Tag Archives: onchocerciasis

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.

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.

 

UK NGO sets their sights on river blindness

Sightsavers, a UK-based NGO that addresses preventable blindness in the developing world and contributors to End the Neglect, is this year’s Financial Times (FT) seasonal appeal recipient. Sgithsavers will receive donations from British readers who contribute to the FT appeal, which will run from November 21 – mid-January. The UK government has also agreed to match individual donations made to the appeal. Click here for more information on the appeal. Below an excerpt on the current state of river blindness published in FT:

“The river in Nigeria’s poor, remote northern state of Zamfara has always played a central part in the 70-year-old’s life. He and his friends swam in it as boys “until our eyes were red”. It is a vital source of water for homes, livestock and crops in Mr Adamu’s village of Birninwaje, a fishing and farming community of 3,000 people, where he was for many years the traditional leader. It is also the source of his blindness. River blindness is endemic in these parts. The parasitical disease is named after the black flies that live near flowing waterways such as the Zamfara – and across sub-Saharan Africa, Latin America and parts of the Arabian peninsula – and transmit one of the world’s leading causes of blindness.” Click here to read the full article. Also, check Jeremiah Norris’ (Director, Center for Science in Public Policy, Hudson Institute) Letter to the Editor in response to this piece.

 

Good News on River Blindness

By: Alanna Shaikh

Mexico, Colombia, and Guatemala are making huge progress against river blindness, aka onchocerciasis. Colombia has eliminated river blindness from within its borders, the first country in Latin America to do so. Mexico and Guatemala have broken the cycle of transmission, and they’re ready to stop mass drug administration next year.

Elimination is a pretty clear term. It means that the disease, while still present on our planet, is down to zero in one particular region; in this case, Colombia. But what does it mean to break the cycle of transmission? Well, onchocerciasis is a tiny parasitic worm[1] that has a pretty complicated life cycle, and one particular kind of fly is essential to the survival of the disease. Without those flies, the disease is not transmitted and dies out.

Photo Credit: The Carter Center

To break the cycle of transmission, you spray insecticide in the areas of fast moving rivers where the flies breed. No more flies, no more onchocerciasis. According to the World Health Organization (WHO), it takes fourteen years of spraying to totally eliminate the reservoir of adult onchocerciasis worms and therefore make sure that the disease is gone. Once you’ve reached that point, it takes three more years of close monitoring to ensure that the disease really is gone. If there really are no cases in those three years, then, like Colombia, your country can be certified as having eliminated the disease. Continue reading

Bite of the black fly – River Blindness

Reposted with permission from Global Health Frontline News (GHFN):

In poor, remote communities in the tropics, river blindness (onchocerciasis) infects nearly 18 million people – 99 percent of them in Africa.

Victims are infected by tiny parasitic worms that are transmitted by the bite of a small black fly that breeds in fast-flowing rivers.

Standing on the bank of the Kitomi River in western Uganda, Dr. Frank Richards, Jr., the Director of the River Blindness Program at the Atlanta-based Carter Center, says, “I wouldn’t be surprised if you got 20 to 25 bites an hour at certain times of the day here. That’s the kind of biting rate that will easily sustain river blindness.” The video below tells the rest of the story: