title: Concurrence of dermatological and ophthalmological morbidity in onchocerciasis.
abstract: Prevalence of skin and eye disorders in African onchocerciasis (river blindness) is well documented. However, less is known about their joint occurrence. Information on concurrence may improve our understanding of disease pathogenesis and is required to estimate the disease burden of onchocerciasis. We analysed data from 765 individuals from forest villages in the Kumba and Ngambe Health districts, Cameroon. These data were collected in 1998, as baseline data for the evaluation of the African Programme for Onchocerciasis Control. Concurrence of symptoms was assessed using logistic regression. Onchocerciasis was highly endemic in the study population (63% nodule prevalence among males aged ≥20). Considerable overall prevalences of onchocercal visual impairment (low vision or blindness: 4%), troublesome itch (15%), reactive skin disease (19%), and skin depigmentation (25%) were observed. The association between onchocercal visual impairment and skin depigmentation (OR 9.0, 95% CI 3.9-20.8) was partly explained by age and exposure to infection (OR 3.0, 95% CI 1.2-7.7). The association between troublesome itch and reactive skin disease was hardly affected by adjustment (adjusted OR 6.9, 95% CI 4.2-11.1). Concluding, there is significant concurrence of morbidities within onchocerciasis. Our results suggest a possible role of host characteristics in the pathogenesis of depigmentation and visual impairment. Further, we propose a method to deal with concurrence when estimating the burden of disease.
authors.affiliation: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands. l.coffeng@erasmusmc.nl
authors.forename: L E
authors.initials: LE
authors.lastname: Coffeng
authors.forename: G
authors.initials: G
authors.lastname: Fobi
authors.forename: G
authors.initials: G
authors.lastname: Ozoh
authors.forename: A C
authors.initials: AC
authors.lastname: Bissek
authors.forename: B O
authors.initials: BO
authors.lastname: Nlatté
authors.forename: P
authors.initials: P
authors.lastname: Enyong
authors.forename: J M Olinga
authors.initials: JM
authors.lastname: Olinga
authors.forename: H G M
authors.initials: HG
authors.lastname: Zouré
authors.forename: J D F
authors.initials: JD
authors.lastname: Habbema
authors.forename: W A
authors.initials: WA
authors.lastname: Stolk
authors.forename: S J
authors.initials: SJ
authors.lastname: de Vlas
authors.forename: M
authors.initials: M
authors.lastname: Boussinesq
authors.forename: M
authors.initials: M
authors.lastname: Noma
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000818:Animals; D000977:Antiparasitic Agents / Q000627:therapeutic use*; D002163:Cameroon / Q000453:epidemiology; D002648:Child; D060085:Coinfection; D005260:Female; D006801:Humans; D007559:Ivermectin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009854:Onchocerca / Q000472:pathogenicity; D009855:Onchocerciasis / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology; D015827:Onchocerciasis, Ocular / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology; D015995:Prevalence; D011788:Quality of Life; D012843:Simuliidae; D055815:Young Adult
chemical_list: D000977:Antiparasitic Agents; D007559:Ivermectin