Ivermectin and doxycycline treatments against Onchocerciasis: Adaptations and impact among semi-nomadic population in Massangam Health District, Cameroon

Abstract

We trialed strategies to reach semi-nomadic population with interventions targeting oncho cerciasis including a combination of community knowledge and Geographical Information System (GIS) technology; nomad-specific sensitization; and mobile outreach. The interven tions included ivermectin (ivm) mass drug administration (MDA) and treating infected indi viduals (found upon skin snip microscopy test) with doxycycline for 35 days. Microscopy negative snips were further tested by Polymerase Chain Reaction (PCR). After 8 months, individuals immigrating or emigrating constituted 47% of the initial population; 59% of indi viduals not born in the area have immigrated during the last five years; 28% (age>9) report edly never taken ivm; 72% (compared to 51% previously) of eligible population (age 5 years) took ivm; and 47% (age > 8, not pregnant, not breastfeeding, not severely ill,) partici pated in the test. A high prevalence of onchocerciasis,15.1%, was found upon microscopy & PCR test; 9/10 tested by skin snip microscopy and PCR at follow-up were all negative. Microfilaria prevalence and intensity upon skin snip microscopy reduced significantly from baseline following the intervention (8.9% to 4.1%, p = 0.032; 0.18 to 0.16, p = 0.013, respec tively). The strategies considerably increased reach to nomadic camps. Treating with doxy cycline in combination with ivm is feasible and has led to a significant reduction in infection level within one year among the semi-nomads. Being potentially curative in one intervention round, this combination should be considered for population group faced with challenges of achieving adequate coverage and adhesion to ivm MDA over prolonged period (>10 years).

Description

Research Article

Keywords

community knowledge, d Geographical Information System (GIS) technology, onchocerciasis, Geographical Information System (GIS) technology

Citation

Citation: Nditanchou R, Dixon R, Atekem K, Biholong B, Wilhelm A, Selby R, et al. (2023) Ivermectin and doxycycline treatments against Onchocerciasis: Adaptations and impact among semi-nomadic population in Massangam Health District, Cameroon. PLoS Negl Trop Dis 17(7): e0011463. https://doi.org/10.1371/journal. pntd.001146