River blindness tamed in more districts

Aug 06, 2014

UGANDA’S expert advisory team on river blindness elimination on Wednesday declared that transmission of river blindness in Moyo district has been interrupted

By Taddeo Bwambale

UGANDA’S expert advisory team on river blindness elimination on Wednesday declared that transmission of river blindness in Moyo district has been interrupted.

This raises the number of districts where transmission has been interrupted to 12 out of 16 where river blindness has previously been endemic.

River blindness, known scientifically as onchocerciasis, is a parasitic infection that can cause intense itching, skin discoloration, rashes, and eye disease that can lead to permanent blindness.

It is transmitted through bites of black flies that breed in fast-flowing streams and rivers, hence the commonly known name of ‘river blindness’.

Interruption of transmission is a key step in eradicating the disease. It is based on reduction in the number of infected population and the vector- the black fly.

The revelation raises Uganda’s hope of wiping out the disease across the country by 2020.

“It is a sign of good progress and Uganda is a model for the elimination campaign,” said Dr Moses Katabarwa, a senior epidemiologist at the Carter Centre which supports the campaign.

Katabarwa, a member of Uganda’s expert advisory committee on river blindness said at least 2.1 million Ugandans were considered safe from the disease after the new findings.

In Uganda, river blindness has been endemic in 16 districts, with an estimated 1.4 million people affected and at least 3 million people at risk of infection.

At least 5,400 people in Kitgum, Lamwo and Pader districts are either blind or visually impaired due to river blindness since the 1990s. 

The inter-agency expert advisory committee is meeting in Kampala to review the country’s progress on eliminating river blindness.

The experts are reviewing preliminary findings from previously endemic sites across the country that show a drop in transmission of the disease in at least three regional sites.

The sites are Obongi which covers Moyo district; West Nile (Koboko and Yumbe) and Nyamugasani (Kasese).

Other sites where transmission has been stopped are: Wadelai which covers Nebbi district, Mt. Elgon (Mbale, Sironko, Bududa and Manafwa), Itwara (Kabarole and Kyenjojo), Mpamba-Nkusi (Kibaale), Maracha-Terego (Maracha) and Imaramagambo (Bushenyi and Mitooma).

The findings show a marked reduction in the presence of black flies in all the sites while blood tests on patients reveal that they do not have microfilariae.

Treatment has been stopped in some sites but post-treatment surveillance measures will continue for at least three years in the affected areas. 

Noah Tibamwenda, who is in charge of Lhubiriha and Nyamugasani sites in Kasese, said there was marked reduction in the presence of infected black fly and patients with microfilariae.

Uganda reduced prevalence of river blindness from 70% in 1993 to about 5% presently.

Uganda became the first African country to adopt the approach of eliminating the disease by combining mass treatment of patients and spraying to kill the black fly.

A team of experts from Ethiopia and Nigeria is in the country to learn from Uganda’s experience in eliminating river blindness, after adopting a similar approach.

Prof Tom Unnasch, the chair of the Uganda’s expert advisory committee, called for cross-border ties for Uganda, South Sudan and Democratic Republic of Congo in the fight against the disease.

The Director General of Health Services, Dr Jane Ruth Aceng said Uganda had developed a master plan on elimination of all neglected tropical diseases, including river blindness.

Globally, river blindness affects 18 million people, with 96% of the cases in Africa, according to the World Health Organisation.

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