papular dermatitis was reduced from 15% to 2%. No change was seen in leopard skin rates (14%). The only incident lesions were three subjects from a single community having the appearance of new nodules (e.g., nodules not identified in the 1995 examinations). Differences in community coverage did not appear to influence the benefit from treatment of individual residents.


Article metrics loading...

Loading full text...

Full text loading...



  1. World Health Organization, 1995. Onchocerciasis and its Control: Report of a WHO Expert Committee on Onchocerciasis Control. World Health Organ Tech Rep Ser 852.
  2. Jiya JJ, 1998. Problems and perspective in programme management: the case of the National Control Programme in Nigeria. Ann Trop Med Parasitol 92 : S167–S168.
  3. Gemade EI, Jiya JY, Nwoke BE, Ogunba EO, Edeghere H, Akoh JI, Omojola A, 1998. Human onchocerciasis: current assessment of the disease burden in Nigeria by rapid epidemiological mapping. Ann Trop Med Parasitol 92 : S79–S83.
  4. Burnham G, 1998. Onchocerciasis. Lancet 351 : 1341–1346.
  5. Edungbola LD, 1991. Onchocerciasis in Nigeria. Parasitol Today 7 : 97–99.
  6. Murdoch ME, Asuzu MC, Hagan M, Makunde WH, Ngoumou P, Ogbuagu KF, Okello D, Ozoh G, Remme J, 2002. Onchocerciasis: the clinical and epidemiological burden of skin disease in Africa. Ann Trop Med Parasitol 96 : 283–296.
  7. Abiose A, 1998. Onchocercal eye disease and the impact of Mectizan treatment. Ann Trop Med Parasitol 92 : 511–522.
  8. Mabey D, Whitworth JA, Eckstein M, Gilbert C, Maude G, Downham M, 1996. The effects of multiple doses of ivermectin on ocular onchocerciasis. A six-year follow-up. Ophthalmology 103 : 1001–1008.
  9. Whitworth JA, Gilbert CE, Mabey DM, Maude GH, Morgan D, Taylor DW, 1991. Effects of repeated doses of ivermectin on ocular onchocerciasis: community-based trial in Sierra Leone. Lancet 338 : 1100–1103.
  10. Brieger WR, Awedoba AK, Eneanya CI, Hagan M, Ogbuagu KF, Okello DO, Ososanya OO, Ovuga EB, Noma M, Kale OO, Burnham GM, Remme JH, 1998. The effects of ivermectin on onchocercal skin disease and severe itching: results of a multicentre trial. Trop Med Int Health 3 : 951–961.
  11. Drameh P, Richards F, Derstine P, Cross C, 2002. Ten years of NGO efforts in controlling onchocerciasis. Trends Parasitol 18 : 378–380.
  12. Seketeli A, Adeoye G, Eyamba A, Nnoruka E, Drameh P, Amazigo UV, Noma M, Agboton F, Aholou Y, Kale OO, Dadzie KY, 2002. The achievements and challenges of the African Programme for Onchocerciasis Control (APOC). Ann Trop Med Parasitol 96 (Suppl 1): S15–S28.
  13. Anosike JC, Onwuliri COE, Payne VK, Amuta EU, Akogun OB, Adeiyongo CM, Nwoke BEB, 1992. Observations on man-sonellosis among Ibos of Abia and Imo State, Nigeria. Angew Parasitol 33 : 235–241.
  14. Nmorsi OP, Oladokun IA, Egwunyenga OA, Oseha E, 2002. Eye lesions and onchocerciasis in a rural farm settlement in Delta state, Nigeria. Southeast Asian J Trop Med Public Health 33 : 28–32.
  15. Udonsi JK, 1988. Filariasis in the Igwun River Basin, Nigeria: an epidemiological and clinical study with a note on the vectors. Ann Trop Med Parasitol 82 : 75–82.
  16. Noma M, Nwoke BEB, Nutall I, Tambala PA, Enyoung P, Namsenmo A, Remme J, Amazigo UV, Kale OO, and Seketeli A, 2002. Rapid epidemiological mapping of onchocerciasis (REMO): its application by the African Programme for Onchocerciasis Control (APOC). Ann Trop Med Parasitol 96 (Suppl 1): S29–S39.
  17. Albiez EJ, Buttner DW, Duke BO, 1988. Diagnosis and extirpation of nodules in human onchocerciasis. Trop Med Parasitol 39 (Suppl 4): 331–346.
  18. Drentlaw KL, Visual Acuity: The Critical Measure. Association of Technical Personnel in Ophthalmology (ATPO). Available at http://www.atpo.org/Education/Continuing_Education_Articles/Drentlaw%20Visual%20Acuity.pdf. Accessed 11/02.
  19. Manafa OU, Isamah AN, 2002. Local knowledge and attitudes about onchocerciasis in Oji-River local government area of Enugu State, Nigeria. Epidemiol Infect 129 : 629–633.
  20. UNICEF, 1998. The State of the World’s Children, 1998. Oxford, United Kingdom: Oxford University Press.
  21. Dadzie KY, 1990. Changes in ocular onchocerciasis four and twelve months after community based treatment with ivermectin in a holoendemic onchocerciasis focus. Trans R Soc Trop Med Hyg 84 : 103–108.
  22. Cousens SN, Cassels-Brow A, Murdoch I, Babalola OE, Jatau D, Alexander NDE, Evans JE, Danboyi P, Abiose A, Jones BR, 1997. Impact of annual dosing with ivermectin on progression of onchocercal visual field loss. Bull World Health Organ 75 : 229–236.
  23. Chippaux JP, Boussineq M, Fobi G, Lafleur C, Auduge A, Banos MT, Ngosso A, Prod’hon J, 1999. Effect of repeated ivermectin treatments on ocular onchocerciasis: evaluation after six to eight doses. Ophthalmic Epidemiol 6 : 229–246.
  24. Kennedy MH, Bertocchi I, Hopkins AD, Meredith SE, 2002. The effect of 5 years of annual treatment with ivermectin (Mectizan) on the prevalence and morbidity of onchocerciasis in the village of Gami in the Central African Republic. Ann Trop Med Parasitol 96 : 297–307.
  25. Moulton L, 1998. Community based rehabilitation and prevention of blindness in south west Uganda. Community Eye Health 11 : 51–52.
  26. Foster A, 1987. Cataract blindness. Med Digest 13 : 4–8.
  27. Onabolu O, 1989. Studies of rural ophthalmology in two villages of Remo Division of Ogun State. Niger Med Pract 18 : 11–13.
  28. Ukaga CC, Dozie IN, Nwoke BE, 2001. Validation of reports of nodules dissolution after repeated ivermectin treatment of onchocerciasis in southeastern Nigeria. East Afr Med J 78 : 515–517.
  29. del Mar Saez-De-Ocariz M, McKinster CD, Orozco-Covarrubias L, Tamayo-Sanchez L, Ruiz-Maldonado R, 2002. Treatment of 18 children with scabies or cutaneous larva migrans using ivermectin. Clin Exp Dermatol 27 : 264–267.
  30. Miri ES, 1998. Problems and perspective of managing an onchocerciasis control programme: a case study from Plateau State, Nigeria. Ann Trop Med Parasitol 92 : 121–128.
  31. Onwujekwe O, Chima R, Shu E, Okonkwo P, 2002. Community-directed treatment with ivermectin in two Nigerian communities: an analysis of first year start-up processes, costs and consequences. Health Policy 62 : 31–51.

Data & Media loading...

  • Received : 26 Aug 2003
  • Accepted : 14 Dec 2003

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error