Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0033774 (pruritus)
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TELC is a chronic allergic conjunctivitis which affects young children. The aetiology which is usually incriminated is dust, dryness or ultraviolet rays. The main symptoms of TELC are: severe pruritus, brownish pigmentation of the conjunctiva, papillae on the upper palpebral conjunctiva, severe limbitis with Trantat's spots, and finally corneal attack with risk of blindness. Treatment basis is made up with sodium chromoglycate and corticoids. We gathered the epidemiological data of TELC in the South of Benin and their links with the meteorological data (pluviometry, temperature, relative dampness rate, sun radiance and middle evaporation), from 1983 to 1992. There are two peaks of exacerbation for TELC: in March and in August. There is a good two months moved correlation between TELC and pluviometry; a positive correlation with temperature during the first peak and a reversed correlation during the second peak. Peaks of TELC are not linked with hours of sunshine rates.
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PMID:[Chronic tropical endemic limboconjunctivitis (TELC) in southern Benin: epidemiological and meteorological data]. 809 Oct 33

Prior to the initiation of an onchocerciasis control program based on the mass administration of ivermectin in the rain forest of southwestern Cameroon, a preliminary baseline study of the area was conducted. The results of this study showed that onchocerciasis was hyperendemic in the area. Skin symptoms and signs were observed including pruritus (67.4% of the population examined), onchocerca nodules (51.6%), skin depigmentation (18.5%), and hanging groins (5.7%). Except for pruritus, the prevalence of these symptoms increased with age. Of the eyes examined, 44.9% had microfilariae in the anterior chamber, 33.5% had choroidoretinitis, 28.0% had punctate keratitis, 8.3% had papillary abnormalities, and 3.6% had sclerosing keratitis. Vision in 10.5% of the eyes examined was classified as blind or very poor (visual acuity = 0-0.10), in 15.7% as poor (visual acuity = 0.11-0.39), and in 73.8% as good (visual acuity = 0.4-1.00). Unlike previous reports that have linked serious ocular damage mainly to savanna onchocerciasis, the present study showed that forest onchocerciasis also caused significant ocular pathology, including blindness. Parasitologically, positive skin snips were recorded for 92.7% of the persons examined, with both sexes being equally infected. The parasite load, expressed as the geometric mean number of microfilariae per skin snip, was 53.6, and was much higher in males than in females. The flv vector, Simulium squamosum, had a high infection rate of 7.5% infective females in Bakumba and 6.8% infective females in Ngbandi, the two fly-catching points. The transmission potential was 266 infective larvae per person per month in Bakumba and 189 in Ngbandi.
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PMID:A study of onchocerciasis with severe skin and eye lesions in a hyperendemic zone in the forest of southwestern Cameroon: clinical, parasitologic, and entomologic findings. 842 83

The cultural context of forest onchocerciasis was studied in the Boulou and Baka ethnic communities in the Dja-Lobo Division of southern Cameroon. A 2-day survey used focus group interviews followed by a questionnaire administered to 212 randomly selected individuals in 8 communities (88 male and 124 females heads of household) to assess their knowledge about onchocerciasis. Most people (98%) had some knowledge about the disease. Minak was the term used for filariasis by most people (97%) and people knew (90%) that black fly (nyamendimi) was responsible for its transmission. Other vectors of the illness identified were mosquitoes, dirty water, sorcery, and taboo foods. 81% thought that maternal transmission was possible and 66% indicated that filariasis could be transmitted sexually. Virtually all respondents associated itching and rash with minak (filariasis) and more than 60% also recognized the swelling of the skin and leopard skin as manifestations of filariasis. Filariasis, malaria, worms, and blindness were placed in the middle category when the severity of various diseases was ranked by 20 Boulou adults. In contrast, the Baka did not think that filariasis caused blindness, nor that it is linked to eye-worms. However, the 212 individuals ranked blindness as the most severe among other diseases (filaria, malaria, diarrhea, and intestinal worms). 80% of the Boulou and Baka adults had had filariasis in the previous year, but only 5% of the Boulou children and none of the Baka children had had filariasis during that time period. With respect to intestinal worms, 71% of the Boulou adults and 60% of the Baka adults had had intestinal worms in the previous year, while more than 90% of the Boulou children and all of the Baka children had had intestinal worms. Of the 90% who revealed that they had had filariasis at least once before, 69% sought treatment. 54% had tried traditional treatment, while 50% had tried Notezine, 49% had tried Phenergan, and 38% had tried M.G. Lumiere.
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PMID:Ivermectin distribution and the cultural context of forest onchocerciasis in South Province, Cameroon. 864 8

