title: Impact of Six Years Community Directed Treatment with Ivermectin in the Control of Onchocerciasis, Western Ethiopia.
abstract: BACKGROUND
  The African Program for Onchocerciais Control (APOC) with a main strategy of community directed treatment with ivermectin (CDTI) was established with the aim of eliminating Onchocerciasis as a disease of public health and socio-economic importance. The study area was a hyper endemic area just before the implementation of CDTI. It has been implemented for six years in this district but yet not been evaluated. So, the objective of this study was to evaluate the impact of six years CDTI on parasitological and clinical indices of Onchocerciasis.
  
  
  METHODS
  This study employed a pre-post impact evaluation design. The minimum sample size for this study was 1318; the respondents were selected by multi-stage sampling technique. Data on socio-demographic characteristics using a semi-structured questionnaire, clinical examination for skin signs and symptoms of Onchocerciasis and two bloodless skin snips from each side of the gluteal fold were taken from the entire study participants. SPSS version 16.0 and Medcalc version 12.2.1.0 were used for analysis.
  
  
  RESULTS
  The microfilaridermia reduced from the pre-intervention value of 74.8% to 40.7%, indicating a 45.6% reduction, mean intensity from 32.1(SD = 61.5) mf/mg skin snip to 18.7(SD = 28.7)indicating 41.75% reduction, CMFL from 19.6 mf/mg skin snip to 4.7 indicating 76% reduction. The result also showed that microfilaridermia and mean intensity decreased as the number of treatment taken increased. Pruritis, leopard skin, onchocercomata and hanging groin reduced by 54.4%, 61.3%, 77.7% and 88.5% respectively.
  
  
  CONCLUSIONS
  The implementation of CDTI significantly reduced the parasitological and clinical indices of Onchocerciasis, so, efforts should be made to improve the annual treatment coverage and sustainability of CDTI to drastically reduce the micro filarial load to the level the disease would no longer be a public health problem.
authors.affiliation: Wollega University College of Medical and Health Sciences Program of Medical Laboratory Sciences, Nekemte, Ethiopia.|Jimma University College of Public Health and Medical Sciences, Department of Medical Laboratory Sciences, Jimma, Ethiopia.
authors.forename: Abdi
authors.initials: A
authors.lastname: Samuel
authors.affiliation: Jimma University College of Public Health and Medical Sciences, Department of Medical Laboratory Sciences, Jimma, Ethiopia.
authors.forename: Tariku
authors.initials: T
authors.lastname: Belay
authors.affiliation: Jimma University College of Natural Sciences, Department of Biology, Jimma, Ethiopia.
authors.forename: Delenasaw
authors.initials: D
authors.lastname: Yehalaw
authors.affiliation: Jimma University College of Public Health, Department of Epidemiology, and Biostatistics, Jimma, Ethiopia.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Taha
authors.affiliation: Jimma University College of Public Health and Medical Sciences, Department of Medical Laboratory Sciences, Jimma, Ethiopia.
authors.forename: Endalew
authors.initials: E
authors.lastname: Zemene
authors.affiliation: Jimma University College of Public Health and Medical Sciences, Department of Medical Laboratory Sciences, Jimma, Ethiopia.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Zeynudin
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006801:Humans; D055552:Infectious Disease Medicine; D007559:Ivermectin / Q000627:therapeutic use*; D008297:Male; D017181:Onchocerca volvulus; D009855:Onchocerciasis / Q000188:drug therapy* / Q000453:epidemiology*; D015995:Prevalence; D011634:Public Health / Q000379:methods*; D012867:Skin / Q000469:parasitology*; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D007559:Ivermectin