Tag Archives: ivermectin

How a Nigerian General Became an Advocate for Stopping River Blindness

Lieutenant General (Ret.) Theophilus Yakubu (TY) Danjuma knows river blindness firsthand. As a Nigerian who grew up in a country with one of the highest rates of river blindness (also known as onchocerciasis) infection in the world, he has not only witnessed the devastation this disease can bring to families and communities, but has also suffered from the disease himself.

River blindness produces rashes, skin lesions and severe skin inflammation that can make the skin change color and lose elasticity. People suffering from the disease often face daily social humiliation and isolation, and infected children struggle to pay attention in school because of intense itching. River blindness, however, is aptly named. Its most debilitating symptoms are severe visual impairment and irreversible blindness.

General Danjuma’s experience with this disease began in the 1960s. While leading a company of soldiers in Nigeria, he was bitten by the Simulium black fly that transmits the worm larvae that cause river blindness. For two years, the larvae spread throughout his body, maturing into adult worms and releasing bacteria that eventually trigger an immune system response. He awoke one morning with swollen eyes and itchy, inflamed skin. General Danjuma successfully underwent two weeks of treatment and experienced no lasting symptoms, but says he has never forgotten the sight of his own skin sample under the microscope at the local clinic. He still shivers at the memory of tiny worms swimming in and out of view under the lens.

General Danjuma is the Grand Patron of an important NGO based in Jos, in Northern Nigeria. The NGO, The Mission to Save the Helpless, better known by its acronym MITOSATH” is well known to the health team in the Africa Region as an important partner of African Programme for Onchocerciasis Control (APOC). MITOSATH is also among the most active NGOs in Nigeria contributing to the control of river blindness other neglected tropical diseases.

Controlling River Blindness in Africa: Setting an Example

A young boy leads a man impacted by river blindness. Photo by Olivier Asselin.

 

 

 

 

 

 

 

 

 

 

 

 

 

When river blindness control programs were first implemented in the 1970s, up to half of all adults in some hard-hit communities had gone blind from the disease. This tragedy caused many Africans to abandon their ancestral homes and livelihoods; the economic losses were estimated at US$30 million. The first Onchocerciasis Control Programme focused primarily on spraying insecticide over infected areas in order to minimize the prevalence of the black fly, preventing transmission of the parasitic worms from person to person, and eventually incorporated treatment with Ivermectin, the drug that treats river blindness, when it became available.

With the help of the World Health Organization and the World Bank in 1995, this program was expanded and renamed the African Programme for Onchocerciasis Control (APOC). Rather than attempting to control the black fly population, APOC sought to control the parasitic worms in humans through community-directed treatment with Ivermectin in 19 countries. Treatment with Ivermectin successfully kills the worms in the people who have them, thereby disrupting transmission of the disease.

Merck & Co. donates Ivermectin to Nigeria (and other countries in need), and APOC trains volunteers to distribute the drug in communities. Today, APOC provides Ivermectin to more than 96 percent of endemic communities in Nigeria, reaching more than 23 million people. Until everyone is treated, however, the risks of re-infection and new outbreaks remain. River blindness is still present in most Nigerian states, including Taraba state where General Danjuma was born. The disease continues to deeply impact communities and the lifetime productivity of the 31 million Nigerians at risk.

Now a successful businessman and politician, General Danjuma’s personal experience with river blindness and the success of MITOSATH and APOC motivated him to donate US$1 million to the program in 2010. With his donation, he hopes to invigorate interest in public health challenges in rural Africa. General Danjuma noted that, “these are not the neglected diseases of tropical Africa, but rather the diseases of neglected people.”

General Danjuma’s crusade to raise the profile of rural health issues has already gained momentum. Following his example, in 2011, the government of Nigeria pledged an additional US$5 million to APOC to assist with its control efforts. General Danjuma hopes that other countries and the private sector will join the movement to eliminate this debilitating disease once and for all.

 

In March 2012, General Danjuma participated in a panel discussion at the Center for Strategic and International Studies. Read our blog post on that event here.

 

Drug Used to Treat River Blindness Could Reduce Malaria Transmission

A new study published in the American Journal of Tropical Medicine revealed that ivermectin, which is used to treat onchocerciasis (also known as river blindness) can also interrupt the transmission of malaria.

From an article on the study:

“The study by scientists from Senegal and Colorado State University found that transmission of malaria parasites by mosquitoes fell substantially among people living in several Senegalese villages over two weeks after they took the drug ivermectin, which was administered as part of a campaign to fight the parasitic roundworm that causes onchocerciasis, or river blindness. The drug appeared to kill malaria-carrying mosquitoes that fed on the blood of the villagers.”

Dr. Peter Hotez, President of the Sabin Vaccine Institute was also quoted in the article saying, “This study offers good news on several fronts, not the least of which is the potential to disrupt the transmission of malaria and save needless suffering and death. We need more creative science like this that has simple yet powerful results in our battle against neglected diseases of poverty. In terms of river blindness, this drug has transformed lives, said Hotez. “To add malaria to its already impressive return on investment would be an incredible development.”

Treating both NTDs and malaria simultaneously is cost-effective and will save many more lives in the long run. To find out how you can help the distribution of ivermectin and other drugs to treat NTDs for just 50 cents, please visit our Get Involved page.

Science magazine also had a write up on the study mentioning the work of the Global Network. The article quotes Dr. Hotez saying, “We’re only beginning to understand the enormous potential impact of MDAs on diseases for which they weren’t intended.”

Venezuela Interrupts Transmission of Onchocerciasis in North-Central Region

Venezuela has successfully interrupted the transmission of onchocerciasis in the north-central region of the country. Using its National Onchocerciasis Elimination program, the country distributed ivermectin throughout the region over a course of seven years (2003-2007). The program was implemented with the goal of interrupting transmission within the region by 2012. Read more about this breakthrough in the fight against NTDs on the Pan American Health Organization’s (PAHO) website.

Photo Courtesy of PAHO

Elimination of lymphatic filariasis: do we have the drugs to complete the job?

2020 is the deadline that the WHO Global Programme to Eliminate Lymphatic Filariasis (GPELF) set to eliminate lymphatic filariasis (LF). Currently LF is treated through mass drug administration (MDA) – which is administering drugs to an entire population to treat a diseases -  using diethylcarbamazine or ivermectin monotherapy, or either drug in combination with albendazole. However, over the past five years of MDA, transmission of LF has yet to be interrupted. Other issues that have arisen include development of adverse health effects (specifically the onset of Loa loa) associated with consumption of the current drugs used for treatment. Moses J. Bockarie and Rinki M. Deb of the Liverpool School of Tropical Medicine recently published an article reviewing the current state of LF elimination. Read the full article here.