111-423: (Redirected from APOC ) Apoc may refer to: African Programme for Onchocerciasis Control, a World Bank and World Health Organization NGO Apolipoprotein C , a family of four proteins that resides on lipoproteins . Anglo-Persian Oil Company , later BP Anarchist People of Color APOC (wrestler) is the ring name of a professional wrestler . Apoc ,
222-453: A biopsy of the skin in normal saline and watching for the larva to come out; looking in the eye for larvae; and looking within the bumps under the skin for adult worms. A vaccine against the disease does not exist. Prevention is by avoiding being bitten by flies. This may include the use of insect repellent and proper clothing. Other efforts include those to decrease the fly population by spraying insecticides . Efforts to eradicate
333-435: A public health problem. The Onchocerciasis Control Programme (OCP) launched in 1974, and at its peak, covered 30 million people in the following countries: Benin, Burkina Faso, Côte d'Ivoire, Ghana, Togo, Mali, and Niger. The OCP utilized the following initiatives: the use of larvicide spraying into fast-flowing rivers to control black fly populations, and from 1988 onwards, the use of ivermectin to treat infected people as
444-475: A Bantu language with many Arabic , Persian and other Middle Eastern and South Asian loan words , developed as a lingua franca for trade between the different peoples in southeastern Africa. In the Kalahari Desert of Southern Africa, the distinct people known as Bushmen (also "San", closely related to, but distinct from " Hottentots ") have long been present. The San evince unique physical traits, and are
555-410: A Business June 2008 through May 2009) , PFI (Press Freedom Index 2009) Sub-Saharan Africa contains over 1,500 languages. With the exception of the extinct Sumerian (a language isolate ) of Mesopotamia , Afroasiatic has the oldest documented history of any language family in the world. Egyptian was recorded as early as 3200 BCE. The Semitic branch was recorded as early as 2900 BCE in
666-512: A French parasitologist, who named it O. caecutiens in 1919, indicating the parasite caused blindness (Latin "caecus" meaning blind). The disease was also reported as being common in Mexico. By the early 1920s, it was generally agreed that the filaria in Africa and Central America were morphologically indistinguishable and the same as that described by O'Neill 50 years earlier. Robles hypothesized that
777-570: A blackfly bite, it can take 12–18 months for the larvae to develop into mature adult worms that will produce their own larvae, which is what leads to the development of symptoms. Almost all the clinical manifestations of onchocerciasis are due to localized host inflammatory responses to dead or dying microfilariae (larvae). The signs and symptoms of onchocerciasis are usually divided into two categories, skin and eye symptoms. Skin symptoms will develop years before any vision problems. These symptoms include: Eye symptoms include: Eye symptoms provides
888-599: A character in the Matrix series Assistant production office coordinator, a film and television administrative job Topics referred to by the same term [REDACTED] This disambiguation page lists articles associated with the title Apoc . If an internal link led you here, you may wish to change the link to point directly to the intended article. Retrieved from " https://en.wikipedia.org/w/index.php?title=Apoc&oldid=1166119058 " Category : Disambiguation pages Hidden categories: Short description
999-929: A core treatment therapy. Alongside the OCP, a joint effort of the World Health Organization , the World Bank , the United Nations Development Programme , and the UN Food and Agriculture Organization , was considered to be a success in controlling onchocerciasis, and in 2002 shifted from control of onchocerciasis to elimination. According to the World Health Organization, four countries have eradicated onchocerciasis that include: Colombia (2013), Ecuador (2014), Mexico (2015), and Guatemala (2016). Continued monitoring ensures onchocerciasis cannot reinvade
1110-399: A dry winter season and a wet summer season. According to paleontology , early hominid skull anatomy was similar to that of their close cousins, the great African forest apes , gorilla and chimpanzee . However, they had adopted a bipedal locomotion and freed hands, giving them a crucial advantage enabling them to live in both forested areas and on the open savanna at a time when Africa
1221-666: A grouping counterpart to North Africa , which is instead grouped with the definition of MENA (i.e. Middle East and North Africa) as it is part of the Arab world , and most North African states are likewise members of the Arab League . However, while they are also member states of the Arab League , the Comoros , Djibouti , Mauritania , and Somalia (and sometimes Sudan ) are all geographically considered to be part of sub-Saharan Africa. Overall,
SECTION 10
#17328489927361332-472: A microscope to check for the presence of microfilaria . If the number of microfilaria is undetectable in the samples, the Mazzotti test is then used. In this test, 6 mg of diethylcarbamazine is administered to the affected area. If the patient experiences intense inflammation or itching in the affected area Microfilaria is present. Slit lamp eye exams are used to identify signs of the parasites in and around
