Onchocerciasis in Yemen: Time to take action against a neglected tropical parasitic disease.
Onchocerciasis is a neglected parasitic disease affecting the poorest underserved people in Yemen. A national control programme with goals to eliminate onchocerciasis has yet to be launched due to the current upheaval and social unrest in the country. The disease, locally termed as sowda, is unique in its clinicopathologic pattern, being of the localized, non-blinding, hyperreactive onchocercal skin disease. Although early reports identified endemic foci along seasonal watercourses, there is a need to redefine its epidemiologic patterns as well as health and socioeconomic impacts. Laboratory diagnosis of sowda among Yemeni patients is difficult due to the low load of microfilariae in skin snips and the presence of asymptomatic itching-free microfilaria carriers. Adoption of ivermectin use at three-month intervals as a control strategy has not been evaluated because the drug is mostly used in clinics and distributed to only a few affected communities. This paper addresses key aspects of onchocerciasis in Yemen and highlights the need for screening at-risk populations using highly sensitive techniques and mapping the distributions of the parasite in human and vector populations of blackflies. The new research should be integrated with the launch of a national onchocerciasis control programme to achieve onchocerciasis elimination.
Department of Parasitology, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen. Electronic address: rashadqb@yahoo.com.
Rashad
R
Abdul-Ghani
Department of Parasitology, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen; Tropical Disease Research Center, Faculty of Medicine, University of Science and Technology, Sana'a, Yemen.
Mohammed A K
MAK
Mahdy
Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
John C
JC
Beier
D000818:Animals; D006801:Humans; D007559:Ivermectin / Q000627:therapeutic use*; D008842:Microfilariae / Q000187:drug effects; D058069:Neglected Diseases / Q000188:drug therapy*; D009855:Onchocerciasis / Q000453:epidemiology / Q000517:prevention & control*; D012843:Simuliidae / Q000469:parasitology*; D015006:Yemen / Q000453:epidemiology
D007559:Ivermectin
Neglected tropical disease; Onchocerca volvulus; Simulium; Sowda; Yemen