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Review
. 2021 Jan 2;14(1):3.
doi: 10.1186/s13071-020-04507-2.

Onchocerciasis control in Ghana (1974-2016)

Nana-Kwadwo Biritwum  1   2 , Dziedzom K de Souza  3 , Odame Asiedu  4 , Benjamin Marfo  4 , Uche Veronica Amazigo  5   6 , John Owusu Gyapong  7
Affiliations
Review

Onchocerciasis control in Ghana (1974-2016)

Nana-Kwadwo Biritwum et al. Parasit Vectors. .

Abstract

Background: The control of onchocerciasis in Ghana started in 1974 under the auspices of the Onchocerciasis Control Programme (OCP). Between 1974 and 2002, a combination of approaches including vector control, mobile community ivermectin treatment, and community-directed treatment with ivermectin (CDTI) were employed. From 1997, CDTI became the main control strategy employed by the Ghana OCP (GOCP). This review was undertaken to assess the impact of the control interventions on onchocerciasis in Ghana between 1974 and 2016, since which time the focus has changed from control to elimination.

Methods: In this paper, we review programme data from 1974 to 2016 to assess the impact of control activities on prevalence indicators of onchocerciasis. This review includes an evaluation of CDTI implementation, microfilaria (Mf) prevalence assessments and rapid epidemiological mapping of onchocerciasis results.

Results: This review indicates that the control of onchocerciasis in Ghana has been very successful, with a significant decrease in the prevalence of infection from 69.13% [95% confidence interval) CI 60.24-78.01] in 1975 to 0.72% (95% CI 0.19-1.26) in 2015. Similarly, the mean community Mf load decreased from 14.48 MF/skin snip in 1975 to 0.07 MF/skin snip (95% CI 0.00-0.19) in 2015. Between 1997 and 2016, the therapeutic coverage increased from 58.50 to 83.80%, with nearly 100 million ivermectin tablets distributed.

Conclusions: Despite the significant reduction in the prevalence of onchocerciasis in Ghana, there are still communities with MF prevalence above 1%. As the focus of the GOCP has changed from the control of onchocerciasis to its elimination, both guidance and financial support are required to ensure that the latter goal is met.

Keywords: Community-directed ivermectin treatment; Ghana; Ivermectin; Onchocerciasis control.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Therapeutic coverage of community-directed treatment with ivermectin in Ghana (1997–2016)
Fig. 2
Fig. 2
Yearly microfilaria (Mf) prevalence estimates. Dots indicate the prevalence for each community assessed. Error bars indicate SE, horizontal lines represent mean Mf prevalence
Fig. 3
Fig. 3
Mf prevalence estimates for the periods 1975–1980, 1990–1997 and 2007–2015. Error bars represent SEM
Fig. 4
Fig. 4
a–c Change in Mf prevalence in Ghana. a Hyper and mesoendemic areas, 1975–1980. b Hyper-, meso- and hypoendemic areas, 1990–1997; c classification based on elimination thresholds, 2007–2015
See this image and copyright information in PMC

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