Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Following the demonstration of onchocercal skin disease's (OSD) public health and social importance in 1994, the UNDP/World Bank/WHO Special Program for Research and Training in Tropical Diseases (TDR) Task Force on Onchocerciasis Operational Research was asked to assess its economic impact. A multi-country study was subsequently undertaken in Ethiopia, Sudan, and Nigeria to measure the effect of OSD upon labor input and the effect of severe reactive skin disease in the household upon school attendance by children. Where the head-of-household had OSD, children were twice as likely to drop out of school compared to other children of the same age from the same community. The relationship was especially strong among girls, who were 2.6 times as likely to drop out of school if the head-of-household had OSD than if the head did not. It follows that onchocerciasis impedes educational development where OSD is highly prevalent. People with OSD spend US$20 more annually on health-related expenditures, 15% of their annual income, than do people without OSD. There are also significant time costs to having OSD. Another study was conducted in Uganda, Ghana, and Nigeria to assess the effect of ivermectin treatment upon OSD. Treatment led to a 40-50% decline in severe itching compared to placebo, sustained for up to 12 months after the first treatment. There was also a significant decline in the prevalence of reactive skin lesions following treatment compared to placebo.
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PMID:New light shed on the importance and care of onchocercal skin disease. 1234 63

Infection by onchocerca volvulus, a parasitic worm, causes onchocerciasis (river blindness), a debilitating and often blinding disease endemic to tropical areas of Africa and Central and South America. The adult onchocerca volvulus invades the human host where it lives and reproduces for up to 14 years, creating millions of infant worms which cause itching, loss of skin color, rapid aging, and disfiguring skin disease in the host. Onchocerciasis often causes blindness in the human host by approximately age 35 years, and is the third leading cause of blindness in Africa. Onchocerca volvulus is transmitted among humans through the bite of blackflies which breed in fast-flowing rivers. The Onchocerciasis Control Program (OCP) was formally launched in 1974 by the UN's Food and Agriculture Organization (FAO), the UN Development Program (UNDP), the World Bank, and the World Health Organization (WHO) in Benin, Burkina Faso, Ghana, Cote d'Ivoire, Mali, Niger, and Togo. Vector control is the central strategy of the OCP, consisting of weekly helicopter spraying of larvacide to prevent the blackfly from reproducing and transmitting the disease. In addition, Merck & Co. is providing drug therapy against the infant worms in the human host free of charge to 16 million people in endemic areas. Onchocerciasis has now almost been eradicated in the 7 original target countries. Also through the OCP, by 1996, more than 34 million people were protected against the disease, about 2 million who were seriously infected have fully recovered, and an estimated 600,000 people have been prevented from going blind. 12 million infants born since the launch of the OCP face no risk of contracting the disease, and approximately 25 million hectares of arable fertile riverine land has been opened for resettlement. Labor productivity has also increased.
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PMID:River blindness. Protection for 54 cents a year. 1234 35

A total of 556 individuals in Agbalenyi Community of Oji-River local government area of Enugu State, Nigeria were studied using questionnaires, focus group discussions and key informant interviews to determine the socio-cultural factors affecting the transmission of onchocerciasis. The result revealed a low level of knowledge about the cause, prevention and complications of onchocerciasis. Respondents have developed a cultural system around the disease due to long exposure. The majority are aware of the disease which they recognize once their body starts itching or musculoskeletal pain develops but only 64.4, 34.0, 1.4 and 3.6%, respectively attributed chronic itching, nodules, bad vision and leopard skin to blackfly bite. Other perceived causes mentioned include ageing, the type of food eaten, farm work and 'bad blood'. Only 0.8% knew diagnosis could be made through skin snips. Neither Oji-River nor any of the river systems were associated with any of the complications of onchocerciasis. Significant differences in most socio-demographic characteristics were associated with differences in the level of knowledge about the disease.
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PMID:Local knowledge and attitudes about onchocerciasis in Oji-River local government area of Enugu State, Nigeria. 1255 48

