Apoc impact assessment study: baseline prevalence and distribution of ocular Onchocerciasis in three ecological zones in Nigeria
Publication year: 1999
During the APOC/WHO Impact Assessment studies in Nigeria held in 1998 and 1999,
one thousand and sixty four randomly selected subjects underwent detailed eye
examination in three selected sites namely, Cross River State (rain forest ecological
zone), Taraba State (savanna ecological zone) and Kogi State (forest- savanna
ecological zone).
The general objective of the impact assessment studies was to evaluate the
ophthalmological impact of onchocerciasis control (CDTI) in Nigeria, this paper
highlights the public health significance of ocular onchocerciasis in three different
ecological zones in Nigeria.
The presence of ocular onchocerciasis was established in all the study sites, with a
predominance of posterior segment manifestations, in the rain forest zone. A blindness
prevalenc e of 2.4o/o was recorded in the study, with onchocerciasis being responsible for
13 out of the 43 (30.2%) bilaterally blind subjects identified. Onchocerciasis-induced
blindness prevalence was relatively high in the rain forest and forest savanna zones of
Cross River and Kogi States with Cross River State having the highest site-specific-
prevalence (5/10) 50.0% of onchocercal blindness followed by Kogr with (5/12) 41.7%.
Taraba site recorded only 27.3% (3121). Other conditions identified included glaucoma,
optic nerve disease and cataract rates of which were also found to be high among the
population (6.90/o,6.5 % and8.9oh respectively). Anterior segment onchocercal lesions,
punctate and sclerosing keratitis were the predominant features of the infection in
Taraba site (14.1o/o and 6.3% respectively), a savanna zone while posterior segment
lesions were much more common in the forest zone of Cross-River site. Visual field
measurements reflected the predominant posterior segment disease.
The need to sustain the present efforts aimed at controlling onchocerciasis through
mass ivermectin distribution is fuither highlighted. Integration of other Eye Care
Programme for the conffol of glaucoma and cataract, into the community directed
treatment initiative of APOC for onchocerciasis control should also be strongly
considered, in order to drastically reduce the prevalence and incidence of ocular
morbidity and blindness, in Nigeria, especially in the onchocerciasis endemic areas.