Flugmedizin · Tropenmedizin · Reisemedizin - FTR 2015; 22(2): 78-81
DOI: 10.1055/s-0035-1552593
Tropenmedizin
© Georg Thieme Verlag Stuttgart · New York

Bekämpfung der Onchozerkose in Afrika – Große tropenmedizinische Erfolge in 40 Jahren durch internationale Partnerschaften

Control of onchocerciasis in Africa – success story of tropical medicine and global partnerschip
Peter Stingl
Further Information

Publication History

Publication Date:
27 April 2015 (online)

Zusammenfassung

Die Onchozerkose ist in über 30 Ländern Subsahara-Afrikas zwischen 15° Nord und 15° Süd von großer volksgesundheitlicher Bedeutung. Die Filarienerkrankung hat gravierende klinische und psycho-sozioökonomische Folgen. Vor Beginn einer großräumigen Bekämpfungskampagne 1975 waren viele Millionen Afrikaner Träger des Erkrankungserregers Onchocerca volvulus und weit über 100 Millionen einem ständigen Infektionsrisiko ausgesetzt. Seit 40 Jahren wird die Erkrankung in Afrika mithilfe von Vektorbekämpfung und Massenchemotherapie großräumig bekämpft. Die bevorstehende Elimination des Gesundheitsproblems ist eine Erfolgsgeschichte der Tropenmedizin und der globalen Partnerschaft. Für die vollständige Eradikation bedarf es jedoch neuer, behandlungsverkürzender, möglichst auf die adulten Filarien zielende Therapeutika.

Summary

Concerning its high prevalence and its serious impacts, onchocerciasis, a filarial disease transmitted by blackfly bites, is of great public health importance in tropical Africa. It affects millions of people in over 30 african countries and far more are at permanent risk of infection. Serious skin disease and ocular lesions leading to blindness make onchocerciasis a disease of great socioeconomic importance. Vector control since 1975 and filaricidal masschemotherapy thereafter make onchocerciasis control a success story of tropical medicine and global partnership. Elimination of onchocerciasis as a public health problem has been almost reached but total eradication will probably need more appropriate treatment tools to kill the adult filariae right away.

 
  • Literatur

  • 1 Hotez PJ, Kamath A. Neglected tropical diseases in sub-saharan Africa: review of their prevalence, distribution and disease burden.. PLoS Negl Trop Dis 3 e412
  • 2 World Health Organization. African Programme for Onchocerciasis Control – report of the sixth meeting of National Task Forces, October 2009.. Wkly Epidemiol Rec 2010; 85: 23-28
  • 3 Murdoch ME, Hay RJ, Mackenzie CD et al. A clinical classification and grading system of the cutaneous changes in onchocerciasis.. Br J Dermatol 1993; 129: 260-269
  • 4 Walker M, Little MP, Wagner KS et al. Density-dependent mortality of the human host in onchocerciasis: relationships between microfilarial load and excess mortality.. PLoS Negl Trop Dis 2012; 6 e1578
  • 5 World Health Organization. African Programm for Onchocerciasis Control (APOC).. 2005 Im Internet: www.who.int/apoc/about/structure/jaf/jaf11_final_communique.pdf
  • 6 Hörauf A, Burchard GD. Filariosen und Drakunkulose. In: Löscher T, Burchard GD. Tropenmedizin in Klinik und Praxis.. 4. Stuttgart: Thieme; 2010
  • 7 Stingl P, Ross M, Gibson DW et al. A diagnostic patch test for onchocerciasis using topical diethylcarbamazine.. Trans R Society Trop Med Hyg 1984; 78: 254-258
  • 8 Ozoh G, Boussinesq M, Bissek AC et al. Evaluation of the diethycarbamazine patch to evaluate onchocerciasis endemicity in Central Africa.. Trop Med Int Health 2007; 12: 123-129
  • 9 Stingl P. Onchocerciasis: clinical presentation and host parasite interactions in patients in southern sudan.. Int J Derm 1997; 36: 23-28
  • 10 Roberts JMD, Neumann E, Göckel CW, Highton RB. Onchocerciasis in Kenya 9, 11 and 18 years after elimination of the vector.. Bull World Health Organ 1967; 37: 195-212
  • 11 Hougard JM, Yameogo L, Sékétéli A et al. Twenty-two years of blackfly control in the onchocerciasis control programme in West Africa.. Parasitol Today 1997; 13: 425-431
  • 12 Aziz MA, Diallo S, Diop IM et al. Efficacy and tolerance of ivermectin in human onchocerciasis.. Lancet 1982; 2: 171-173
  • 13 Stingl P. Onchocercias: developments in diagnosis, treatment and control.. Int J Dermatol 2009; 48: 393-396
  • 14 World Health Organization.. African Programme for Onchocerciasis Control: meeting of National Onchocerciasis Task Forces, September 2013.. Wkly Epidemiol Rec 2013; 88: 533-544
  • 15 Gardon J, Gardon-Wendel N Demanga-Ngangue et al. Serious reactions after mass treatment of onchocerciasis with ivermectin in an area endemic for Loa loa infection.. Lancet 1997; 350: 18-22
  • 16 Hörauf A, Mand S, Volkmann L et al. Doxycycline in the treatment of human onchocerciasis: Kinetics of Wolbachia endobacteria reduction and of inhibition of embryogenesis in female Onchocerca worms.. Microbes Infect 2003; 5: 261-273
  • 17 Tamarozzi F, Tendongfor N, Enyong PA et al. Long term impact of large scale community-directed delivery of doxycycline for the treatment of onchocerciasis.. Parasit Vectors 2012; 5: 53-53
  • 18 Tekle AH, Elhassan E, Isiyaku S et al. Impact of long-term treatment of onchocerciasis with ivermectin in Kaduna State, Nigeria: first evidence of the potential for elimination in the operational area of the African Programme for Onchocerciasis Control.. Parasit Vectors 2012; 5: 28-28
  • 19 Traore MO, Sarr MD, Badji A et al. Proof-of-principle of onchocerciasis elimination with ivermectin treatment in endemic foci in Africa: final results of a study in Mali and Senegal.. PLoS Negl Trop Dis 2012; 6 e1825