Sight for the Blind

Presented by:Berhane Chiche

MPH Student

Environmental Health-PUBH 6165 - 5

Instructor: Dr. Raymond Thron

Summer Qtr. 2014

Walden University

Introduction

This presentation is mainly focused on:

Educating Ethiopian people about River Blindness, (Onchocerciasis)

Its causes, effects, preventions, controls, and available resources.

The major stakeholders of this presentation include:

Ethiopian Federal Government

Teppi province ministry of health

Community Health Center

Introduction (Cont’d)

Non- Governmental Organization (NGOs)

Charity Organizations through churches

World Health Organization (WHO)

The Carter Center Foundation and River Blindness

The National Onchocerciasis Task Force (NOTF)

Environmental Health Department

Map of Ethiopia

The audience of this presentation Representative from Ministry of Health

Local Health center Workers including doctors, Nurses, and Axillary nurses

Representative from different charity organization

Jimma University Medical School

Carter's foundation representative

Objectives of this presentation

Participants should be able to identify possible causes of River Blindness (Onchocerciasis)

How the disease spread among the population

Knowing prevention method at primary, secondary, and tertiary level

Identify barriers to the access of services to those suffering from this disease

The community of Teppi should be able to participate in the discussion to minimize the River blindness

Objectives (Cont’d)

To Create Awareness in the community

To get non-governmental financial and help for the people who are suffering from Oncosoroasis.

To get the Ethiopian government attention to fight and eradicate River Blindness in Teppi region and other part of the country

To reach other parts of the country who are suffering from the same dilemma of the disease

To know the current diagnosis and treatment available for River blindness

Pathophysiology of River Blindness

In 1875, the scientist, John O’neill was the first to observe and document volvulus microfilariae,

with the name craw-craw, the West African name of the disease.

Almost 50 years later, the scientist Blacklock discovered that the true cause of River Blindness is simulium (Hoerauf, 2003).

Hoerauf, A. (2003). Onchocerciasis. Journal of Science, Medicine, and the Future, v.326,p.207-210.

What causes onchoceriasis?

River Blindness is a given nickname to this disease because of it occurrence mostly in rural areas near rapid flowing river.

An infection manifested by onchoceriasis which resides and multiplies at river out flow

It ranks 2nd causing blindness in the world.

River Blindness or Onchocerciasis is a vision hazard manifested by onchocerca volvulus. It is found where river stream is found

World Health Organization (WHO), (2002) and (www.sightsavers.org/in)

What causes onchoceriasis?(Cont'd)

It is one of the Neglected tropical disease (NTD) River Blindness (Onchoceriasis) public health

concern and is one of the socioeconomic importance in Ethiopia.

There is insufficient information on River Blindness in Ethiopia

Zein, A. Z. (1986): The epidemiology of onchocerciasis in north western Ethiopia. Trop. Geog. Med.; 38(1):33-37

Significance of River Blindness in Different countries

Approximately 17.7 million people are affected worldwide by onchoceriasis

Nearly 99% of infected persons live in Africa and the 1% lives in Yemen and six countries in America

Over 500,000 individuals encounter visual damage. 270,000 individuals lost their sight by this disease.

http://cid.oxfordjournals.org/content/44/1/53.long)

 

(http://cid.oxfordjournals.org/content/44/1/53.long)

Significance Cont`d

The southwestern part of Teppi region has high prevalence rate (85.3%)

Kuwara region has the lowest prevalence rate (6.9%)

(ispub.com/IJPD/1/2/3369)

Diagnosis of River Blindness

The diagnosis is referred as skin disease

Nodules form around the worms on the skin

Inflammation cause on the skin surface

Skin snip

General antibody test

In Ethiopia, it is more of skin disease and enlargement of the scrotal in male.

(www.cdc.gov/parasites/onchocerciasis/add)

Mode of Transmission

Effects of the disease

Eyes of infected person and how the worm is embedded under the skin disfiguring the body.

(World Health Organization, 2010).

