Concurrence of dermatological and ophthalmological morbidity in onchocerciasis

• Published in: Transactions of the Royal Society of Tropical Medicine and Hygiene 2012-04, Vol.106 (4), p.243-251
• Main Authors: Coffeng, L.E., Fobi, G., Ozoh, G., Bissek, A.C., Nlatté, B.O., Enyong, P., Olinga Olinga, J.M., Zouré, H.G.M., Habbema, J.D.F., Stolk, W.A., de Vlas, S.J., Boussinesq, M., Noma, M.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age Distribution; Aged; Animals; Antiparasitic Agents - therapeutic use; Biological and medical sciences; Burden of disease; Cameroon - epidemiology; Child; Coinfection; Concurrence; Correlation; Diseases caused by nematodes; Eye disease; Female; Filariases; General aspects; Helminthic diseases; Humans; Infectious diseases; Ivermectin - therapeutic use; Lymphatic filariases; Male; Medical sciences; Middle Aged; Onchocerca - pathogenicity; Onchocerciasis; Onchocerciasis - drug therapy; Onchocerciasis - epidemiology; Onchocerciasis - immunology; Onchocerciasis, Ocular - drug therapy; Onchocerciasis, Ocular - epidemiology; Onchocerciasis, Ocular - immunology; Onchocercosis; Parasitic diseases; Prevalence; Quality of Life; Simuliidae; Skin disease; Young Adult
• ISSN: 0035-9203; 1878-3503
• DOI: 10.1016/j.trstmh.2011.12.006

Prevalence of skin and eye disorders in African onchocerciasis (river blindness) is well documented. However, less is known about their joint occurrence. Information on concurrence may improve our understanding of disease pathogenesis and is required to estimate the disease burden of onchocerciasis. We analysed data from 765 individuals from forest villages in the Kumba and Ngambe Health districts, Cameroon. These data were collected in 1998, as baseline data for the evaluation of the African Programme for Onchocerciasis Control. Concurrence of symptoms was assessed using logistic regression. Onchocerciasis was highly endemic in the study population (63% nodule prevalence among males aged ≥20). Considerable overall prevalences of onchocercal visual impairment (low vision or blindness: 4%), troublesome itch (15%), reactive skin disease (19%), and skin depigmentation (25%) were observed. The association between onchocercal visual impairment and skin depigmentation (OR 9.0, 95% CI 3.9–20.8) was partly explained by age and exposure to infection (OR 3.0, 95% CI 1.2–7.7). The association between troublesome itch and reactive skin disease was hardly affected by adjustment (adjusted OR 6.9, 95% CI 4.2–11.1). Concluding, there is significant concurrence of morbidities within onchocerciasis. Our results suggest a possible role of host characteristics in the pathogenesis of depigmentation and visual impairment. Further, we propose a method to deal with concurrence when estimating the burden of disease.