Onchocerciasis is an infestation caused by the nematode, Onchocerca volvulus, and characterized by eye manifestations, skin lesions and troublesome itching. Although partially controlled by international mass treatment programs, onchocerciasis remains a major health hazard in endemic areas in Africa, Arabia, and the Americas. Onchocerciasis is spread by bites from infested blackflies which transmit larvae that subsequently develop into adult filariae. Skin findings are commonly non-specific, and include severe pruritus, acute and chronic dermatitis, vitiligo-like hypopigmentation and atrophy. Onchocercal ocular disease has a large spectrum of manifestations and may even lead to blindness. Diagnosis is usually made by direct visualization of the larvae emerging from superficial skin biopsies, "skin snips". In some cases, the microfilariae can also be directly observed with a slit lamp when they migrate into the anterior chamber of the eye. Ivermectin is highly microfilaricidal, and is the current drug of choice for both skin and ocular manifestations.
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PMID:[Onchocerciasis]. 1275 35

In Cameroon, a 3-year randomized, double-blind controlled trial was conducted to determine if ivermectin, given at 3-monthly intervals and/or at high doses (800 microg/kg), had a greater effect on adult Onchocerca volvulus than standard annual doses of 150 microg/kg. Adverse reactions were recorded and analysed in a logistic regression model with random effects to assess the influence of the dose and rhythm of treatment on their occurrence. After the first dose, 3-monthly treatment was associated with a clearly reduced risk of reactions, especially oedematous swellings, pruritus and back-pain. Oedematous swellings and subjective ocular troubles were found to be associated with high doses of ivermectin. These results reinforce former parasitological conclusions that it would be desirable to evaluate the feasibility and effects on transmission of large-scale 3-monthly treatments with standard doses of ivermectin for onchocerciasis control. Owing to the unexpected ocular reactions, the use of high doses to counteract any future resistance of O. volvulus to ivermectin should be considered with caution.
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PMID:Adverse systemic reactions to treatment of onchocerciasis with ivermectin at normal and high doses given annually or three-monthly. 1518 39

Onchocerciasis (river blindness) is a serious public health problem with important socioeconomic consequences. The presence of onchocercal skin lesions is unsightly and has a psychosocial effect on the affected. This cross-sectional study was undertaken to assess the perception and social implication of onchocerciasis in the village of Apana in Nigeria. Apana is a rural community, hyper-endemic for onchocerciasis and currently receiving ivermectin treatment. The village is one of the ten communities of Uzairue district of Etsako West Local Government Area (LGA), Edo State, Nigeria. There are many water streams in the community which serve the domestic needs of the inhabitants but also provide the breeding sites for the vector flies of onchocerciasis. Multi-stage sampling methods were used to select the 385 respondents that participated after informed consent was obtained. A structured researcher-administered questionnaire was the tool for data collection. Of the 385 respondents that participated in the survey, 240 (62.3%) were male while 145 (37.7%) were female. The awareness of the disease among the respondents was fair. They were aware of the nuisance value of blackflies ('Uja-ini') and associated the bite with itching. The signs and symptoms of onchocerciasis were recognised as specific diseases with specific local names. They called itching and rashes 'Erhue', nodules and leopard skin 'Evbiomu-Ogui', worm in the eye 'Okogho-Ikpalo' and blindness 'Orunalo'. The attitude of the non-affected towards the affected was partially discriminatory and suspicious. The affected were socially withdrawn, probably due to the frustration of their health condition. There is a need to improve people's attitude towards the disease and improve disease awareness through appropriate health education, which will encourage the acceptance of ivermectin as adequate treatment and compliance to the treatment regimen to reduce morbidity and promote self-esteem.
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PMID:Psychosocial effects of river blindness in a rural community in Nigeria. 1519 54

