Point prevalence mapping reveals hotspot for onchocerciasis transmission in the Ndikinimeki Health District (Centre Region, Cameroon) release_jdsimlnw2bc7bdjvau5sadhiui

by Afor René Aza'ah, Laurentine Sumo, Ngum Helen Ntonifor, Jean Bopda, Rolph Bamou Heumou, Hugues Clotaire Nana Djeunga

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<jats:title>Abstract</jats:title> Background Ivermectin-based preventive chemotherapy is distributed annually to all at risk eligible individuals to fight onchocerciasis. Data reporting the impact of mass ivermectin administration on onchocerciasis transmission are scanty, and it is tricky to appreciate the progress towards elimination and engage adapted corrective measures. To fill that gap in the Centre Region in Cameroon, this study aimed at assessing onchocerciasis endemicity level in the Ndikinimeki Health District after almost three decades of mass treatments. Methods As part of a cluster-based cross-sectional survey, all volunteers aged ≥ 5 years were (i) interviewed on their compliance to ivermectin over the past five years and (ii) underwent clinical (nodule palpation and visual search for onchocercal lesions) and parasitological examinations (skin snip) for onchocerciasis. Results The overall <jats:italic>O. volvulus</jats:italic> prevalence was 7.0% (95% CI: 5.2–9.3), significantly higher in the communities Kiboum 1 and Kiboum 2 compared to the other communities (highest prevalence in Makénéné Town Water: 8.5%; 95% CI: 2.3–20.4) (Chi-square = 51.314; df = 11; <jats:italic>p</jats:italic> = 0.0001). The proportion of systematic non compliers was relatively high (23.3%; 95% CI: 19.9–27.1) among individuals interviewed. In the sentinel sites (Kiboum communities), river blindness prevalence decreased from 95.2% (95% CI: 88.3–98.1) to 23.7% (95% CI: 14.7–36.0) thanks to 28 years of annual ivermectin but was still meso-endemic to onchocerciasis. Conclusions After almost three decades of preventive chemotherapy, onchocerciasis is now hypo-endemic in the Ndikinimeki Health District. However, transmission is ongoing, with a potential hotspot near Kiboum 1 and Kiboum 2 known as first line communities (closest to breeding sites of the vector). Alternative or complementary strategies to annual ivermectin appear compulsory to accelerate the momentum towards onchocerciasis elimination.
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Date   2020-06-02
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