37.3.4 Prevention and control of onchocerciasis
The WHO believes that onchocerciasis can be eliminated through the application of effective prevention and control methods, which are summarised below:
- Integrated vector control measures to reduce the population of blackflies, through application of insecticides in vegetation where vectors breed, and environmental management to reduce vegetation around fast-flowing rivers where people live.
- Personal protective clothing to avoid the bite of blackflies by covering exposed skin with clothing and wearing headgear in endemic areas.
- Community-directed mass drug administration (MDA) with ivermectin, i.e. mass drug treatment of everyone in communities where the diseases is endemic with the drug ivermectin, which kills the microfilaria, every 6 to 12 months (Figure 37.16). This is the most successful intervention at community level. Community members fully participate in the programme and the drugs are delivered by trained village drug distributors, supervised by Health Extension Workers and Practitioners like you. Community-directed MDA is being implemented in endemic areas of Ethiopia such as Pawe, Jimma, Illubabor and Keffa.
- Rapid case detection and referral, particularly for complicated cases involving sight loss
- Education in the community about the causes, mode of transmission and prevention measures against onchocerciasis (Figure 37.17). Encouraging acceptance of the mass drug administration programme is an important health education message that you can deliver in affected communities.