Onchocerciasis in Sierra Leone.2: A comparison of forest and savanna villages

Very little of the original primary forest remains in Sierra Leone and the savanna is mainly woodland or a forest-savanna mosaic. The prevalence of microfilariae of Onchocerca volvulus, nodules and moderate or severe skin lesions was higher in forest than savanna villages. In forest villages the prevalence of microfilariae was 71.8% at the iliac crest, 36.6% (outer canthus), 12.8% (cornea) and 34.1% in the anterior chamber of the eye. Corresponding figures for the savanna villages were 51.9%, 20.5%, 5.6% and 21.8%. The overall prevalence of nodules in the forest and savanna was 70.5% and 53.2% respectively, while the prevalence of head and upper body nodules was 14.8% (forest) and 11.0% (savanna). The prevalence of moderate or severe skin lesions was 17.7% in forest and 13.0% in savanna villages. Lesions of the groin and scrotum were few in both zones. In persons aged 30 years or more the prevalence rates of severe eye lesions--sclerosing keratitis, iritis, optic atrophy and choroidoretinitis--were 4.3%, 16.1%, 13.9% and 14.8% respectively in forest villages. Corresponding figures for the savanna villages were 3.7%, 8.7%, 14.2% and 11.3%. Males were more commonly affected than females. At least one of these lesions was found in 32% persons in forest and 24% in savanna villages.