Uganda is in the final stages of eliminating onchocerciasis, also known as river blindness, from all areas where it is endemic.
Once this milestone is achieved, Uganda will become the first African country to eliminate this parasitic disease caused by the fi larial worm, according to Dr. Edridah Tukahebwa, the outgoing assistant commissioner for vector control at the Ministry of Health.
River Blindness is transmitted by black flies, which breed in fast-flowing rivers. It causes severe eye and skin ailments that may result in blindness.
Currently, Kasese is the only district with ongoing transmission of river blindness, a disease that was previously endemic in 40 districts of Uganda, with about 4.7 million people being at risk. About 144,000 people in Kasese are at risk of contracting the disease if interventions do not reach them in time.
Whereas active transmission should have been interrupted, Tukahebwa said insecurity, Ebola and COVID-19 outbreaks, as well as cross-border activities with the Democratic Republic of Congo (DRC), have made it hard for health workers to get through to communities in Kasese.
“The interventions for river blindness include mass treatment of the communities and river dousing to kill the young stages of the flies. These rivers flow from Uganda into the DRC. Ideally, what we would be doing is killing the young stages of the flies in the rivers up to where we have confirmed that there is the breeding of the black flies. But this has not been possible in Kasese because our teams cannot cross into the DRC, given the insecurity,” she said.
Tukahebwa was speaking to journalists during the 15th session of the Uganda onchocerciasis elimination expert advisory committee meeting at Sheraton Hotel on Wednesday
Symptoms include severe itching, disfiguring skin conditions, and visual impairment, including permanent blindness. The Government launched the national onchocerciasis elimination policy in 2007.
The strategy used to eliminate river blindness from Uganda is mass treatment in the affected communities with ivermectin being administered twice a year and vector control elimination, where feasible.
Bayo Fatunmbi, who represented the World Health Organisation at the meeting, said more than 99% of infected people live in 31 African countries. Of these, he said approximately 220 million require preventive chemotherapy, while 14.6 million of the infected people are already suffering from skin disease.
There are also 1.15 million that have had vision loss. Fatunmbi underscored the need to act faster to prevent additional consequences. The areas of focus, he explained, should be vector control, preventive treatment, as well as strengthening cross-border elimination.
Dr Daniel Kyabayinze, the director of public health at the health ministry, said the country would continue carrying out surveillance, as well as looking out for any re-introduction of the disease. “Our biggest challenge as a country is the borders because we have families on either side, but also 1.5 million refugees who keep crossing in and out of the country. Our effort, therefore, is to ensure that we handle people in refugee settlements by treating them and encouraging cross-border assessment and surveillance,” he said.
Dr Kashef Ijaz, the vice-president health programmes at the Carter Center, a non-governmental organisation that helps to improve lives by resolving conflicts and preventing diseases, said one of the things Uganda should do to achieve total elimination is continuous mass drug administration and vector control activities, coupled with health education for the communities.
This process, he said, could take a year or so, depending on how the various activities to eliminate the disease are put in place. “The expert committee will then review this data annually and carry out post-transmission surveillance work. This is what will determine whether it has been eliminated or not,” he said.