[Vision 2020: 100 years of river blindness research].

Klin Monbl Augenheilkd

Augenärztliche Gemeinschaftspraxis und Belegabteilung, Krankenhaus Wermelskirchen, Germany.

Published: March 2002

AI Article Synopsis

  • Early research on onchocerciasis did not recognize significant eye disease until the 1930s, when findings revealed that a notable percentage of patients in the Belgian Congo were blind.
  • Investigators sought to understand why severe eye complications developed later in African onchocerciasis and assessed possible reasons, including oversight by early doctors, low microfilariae levels, and potential mutations in the parasite.
  • Evidence supports that the ocular complications were previously localized and may have resulted from varying disease severity and milder infections, indicating that ongoing control efforts have helped prevent further blindness despite some treatment gaps.

Article Abstract

Background: The early investigators of onchocerciasis from 1874 - 1930 in Africa made no mention at all of concomitant severe eye disease. Publications of the observations in Central America in 1917/1919 prompted some specialists in tropical medicine to look for eye disease associated with African onchocerciasis. However, there did not seem to be any eye disease leading to blindness. It was not until 1930/1931 that Hissette reported that 20 % of patients with onchocerciasis were blind in an onchocerciasis focus on the Sankuru river in the Belgian Congo, and that 50 % of the villagers suffered from eye troubles. Two years later, he found a second focus with the same pathology on the Uéle river.

Working Hypothesis: We wished to establish why African river blindness manifested itself so unusually late and what criteria must be fulfilled for it to be brought under control quickly. The following questions are examined: (1) Had the early tropical doctors overlooked river blindness? (2) Could the still low distribution and density of microfilariae in the body of the affected patients have determined whether or not eye disease is likely to occur? (3) Had the microfilariae mutated into a more aggressive variety?

Results: There are indications confirming all three points in the working hypothesis. Before 1930, cases of African onchocerciasis with ocular complications were demonstrably very localized on the Uéle river. The reason for this is likely to have been that the severity of the disease still varied from focus to focus at that time and/or because the individuals concerned still had a relatively mild microfilarial infection.

Conclusion: In principle, onchocerciasis has reverted to the situation before occurrence of ocular complications in consequence of the ongoing control measures even though the insect destruction and mass therapy are sometimes incomplete. This appears to be sufficient to prevent blindness even if onchocerciasis is not cured. Only a few of the present-day patients with river blindness will still be left by 2030. By then, the problem of river blindness is likely to have become a thing of the past.

Download full-text PDF

Source
http://dx.doi.org/10.1055/s-2002-26726DOI Listing

Publication Analysis

Top Keywords

river blindness
16
eye disease
16
african onchocerciasis
8
ocular complications
8
river
7
onchocerciasis
7
blindness
6
eye
5
disease
5
[vision 2020
4

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!