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The prevalence of onchocerciasis in Africa and Yemen, 2000–2018: a geospatial analysis

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posted on 2023-12-19, 11:44 authored by CA Schmidt, EA Cromwell, E Hill, KM Donkers, MF Schipp, KB Johnson, DM Pigott, J Abbas, V Adekanmbi, OO Adetokunboh, MB Ahmed, FM Alanezi, TM Alanzi, V Alipour, CL Andrei, T Andrei, D Anvari, SCY Appiah, M Aqeel, J Arabloo, MA Jafarabadi, M Ausloos, AA Baig, M Banach, TW Bärnighausen, K Bhattacharyya, ZA Bhutta, A Bijani, OJ Brady, NL Bragazzi, ZA Butt, F Carvalho, VK Chattu, SMA Dahlawi, G Damiani, FM Demeke, K Deribe, SD Dharmaratne, D Diaz, A Didarloo, L Earl, MES Zaki, M El Tantawi, N Fattahi, E Fernandes, NA Foigt, M Foroutan, RC Franklin, Y Guo, A Haj-Mirzaian, S Hamidi, H Hassankhani, C Herteliu, TB Higazi, M Hosseini, M Hosseinzadeh, M Househ, OS Ilesanmi, IM Ilic, MD Ilic, SSN Irvani, RP Jha, JS Ji, JB Jonas, JJ Jozwiak, LR Kalankesh, N Kamyari, BK Matin, SE Karimi, GA Kayode, AK Karyani, EA Khan, MN Khan, K Khatab, MM Khater, N Kianipour, YJ Kim, S Kosen, D Kusuma, C La Vecchia, VC Lansingh, PH Lee, S Li, S Maleki, MA Mansournia, FR Martins-Melo, C McAlinden, W Mendoza, T Mestrovic, M Moghadaszadeh, A Mohammadian-Hafshejani, SM Mohammadi, S Mohammed, R Moradzadeh, P Moraga, M Naderi, AJ Nagarajan, I Negoi, CT Nguyen, HLT Nguyen
Background: Onchocerciasis is a disease caused by infection with Onchocerca volvulus, which is transmitted to humans via the bite of several species of black fly, and is responsible for permanent blindness or vision loss, as well as severe skin disease. Predominantly endemic in parts of Africa and Yemen, preventive chemotherapy with mass drug administration of ivermectin is the primary intervention recommended for the elimination of its transmission. Methods: A dataset of 18,116 geo-referenced prevalence survey datapoints was used to model annual 2000–2018 infection prevalence in Africa and Yemen. Using Bayesian model-based geostatistics, we generated spatially continuous estimates of all-age 2000–2018 onchocerciasis infection prevalence at the 5 × 5-km resolution as well as aggregations to the national level, along with corresponding estimates of the uncertainty in these predictions. Results: As of 2018, the prevalence of onchocerciasis infection continues to be concentrated across central and western Africa, with the highest mean estimates at the national level in Ghana (12.2%, 95% uncertainty interval [UI] 5.0–22.7). Mean estimates exceed 5% infection prevalence at the national level for Cameroon, Central African Republic, Democratic Republic of the Congo (DRC), Guinea-Bissau, Sierra Leone, and South Sudan. Conclusions: Our analysis suggests that onchocerciasis infection has declined over the last two decades throughout western and central Africa. Focal areas of Angola, Cameroon, the Democratic Republic of the Congo, Ethiopia, Ghana, Guinea, Mali, Nigeria, South Sudan, and Uganda continue to have mean microfiladermia prevalence estimates exceeding 25%. At and above this level, the continuation or initiation of mass drug administration with ivermectin is supported. If national programs aim to eliminate onchocerciasis infection, additional surveillance or supervision of areas of predicted high prevalence would be warranted to ensure sufficiently high coverage of program interventions.

Funding

To expand the evidence base for effective policymaking in health by substantially improving the spatial and temporal resolution at which we can map, and therefore track, major global health challenges, including the major causes of under-5

Bill & Melinda Gates Foundation

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History

Author affiliation

School of Business, University of Leicester

Version

  • VoR (Version of Record)

Published in

BMC Medicine

Volume

20

Issue

1

Pagination

293

Publisher

BMC

issn

1741-7015

eissn

1741-7015

Copyright date

2022

Available date

2023-12-19

Spatial coverage

England

Language

eng

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