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Ivermectin: Panacea to river blindness

BY: Carl Wiafe
  Prof. Satoshi Omura with a blind person during his visit to Asubende

Located between Kintampo and Prang, on the way to Yeji, Asubende, a small community in the Pru District of the Brong Ahafo Region is making big news in Japan. This is the place where the drug Ivermectin is being hailed as panacea to river blindness, the disease that has become the scourge, incapacitating victims bitten by blackfly, along the Volta river basin.

The drug, is the discovery of a renowned Japanese scientist, Professor Satoshi Omura, who was recently awarded joint Nobel Prize - 2015, in medicine for the discoveries relating to a novel therapy against infections caused by roundworm parasites.

 

During the latter part of 2015, Asubende was besieged by a multitude of press corps relating to broadcasting systems in the nation of Japan.   The Japanese Noble prize laureate,Professor Omura once visited Asubende, to evaluate treatment from the drug. Probably this visit was the catalyst to the sorties of press corps to the community in Ghana.

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Bite from black fly

River blindness is one of the diseases manifested by the incidence of a bite from blackfly, a phenomenon which is characterised by the fly invasion of the Volta basin of Ghana. The challenge of blackfly invasion that has affected the village has been part of the widespread scourge of the Volta basin of West Africa, an area that includes about 75 per cent of Ghana’s landscape.

 Little had been known of the relationship between the incidence of the biting by the blackfly, and the blindness in communities such as Asubende until the late 1950s, when this discovery led to a mass intervention exercise, to douse the rivers of the basin with insecticides to control the blackfly population in the communities.

Professor Omura, a microbiologist with long pursuit for the behaviour of microbe organisms, started his career, as a night schoolteacher in a Tokyo public school attended by factory workers. His ardent work in science and medicine has made him a Nobel Prize laureate, which he jointly shares with two other colleagues from Ireland and China.

 Earlier in 2004, Prof. Omura visited Asubende in Ghana, to evaluate treatment of parasitic worm diseases that use his drug discovery, Ivermectin, spearheaded by the World Health Organisation (WHO), that had gotten the incidence of river blindness and elephantiasis responding positively.

Deserted community

Asubende, once a bustling community of about 800 inhabitants around the time of the Onchocerciasis Control Programmes’s (OCP) campaign, is now reduced to less than 50 persons, with six blind persons and their nuclear family of supporters that are adamant of the onslaught of the blackfly attacks. The vast majority of both other able bodied and blind settlers have abandoned the community.  The prosperous market and vibrant entertainment spots that were then the envy of the other nearby communities have lost any trace of their earlier existence in the village. The primary school built in the village is now just an evidence of its earlier prominence in the neighbourhood, and is now educating children mainly from other nearby villages.

 In the early 2000s, this strategy to exterminate the flack fly population, by dousing the rivers with insecticides proved to be quiet successful, but was changed to medication.  Ivermectin became the controlling drug, to curb the incidence of this blindness. Success from treatment of blindness by the use of the drug Ivermectin is quite evident in the communities.

This strategy saw the increasing trend of the incidence of blindness halted, to the extent that there is no new reports of blindness in the community, since the introduction of the medicine Ivermectin. More so, the itching experience of the skin of the victims of fly bite has subsided.

The people of Asubende appeared to have been freed from the worries of new incidences of blindness and the itching experience from these interventions, only to realise the glowing decline of the village’s population.

Discomforting experience

The blackfly bite brings two discomforting experiences. Apart from making its victims blind after about 20-30 years of continuous biting, the fly invasion also is a source of nuisance to the victims. Blindness and elephantiasis have been the manifestations of illnesses from the fly biting. Parasitic nodules that are deposited into the bodies of the victims during the biting, metamorphose into either blindness agents or elephantiasis agents. Luckily, both diseases, including the itchiness on the skin of victims respond positively to Ivermectin treatment.

The incidence of fly biting is a means of transmitting the parasite ochocerca volvulus into the victim. There are two strains of this parasite: the ones that are found in the savannah regions, and those that are found in the forest zones. Victims of the savannah parasites are prone to blindness, elephantiasis as well as skin itching. The ones that are found in the forest regions only bring about skin itching and colouration.

 The challenge now to this incidence of fly biting, therefore, appears to be preventing the fly bite in the first place. Most humans and livestock are unable to cope with the nuisance of the fly biting and attacks; hence those with lighter heels have taken to them in moving out of the community.

The Volta basin of West Africa has no monopoly of this incidence of blackfly attack. All over the world, wherever there is a fast-flowing river has the potential to breed these flies, which in some later stages of their life cycle are unleashed unto the neighbouring communities. In some parts of Canada, blackflies continue to cause human suffering and are a scourge to livestock. In Saskatchewan (Canada), huge numbers of cattle are known to have been killed by blackfly species attack during the outbreak years of 1944 to 1947. Blackflies are nuisance to humans. For example, forest workers in northern British Columbia and Québec (both in Canada) demand blackfly control as part of their work contract.

OCP campaign

Indeed the World Bank sponsored the OCP campaign of aerial spraying of insecticides into the rivers, in the bid to control the fly population. This strategy saw the blackfly invasion incidence reduced considerably. But this strategy was replaced by the use of the Ivermectin medicine, spearheaded by the WHO, to control the blindness in the communities.

The incidence of blindness appears to have been effectively controlled; thanks to Professor Omura and his colleagues’ invention of the Ivermectin drug, of which the remnant community is highly gracious.

 Most of the villagers believe that they owe their freedom from blindness and the body itching to this illustrious son of Japan and his other colleagues.

Words from the communities of the Volta basin may not be enough to express gratitude to Prof. Omura and his other colleagues for the invention of this medicine that appears to be the panacea to blindness and skin itching in the communities like Asubende.

As the fanfare of the Nobel Prize award rages on, it is the fervent wish of the people of Asubende, to join Prof. Omura in the celebrations.

To Prof. Omura and his other colleagues, the people of Asubende, and for that matter Ghana, and the entire Volta basin salute you on this big achievement of yours. Professor, Ayikooo!!