Olamiju Francisca O, Mogaji Hammed O, Bjørn Marcus Trappaud, Marcus Ayodele J, Oduwa Vera, Olamiju Olatunwa J, Nzunde Markus, Ikyerga David K, Hopkins Adrian
Mission To Save The Helpless (MITOSATH), Jos, Nigeria.
Parasitology and Epidemiology Unit, Department of Animal and Environmental Biology, Federal University Oye-Ekiti, Nigeria.
Parasite Epidemiol Control. 2023 Mar 11;21:e00296. doi: 10.1016/j.parepi.2023.e00296. eCollection 2023 May.
Onchocerciasis is the world's second leading cause of infectious blindness and remains a major problem in parts of Africa. In light of the efforts targeted towards improving ongoing elimination program, this study assessed onchocerca-induced visual impairments in Gashaka local government areas (LGA) in Taraba State, north-eastern Nigeria.
In 2019, we recruited 158 consenting visually impaired persons across three communities in Garbabi ward of Gashaka LGA. To avoid confusion with co-endemic trachoma, the integrity of the tarsal conjunctiva, eyelashes were assessed using direct light. The anterior segment of the eye was also examined using a torchlight with oblique illumination. However, the posterior segment of the eye was assessed using a fundus camera. Two photographic images for the left and right eye of each participant were captured using the clinical fundus camera. The photographic eye images that were too dark were discarded, and only clear images were analyzed by two ophthalmologists. An ocular manifestation report was recorded for each participant following consensus between the ophthalmologists.
Of the 316 photographic eye images, almost half 146 (46.2%) from 73 participants were just too destroyed for light to penetrate and was not included in the analysis. Only 170 from 85 participants were clear and examinable. A total of 33 (39%) participants had chorioretinitis suggestive of onchocerciasis, including 22(25.9%) with chorio-retinal atrophy, 7(8.2%) and 4(4.7%) had chorioretinal atrophy in combination with early cataract and signs of trachoma respectively. In addition, 3(3.5%) of the participant had eye images which showed lens opacities, 1(1.2%) showed signs of keratoconus and 1(1.2%) showed a scared and pigmented cornea, possibly due to onchocerciasis. Furthermore, 28 (32.9%) had some ill-defined changes and 19 (22.4%) showed poorly defined chorio-retinal atrophy.
In a bid to sustain MDA gains towards elimination of onchocerciasis, this work highlights the need for continuous assessment of onchocerciasis induced visual impairment, strengthening of ivermectin delivery and optimizing compliance and patient care among affected populations. These would require resource acquisition and local capacity building. Our preliminary findings call for further operational research on ocular morbidity as well as future stakeholders' consultations in this important and understudied area.
盘尾丝虫病是全球感染性失明的第二大主要病因，在非洲部分地区仍然是一个重大问题。鉴于为改善现行消除计划所做的努力，本研究评估了尼日利亚东北部塔拉巴州加沙卡地方政府辖区（LGA）盘尾丝虫引起的视力损害情况。
2019年，我们在加沙卡LGA加尔巴比区的三个社区招募了158名同意参与的视力受损者。为避免与共同流行的沙眼混淆，使用直射光评估睑结膜和睫毛的完整性。还用手电筒进行斜照检查眼睛的前段。然而，使用眼底相机评估眼睛的后段。使用临床眼底相机为每位参与者的左眼和右眼拍摄两张照片。丢弃太暗的眼部照片，仅由两名眼科医生分析清晰的图像。在两位眼科医生达成共识后，为每位参与者记录一份眼部表现报告。
在316张眼部照片中，来自73名参与者的近一半（146张，46.2%）损坏严重，光线无法穿透，未纳入分析。只有来自85名参与者的170张照片清晰且可检查。共有33名（39%）参与者患有提示盘尾丝虫病的脉络膜视网膜炎，其中22名（25.9%）患有脉络膜视网膜萎缩，7名（8.2%）和4名（4.7%）分别患有合并早期白内障和沙眼体征的脉络膜视网膜萎缩。此外，3名（3.5%）参与者的眼部图像显示晶状体混浊，1名（1.2%）显示圆锥角膜体征，1名（1.2%）显示可能由盘尾丝虫病引起的角膜瘢痕和色素沉着。此外，28名（32.9%）有一些不明确的变化，19名（22.4%）显示不明确的脉络膜视网膜萎缩。
为了维持大规模药物驱虫（MDA）在消除盘尾丝虫病方面取得的成果，这项工作强调需要持续评估盘尾丝虫病引起的视力损害，加强伊维菌素的给药，并优化受影响人群的依从性和患者护理。这些需要资源获取和当地能力建设。我们的初步研究结果呼吁在这个重要且研究不足的领域进一步开展关于眼部发病率的行动研究以及未来与利益相关者的磋商。
