Onchocerciasis control program

Onchocerciasis, "river blindness", is a parasitic disease caused by a filarial worm called Onchocerca volvulus. The disease is transmitted by the blood feeding black fly, of the genus Simulidae. The fly breeds in fast flowing rivers and streams. Hence, transmission is most intense in the river valleys and the disease is most severe in communities located near these rivers. The severity of onchocerciasis is closely related to the prevalence and intensity of infection in the community. Onchocerciasis is endemic in many tropical countries but mainly in the equatorial region of Africa. Out of the estimated 18 million infected people worldwide more than 80% live in Africa.

In Ethiopia 1.38 million people were estimated to be affected by the disease in 1988, whereas 7.3 million people are at risk of infection. The endemic areas extend from the northwest part to southwest part of the country that borders the Sudan. In Ethiopia the main symptom of the disease is dermal (skin) manifestations that are characterized by intense itching and thickening of the skin, hanging groin etc. Blindness, which is a common manifestation of the disease in West Africa, is a rare complication in this country.

Ethiopia is a member of the African Program for Onchocerciasis Control (APOC), which was established in December 1995. APOC was built on the success of the onchocerciasis control program in West African countries, which now have reached to the verge of eliminating the disease. APOC is unique partnership that has brought together donors, 19 affected countries in Africa, non-governmental development organizations (NGDOs), the private sector and affected communities. The main control approach employed by this program is control of the disease by establishing community-directed treatment with the drug ivermectin (CDTI), supplemented with vector eradication in a few isolated foci.

National Onchocerciasis Task Force (NOTF) in Ethiopia was established soon after the government signed the agreement to implement CDTI in 1997. The members of the task force include MOH, the carter center, WHO and representatives from the academia and health research institutes. Immediately after its establishment, NOTF has developed a 5-year plan of action and 3 CDTI project proposals, which were submitted, were subsequently approved by WHO/APOC for funding and technical support. The first approved proposal was the Kaffa-Sheka project that marked the launching of the Ethiopian program for onchocerciasis control (EPOC) in 2000.

Goal

The ultimate goal of APOC and thus EPOC is to eliminate onchocerciasis as a disease of public health and socio-economic development importance.

Objectives

To establish effective and self-sustainable CDTI through out the endemic areas

To eliminate the vector and hence the disease

Strategy

CDTI is the main strategy of APOC and EPOC.