Preliminary assessment of Onchocerca-induced visual impairment using clinical fundus camera in Gashaka local government area of Taraba state, north eastern Nigeria.

Introduction: Onchocerciasis is the world's second leading cause of infectious blindness and remains a major problem in parts of Africa. In light of the efforts targeted towards improving ongoing elimination program, this study assessed onchocerca-induced visual impairments in Gashaka local government areas (LGA) in Taraba State, north-eastern Nigeria. Methods: In 2019, we recruited 158 consenting visually impaired persons across three communities in Garbabi ward of Gashaka LGA. To avoid confusion with co-endemic trachoma, the integrity of the tarsal conjunctiva, eyelashes were assessed using direct light. The anterior segment of the eye was also examined using a torchlight with oblique illumination. However, the posterior segment of the eye was assessed using a fundus camera. Two photographic images for the left and right eye of each participant were captured using the clinical fundus camera. The photographic eye images that were too dark were discarded, and only clear images were analyzed by two ophthalmologists. An ocular manifestation report was recorded for each participant following consensus between the ophthalmologists. Results: Of the 316 photographic eye images, almost half 146 (46.2%) from 73 participants were just too destroyed for light to penetrate and was not included in the analysis. Only 170 from 85 participants were clear and examinable. A total of 33 (39%) participants had chorioretinitis suggestive of onchocerciasis, including 22(25.9%) with chorio-retinal atrophy, 7(8.2%) and 4(4.7%) had chorioretinal atrophy in combination with early cataract and signs of trachoma respectively. In addition, 3(3.5%) of the participant had eye images which showed lens opacities, 1(1.2%) showed signs of keratoconus and 1(1.2%) showed a scared and pigmented cornea, possibly due to onchocerciasis. Furthermore, 28 (32.9%) had some ill-defined changes and 19 (22.4%) showed poorly defined chorio-retinal atrophy. Conclusion: In a bid to sustain MDA gains towards elimination of onchocerciasis, this work highlights the need for continuous assessment of onchocerciasis induced visual impairment, strengthening of ivermectin delivery and optimizing compliance and patient care among affected populations. These would require resource acquisition and local capacity building. Our preliminary findings call for further operational research on ocular morbidity as well as future stakeholders' consultations in this important and understudied area.

A Post-Lockdown Assessment of Albendazole Treatment Coverage in Mass Drug Administration Campaigns Implemented Before and During COVID-19 Pandemic in Ekiti, Southwest Nigeria.

Objective: This study assessed the coverage of albendazole (ALB) in mass drug administration (MDA) programs implemented before (2019) and during the (2020 and 2021) COVID-19 pandemic in Ekiti State, Nigeria. Methods: Standardized questionnaires were administered to 1,127 children across three peri-urban communities to ascertain if they received and swallowed ALB across the years. Reasons, why ALB was not received, were documented and analyzed in SPSS. 20.0. Results: In 2019, the medicine reach was between 42.2%-57.8%, however, during the pandemic, the reach significantly reduced to 12.3%-18.6%, and increased to 28.5%-35.2% in 2021 (p < 0.000). About 19.6%-27.2% of the participants have missed 1 MDA, while 26.9%-37.8% and 22.4%-32.8% have missed 2 and 3 MDAs, respectively. The majority who did not receive ALB (60.8%-75%) claimed drug distributors never came, while about 14.9%-20.3% mentioned they did not hear about MDA. However, individual compliance towards swallowing was above 94% across the study years (p < 0.00). Conclusion: These results highlight the need to explore the perceptions of those who have consistently missed MDAs, and also understand the health-system-related issues including those imposed by the pandemic affecting MDA.

Attendee's awareness about preventive chemotherapy neglected tropical diseases (PC-NTD) control during the first world neglected tropical diseases day in Ekiti State, Nigeria.