The greatest burdens related to human onchocerciasis are the result of the eye and skin lesions and severe itching produced by the microfilariae. Although the major manifestations of the disease do show geographical variation (e.g. onchocercal blindness is not a common complication in all endemic countries), they are often sufficiently severe to prevent human use of the often very fertile land close to the rivers in which the vectors breed. Though for many years thought to be of relatively minor importance compared with onchocercal eye disease, the skin lesions of onchocerciasis have recently been shown to be a major socio-economic burden, in terms of disability-adjusted life-years. The demonstration of an excellent correlation between the prevalence of palpable nodules in a community and the community microfilarial load has led to the development of rapid, safe and non-invasive methods to assess and map the levels of endemicity across whole countries. This has enabled mass treatment with Mectizan (ivermectin, MSD) to be targeted first at hyperendemic communities. Estimates of the burden of onchocerciasis will continue to change as better means of measurement become available. It seems possible, however, that use of Mectizan will eliminate the disease before its true burden can be estimated accurately.
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PMID:Onchocerciasis: the burden of disease. 986 Dec 75

Onchocerciasis has been reported in Sudan since 1908 and now prevails in three endemic regions known as the southern, northern and eastern foci. The southern focus is the largest, with nodule and blindness rates exceeding 80% and 12%, respectively, in certain villages. Onchocercal infection in this region causes only a mild skin reaction although microfilarial loads in the skin are high. In contrast, those with onchocerciasis in the northern focus, located between the fourth and fifth Nile cataracts, present with limited but severe skin reactions, low nodule rates (16%), low microfilarial loads in the skin and no ocular involvement. The characteristics of patients from the eastern focus, close to the border with Ethiopian border are similar to those in the north, although most onchocercal skin disease in this area comprises the severe localized pruritus known as sowda.
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PMID:The burden of Onchocerca volvulus in Sudan. 986 Dec 78

An attempt was made to assess the true public-health importance of onchocercal skin disease throughout the African region and hence provide an objective basis for the rational planning of onchocerciasis control in the area. The seven collaborative centres that participated in the study (three in Nigeria and one each in Ghana, Cameroon, Tanzania and Uganda) were all in areas of rainforest or savannah-forest mosaic where onchocercal blindness is not common. A cross-sectional dermatological survey was undertaken at each site following a standard protocol. At each site, the aim was to examine at least 750 individuals aged 5 years and living in highly endemic communities and 220-250 individuals aged 5 years and living in a hypo-endemic (control) community. Overall, there were 5459 and 1451 subjects from hyper-and hypo-endemic communities, respectively. In the highly endemic communities, the prevalence of itching increased with age until 20 years and then plateaued, affecting 42% of the population aged 20 years. There was a strong correlation between the prevalence of itching and the level of endemicity (as measured by the prevalence of nodules; r=0.75; P<0.001). The results of a multivariate logistic regression analysis showed that, at the individual level, the presence of onchocercal reactive skin lesions (acute papular onchodermatitis, chronic papular onchodermatitis and/or lichenified onchodermatitis) was the most important risk factor for pruritus, with an odds ratio (OR) of 18.3 and 95% confidence interval (CI) of 15.19-22.04, followed by the presence of palpable onchocercal nodules (OR=4.63; CI=4.05-5.29). In contrast, non-onchocercal skin disease contributed very little to pruritus in the study communities (OR=1.29; CI=1.1-1.51). Onchocercal skin lesions affected 28% of the population in the endemic villages. The commonest type was chronic papular onchodermatitis (13%), followed by depigmentation (10%) and acute papular onchodermatitis (7%). The highest correlation with endemicity was seen for the prevalence of any onchocercal skin lesion and/or pruritus combined (r=0.8; P<0.001). Cutaneous onchocerciasis was found to be a common problem in many endemic areas in Africa which do not have high levels of onchocercal blindness. These findings, together with recent observations that onchocercal skin disease can have major, adverse, psycho-social and socio-economic effects, justify the inclusion of regions with onchocercal skin disease in control programmes based on ivermectin distribution. On the basis of these findings, the World Health Organization launched a control programme for onchocerciasis, the African Programme for Onchocerciasis Control (APOC), that covers 17 endemic countries in Africa.
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PMID:Onchocerciasis: the clinical and epidemiological burden of skin disease in Africa. 1206 75

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

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

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

The filarial parasites that affect humans most seriously include Onchocerca volvulus, Wuchereria bancrofti, Brugia malayi and Loa loa. In general, these species cause disease that is debilitating long before it is fatal, producing clinical manifestations such as general malaise, pruritus and lichenification of the skin, lymphangitis, elephantiasis and blindness(1). As a result, infection with any one of these organisms is physically, as well as economically, devastating. Currently, the pharmacological armamentarium with which to treat filarial infections is very limited and many of the drugs that are known to be efficacious against these worms may produce side effects that cause extreme discomfort. Here, Elizabeth Vande Waa describes the quest for new chemotherapeutic approaches for the treatment of filarial infections.
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PMID:Chemotherapy of filariases. 1546 92


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