Treatment for River blindness

The drug Ivermectin does not kill the adult parasites in the body, but it does reduce the microfilariae in the skin so that the disease does not progress. This medication is administered orally.

Mectizan is another potent drug that temporarily renders the female worm infertile. This kills the larvae (Center for the Disease Control and Prevention, 2010).

emedicine.medscape.com/article/224309-overview & (www.cdc.gov/parasites/onchocerciasis/add)

Intervention, Prevention and control

There are two main actions needed:

The spraying of larvicides in and around the breeding sites of the black fly.

Early treatment with a powerful drug called Ivermectin that kills the young worms in the body (World Health Organization,

2010).

Demographics of River blindness

There are two main actions needed:

The spraying of larvicides in and around the breeding sites of the black fly.

Early treatment with a powerful drug called Ivermectin that kills the young worms in the body (World Health Organization, 2010).

(World Health Organization, 2010).

Who is at risk to get this disease?

Travelers, missionaries, and Peace Corp volunteers

People who live in villages near rapidly flowing streams/rivers (CDC, 2010):

(www.cdc.gov/parasites/onchocerciasis/add)

Conclusion Ocular onchocerciasis considered as mild

or rare in Ethiopia, but ocular manifestations has been reported in some of the studies. This needs more research.

The popularity of the disease is related with the daily occupational work including farming near the river, taking bath in the river, and also swimming which reveals the person to the vector.

Conclusion (Cont'd)

River blindness is a serious condition which has been neglected for so long because of inadequate treatment and early diagnosis.

Measures should be taken by individuals, communities, organizations at both State and Federal level to fight this disease.

We can lower the incidence rate of River blindness and make our citizens free from this terrible disease by disseminating information Education on this disease.

Recommendations

Ethiopian researchers` and nonprofit organizations, and interested individuals need to study more on ocular manifestations in divergent provinces of Ethiopia.

The federal government and NGO’s should continue to work together to elevate consciousness to the communities in endemic area-----etc.

World Health Organization, 2002).

Recourses for Help Local Health Centers

Ministry of Health

Sight Savers

Charity Organizations like Churches

Missionary Organizations like Helen International

Carter foundation for the blind

References:

Centers for Disease Control and Prevention (CDC), (2010): Onchocerciasis FAQs: Retrieved on from (www.cdc.gov/parasites/onchocerciasis/add)

Hoerauf, A. (2003). Onchocerciasis. Journal of Science, Medicine, and the Future, v.326,p.207-210.

Udell, D. (2007): Recent Updates on Onchocerciasis: Diagnosis and Treatment. Oxford Journals Retrieved from(http://cid.oxfordjournals.org/content/44/1/53.long)

River Blindness (2000): Retrieved from(http://www.cartercenter.org/countries/ethiopia.html

Jira, C. (1993). Prevalence of onchocerciasis in Blue Nile valley of western Ethiopia. Indian J. Pub. Hlth; 37(4):135-7 .

References (cont'd)

Taticheff, S., Williams, J. F. & Wondimu, W.(1993): Longitudinal study of onchocerciasis in Bebeka, Ethiopia. Ethiopian med. J. 31(3): 191-200 (ispub.com/IJPD/1/2/3369)

Taticheff, S., Abebe, M., Workneh, W. & Hana N.G. (1987): Onchocerciasis: A prevalence study in Bebeka, Ethiopia. Trop. Med. Parasitol.; 38(4):279-82 (www.ncbi.nlm.nih.gov/pub)

River Blindness (2000): Carter Center. Retrieved from

(WWWwww.cartercenter.org/documents/1175.pdf)

 

.

References (cont'd)

River Blindness (2000): Carter Center. Retrieved from, (WWWwww.cartercenter.org/documents/1175.pdf)  

World Health Organization (WHO), (2002) (www.who.int/apoc/onchocerciasis/status/en/)

Zein, A. Z. (1986): The epidemiology of onchocerciasis in north western Ethiopia. Trop. Geog. Med.; 38(1):33-37