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Onchocerciasis in pre-primary school children in Nigeria: lessons for onchocerciasis country control programme
1Department of Biological Science, Nnamdi Azikwe University, Awka, Nigeria.
Insights
Onchocerciasis affects 15.7% of children aged 0-4 years in Southeast Nigeria, with infection risk present from age 1. Adults show higher prevalence (26.9%), indicating universal risk in endemic areas.
Area of Science:
- Tropical medicine
- Parasitology
- Public health
Background:
- Limited data exists on onchocerciasis prevalence in young Nigerian children.
- Ivermectin treatment is contraindicated for children under five, complicating control program design.
- Infection risk and complication severity correlate with duration and intensity of onchocerciasis.
Purpose of the Study:
- To determine the prevalence of onchocerciasis in children aged 0-4 years in Enugu State, Nigeria.
- To inform the design of effective onchocerciasis control programs targeting all age groups.
Main Methods:
- A cross-sectional study was conducted involving 642 children aged 0-4 years in three Local Government Areas of Enugu State, Nigeria.
- Onchocerciasis diagnosis was based on positive skin snip results.
- Prevalence was also assessed through clinical signs like onchocercal rash and palpable subcutaneous nodules.
Main Results:
- Overall onchocerciasis prevalence in children aged 0-4 years was 15.7%.
- No infections were detected in children under one year old.
- Clinical signs included rash in 11.1% and nodules in 4.6% of children. Adult prevalence was 26.9%.
Conclusions:
- Onchocerciasis is prevalent in young children in endemic areas of Nigeria, challenging previous assumptions about age-related risk.
- The findings highlight the need for age-inclusive onchocerciasis control strategies.
- All individuals in endemic communities, regardless of age, are potentially at risk for onchocerciasis infection.
Abstract:
There is limited data on the prevalence of onchocerciasis in young children in Nigeria, partly because treatment with the effective drug Ivermectin has been contra-indicated in children less than 5. As the risk of complications of onchocerciasis is related to duration and intensity of infection, it would be beneficial to know the prevalence in young children for design of control programmes. A study was therefore undertaken to determine the prevalence of onchocerciasis in 642 children 0-4 years old in a rain forest endemic community in South East Nigeria. The overall onchocerciasis prevalence (positive skin snips) for children 0-4 years old in three Local Government Areas in Enugu State, Eastern Nigeria was 15.7% with no significant difference in infection rates between male and female children. There was no detectable infection in children less than 1 year old. Characteristic onchocercal rash was identified in 11.1% of the children and presence of typical onchocercal subcutaneous palpable nodules in 4.6%. Total prevalence for adults in the same population was found to be 26.9%. This indicates that in onchocerciasis endemic communities, everybody may be at risk of infection irrespective of age.