BACKGROUND: The need to control Neglected Tropical Diseases (NTDs) and sustain progress towards elimination through mass administration of medicines requires substantial communal participation. This study, therefore, assessed the knowledge and perception of attendees' regarding NTDs and its control activities during the inaugural World NTD day event in Ekiti State, Nigeria. METHODOLOGY: A cross-sectional study involving the administration of pretested semi-structured questionnaires to consenting attendees at the Inaugural World NTD day event was conducted on the 30th January, 2020. The questionnaire collected data on attendee's demography, knowledge and awareness about NTDs and its control in Nigeria. Quantitative data were analysed using descriptive statistics in SPSS. 20.0 software and expressed as frequencies and percentages. However, qualitative data to support quantitative analysis were obtained using open-ended questionnaires and analysed thematically. PRINCIPAL FINDINGS/CONCLUSION: A total of 309 attendees comprising 167 (54.0%) females, and 142 (46.0%) males participated in this study. By age groupings, majority 206 (66.7%) were within 15-25 years. 167 (54.8%) of the attendees have not heard about NTDs before, whereas 77(35.0%) have heard about NTDs through the advertisement of the event. 181(63.3%) were aware of ongoing NTD control programs in schools and communities. Also, 246 (83.4%) of them have not taken or do not know anyone that has taken drugs donated in schools or communities. The number of attendees 41(13.3%) who incorrectly classified malaria as NTDs is higher than those who recognized onchocerciasis 36 (11.7%) and worm infections 34(11.0%) as NTDs (p>0.05). This study has shown that awareness and knowledge about NTDs control activities in Ekiti State is low, thus justifying the event as an awareness day for addressing NTDs. Public enlightment and regular promotional activities such as media engagement will raise the public appreciation and participation in NTDs control activities.

Bayesian geostatistical model-based estimates of soil-transmitted helminth infection in Nigeria, including annual deworming requirements.

BACKGROUND: The acceleration of the control of soil-transmitted helminth (STH) infections in Nigeria, emphasizing preventive chemotherapy, has become imperative in light of the global fight against neglected tropical diseases. Predictive risk maps are an important tool to guide and support control activities. METHODOLOGY: STH infection prevalence data were obtained from surveys carried out in 2011 using standard protocols. Data were geo-referenced and collated in a nationwide, geographic information system database. Bayesian geostatistical models with remotely sensed environmental covariates and variable selection procedures were utilized to predict the spatial distribution of STH infections in Nigeria. PRINCIPAL FINDINGS: We found that hookworm, Ascaris lumbricoides, and Trichuris trichiura infections are endemic in 482 (86.8%), 305 (55.0%), and 55 (9.9%) locations, respectively. Hookworm and A. lumbricoides infection co-exist in 16 states, while the three species are co-endemic in 12 states. Overall, STHs are endemic in 20 of the 36 states of Nigeria, including the Federal Capital Territory of Abuja. The observed prevalence at endemic locations ranged from 1.7% to 51.7% for hookworm, from 1.6% to 77.8% for A. lumbricoides, and from 1.0% to 25.5% for T. trichiura. Model-based predictions ranged from 0.7% to 51.0% for hookworm, from 0.1% to 82.6% for A. lumbricoides, and from 0.0% to 18.5% for T. trichiura. Our models suggest that day land surface temperature and dense vegetation are important predictors of the spatial distribution of STH infection in Nigeria. In 2011, a total of 5.7 million (13.8%) school-aged children were predicted to be infected with STHs in Nigeria. Mass treatment at the local government area level for annual or bi-annual treatment of the school-aged population in Nigeria in 2011, based on World Health Organization prevalence thresholds, were estimated at 10.2 million tablets. CONCLUSIONS/SIGNIFICANCE: The predictive risk maps and estimated deworming needs presented here will be helpful for escalating the control and spatial targeting of interventions against STH infections in Nigeria.

Public awareness and knowledge of neglected tropical diseases (NTDs) control activities in Abuja, Nigeria.

The need to engage the public in Neglected Tropical Diseases (NTDs) control activities has become imperative in the context of morbidity reduction through preventive chemotherapy and community participation. Therefore, a survey was conducted among the general public to assess their knowledge and awareness of NTDs control activities in Nigeria. A simple questionnaire was administered to the general public attending a job fair in Abuja, Nigeria. Of the 461 respondents, a significant proportion 337 (73.1%) have heard of NTD before, but only 291 (63.1%) have good knowledge about NTDs. However, among the specific NTDs, only the control of onchocerciasis (50.8%) was of average public awareness in Nigeria, while all the other NTDs control activities were significantly less known to the general public. 397 (87.1%) stated that government support for NTD control activities is poor and were willing to assist to advocate for NTDs control. This survey demonstrates that despite government's numerous activities towards the control of NTDs in Nigeria, there is little sensitization of the general public. There is a need for policy changes that would raise the participation and involvement of the general public in NTDs control activities for sustainability.