A comprehensive survey of onchocerciasis was performed on 1259 inhabitants in San Vicente Pacaya and the surrounding area. The total number of inhabitants examined was 1259, 763 males and 496 females. An examination of microfilarial density was carried out by the skin snip method. There were 610 microfilarial positives (50.4%) out of 1211 persons, 448 males (60.9%), and 162 females (34.1%). Nodules were examined by palpation, and there were 404 (32.8%) positives for nodule out of 1232 persons, 299 males (40.3%), and 105 females (21.4%). Eczematous dermatitis was seen in 149 persons, the generalized type in 13, and other types in 136. Depigmentation on the lower extremities was seen in 290 persons, the severity was graded from 0 to 4, and grade 1 depigmentation was seen in 91; grade 2, in 143; grade 3, in 52 and grade 4 in 4 persons out of 1159 individuals examined. The positives for lymphadenopathy (above grade 2) were 464 (41.2%) out of 1127 individuals. Itching was seen in 129 (18.3%) of 705 individuals examined by the inquiry card method. The correlation between skin changes and onchocerciasis was also analyzed. Those individuals who were microfilarial positive in the skin snip and eyes, and who had palpable nodules were defined as being onchocerciasis patients. There was a high frequency of eczematous dermatitis, depigmentation on the lower extremities and lymphadenopathy in the onchocerciasis infected group, compared with the non-infected group, but there was no difference in the rate of itching between them. Hanging groin, elephantiasis and "erisipela de la costa" were not seen in this endemic area, and the degree of skin changes was slight, compared with that reported in Africa thus far.
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PMID:Dermatological survey of onchocerciasis in Guatemala. 1546 77

Epilepsy and onchocerciasis (river blindness) constitute serious public health problems in several tropical countries. There are four main mechanisms that might explain a relationship between these two diseases: (i) the presence of Onchocerca volvulus in the central nervous system; (ii) the pathogenicity of various O. volvulus strains; (iii) immunological mechanisms involving cross-reactive immunization or cytokine production during infection; and (iv) the triggering role of insomnia due to itching.
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PMID:Onchocerciasis-related epilepsy? Prospects at a time of uncertainty. 1630 6

Travelers to West Central Africa are at risk for infection with Onchocerca volvulus. We describe the case of an adventurous traveler who became infected with O volvulus after a 10-day stay in rural Cameroon. Two years after his return, he was diagnosed with a 3-month history of limb swelling with pruritus and fixed edema of the right arm. He was successfully treated by a single dose of ivermectin, with an additional treatment with doxycycline. The patient was followed-up during 1 year after therapy without relapse. Such travelers experiencing unusual dermatitis syndromes should prompt evaluation for onchocerciasis.
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PMID:Onchocerciasis-associated limb swelling in a traveler returning from Cameroon. 1641 9

Onchocercosis or riverblindness, caused by the filaria ochnocerca volvulus, is endemic in many countries of central and Western Africa. Symptoms of the disease can occur years after the infection, chronic itching dermatitis is the first sign, without treatment blindness may develop after years. Onchodermatitis is a hyperreactive course of onchocercosis with massive eosinophilia and elevated IgE, which suppresses a microfilarial spread through the body. Here, we report about the case of an 9-year-old girl who immigrated from the republic of Congo at the age of seven and has been living in Germany for more than two years. Presumably she suffered from onchodermatitis. She presented papular, indurated and itching skin lesions with pigmentary changes, predominantly located at the limbs. Remarkable results of blood tests were 11,000/microl (60 %) eosinophils and IgE 28 000 KU/l, ECP > 200 mg/l, without a history of atopic diseases. HIV, Strongylosis and Loa Loa were excluded. Anti filaria antibodies were detected in a concentration of 51 AKE, microscopy of skin samples failed to detect the parasites. After a single dose of Ivermectin the dermatitis improved, after two weeks the itching was absent, results of repeated blood tests tend to normalize in the following months. Due to the long lifespan of filaria in humans, the disease occurs years after infection in endemic areas. The differential diagnosis for itching skin lesions with high eosinophils in children from developing countries should include onchocercosis.
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PMID:[Dermatitis and eosinophilia in a 9-year-old girl from Congo: putative onchodermatitis]. 1643 76


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