Onchocerciasis (River blindness)

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Onchocerciasis – or “river blindness” – is a parasitic disease transmitted by repeated bites of infected blackflies.

Causes

  • Filarial nematode Onchocerca volvulus (the vector is a blackfly which breeds along fast-flowing rivers and streams)

Signs and symptoms

  • Pruritis is the most common early symptom – (can be mild to severe and intermittent to unremitting)
  • Lymphadenopathy in inguinal and femoral regions
  • Subcutaneous nodules over bony prominences
  • Visual changes can range from mild to frank blindness
  • Weight loss may occur
  • Dermatitis – acute or chronic popular dermatitis
  • Depigmentation in advanced cases

Investigations

  • Blood should be drawn at night and viewed under the microscope for the microfilaria

Pharmacological treatment

Ivermectin oral

Adults and children 5-17 years

150 microgram/kg as a single dose

Repeat

Intervals of 6-12months depending on symptoms until adult worms die out

Eye involvement

Prednisolone oral

1 mg/kg

Note: Start several days before treatment with Ivermectin

Surgical intervention

  • Excise individual nodules (nodulectomy)