Clinical manifestations of Onchocerciasis and some aspects of its control in Achi, Oji River Local Government Area, Enugu State, Nigeria

The clinical manifestations of Onchocerciasis are studied to highlight both the prevalence and the nature of morbidity of the disease in Achi, Oji River Local Government Area, Enugu State, Nigeria, and to comment on the control measures currently going on in the area. The main purpose is to contribute effectively to the incumbent work covered in the whole of Nigeria on Onchocerciasis with the view of discussing the medical and socio-economic importance of the disease and its vector in human populations, in the endemic areas. Parasitological examination by skin-snipping the local populace was carried out form ward to ward to establish the disease by the presence of microfilariae of O.volvulus. Also used to establish the disease was the palpating for nodules and the presence of other clinical manifestations. Ocular examination was carried out to determine ocular Onchocerciasis by impairment of visions, partial and total blindness. Visual acuity testing was carried out by employment of Snellen's Chart. Out of 10,000 subjects clinically examined, the result of 3,000 subjects were analysed as following: a total of 2,040 (68%) had onchocerciasis (clinically), 1,530 (75%) were adults, 510 (25%) were children. Of these 504 (24.7%) had onchodermatitis, 230 (45.7%) of whom were males and 274 (54.3%) were females; 167 (33.2%) were children and 337 (66.8%) were adults. Also 904 (44.3%) subjects had nodules, 367 (18%) had lizard skin, 408 (20%) had tigroid/leopard skin 8 (0.4%) had lymphadenopathies, 265 (62.3%) patients out of 426 for ocular examination had ocular lesions, while 5 (1.1%) were blind. The above results show Achi as hyperendemic. The clinical manifestations contribute immensely to the medical status, psyco-economic importance of the disease such as: marriage stigma, lower social and economic status, psycho-socio behavioural influence, confinement and immobilization of the patient, unproductive and incapacitated life and uncontrollable itching embarrassment. The productivity is lowered also by the biting menace of the vectors. The patient suffers loss in working days, the quality of life is reduced; in females, pregnancies could be affected and could be fatal. The above encounters are common in most endemic areas. Nigerian Journal of Parasitology Vol. 25, 2004: 101-10