1443-650: A spiritual religious guardian. This imperial cult or system of divine kings was spread to most of central Africa by rivals in kingship migrating and forming new states. Many new states received legitimacy by claiming descent from the Lunda dynasties. The Kingdom of Kongo existed from the Atlantic west to the Kwango river to the east. During the 15th century, the Bakongo farming community was united with its capital at M'banza-Kongo , under
1554-610: Is 8 mg in a single dose. Moxidectin has been found to more strongly suppress the O. volvulus microfilariae for longer than ivermectin treatments, with peak clearance of microfilariae in the skin at one month after treatment. At six months post treatment, many individuals treated with moxidectin have no detectable microfilariae present in their skin. About 21 million people were infected with this parasite in 2017; about 1.2 million of those had vision loss. As of 2017, about 99% of onchocerciasis cases occurred in Africa . Onchocerciasis
1665-512: Is abnormal but cerebrospinal fluid (CSF) and magnetic resonance imaging (MRI) are normal or show non-specific changes. If there are abnormalities on the MRI, they are usually present in the hippocampus . When a clinical diagnosis of onchocerciasis is obtained, doctors take small snips of skin containing 3–5 mg of skin tissue. The skin samples taken are only from the upper dermis . These samples will then be soaked in saline and examined underneath
1776-628: Is also spread by black flies. Both systems are useful, but not exact, animal models. A study of 2501 people in Ghana showed the prevalence rate doubled between 2000 and 2005 despite treatment, suggesting the parasite is developing resistance to the drug. A clinical trial of another anti-parasitic agent, moxidectin (manufactured by Wyeth ), began on July 1, 2009 ( NCT00790998 ). A Cochrane review compared outcomes of people treated with ivermectin alone versus doxycycline plus ivermectin. While there were no differences in most vision-related outcomes between
1887-514: Is currently relatively common in 31 African countries, Yemen , and isolated regions of South America. Over 85 million people live in endemic areas, and half of these reside in Nigeria. Another 120 million people are at risk for contracting the disease. The Onchocerca volvulus main habitat is fast flowing rivers, Onchocerciasis is more commonly found along the large rivers in northern and central regions of Africa, with cases decreasing with distance from
1998-440: Is different from Wikidata All article disambiguation pages All disambiguation pages Onchocerciasis Onchocerciasis , also known as river blindness , is a disease caused by infection with the parasitic worm Onchocerca volvulus . Symptoms include severe itching, bumps under the skin, and blindness . It is the second-most common cause of blindness due to infection, after trachoma . The parasitic worm
2109-549: Is due to two potential target product profiles (TPPs) that have to be in consideration when developing a vaccine for onchocerciasis. This includes the development of a preventive vaccine for use in children five years or less in age, as this population does not receive ivermectin. Development of a therapeutic vaccine is also necessary that targets adult worms, microfilariae, and the causative agents of pathology and transmission, or both, for children and adults with O. volvulus infection. In mass drug administration (MDA) programmes,
2220-669: Is located on the Swahili coast . Johannesburg is the largest city in South Africa . It is the provincial capital and largest city in Gauteng , which is the wealthiest province in South Africa. While Johannesburg is not one of South Africa's three capital cities , it is the seat of the Constitutional Court . The city is located in the mineral-rich Witwatersrand range of hills, and is
2331-429: Is one of the fastest-growing cities in the world, and also one of the most populous urban agglomerations . Lagos is a major financial centre in Africa; this megacity has the highest GDP, and also houses Apapa , one of the largest and busiest ports on the continent. Dar es Salaam is the former capital of, as well as the most populous city in, Tanzania ; it is a regionally important economic centre. It
SECTION 20
#17328489927362442-427: Is so common when DEC is used that this drug is the basis of a skin patch test used to confirm that diagnosis. The drug patch is placed on the skin, and if the patient is infected with O. volvulus microfilaria, localized pruritus and urticaria are seen at the application site. This is an unusual form of epidemic epilepsy associated with onchocerciasis although definitive link has not been established. This syndrome
2553-463: Is spread by the bites of a black fly of the Simulium genus. Usually, many bites are required before infection occurs. These flies live near rivers, hence the common name of the disease. Once inside a person, the worms create larvae that make their way out to the skin, where they can infect the next black fly that bites the person. There are a number of ways to make the diagnosis, including: placing
2664-508: Is the area and regions of the continent of Africa that lie south of the Sahara . These include Central Africa , East Africa , Southern Africa , and West Africa . Geopolitically, in addition to the African countries and territories that are situated fully in that specified region, the term may also include polities that only have part of their territory located in that region, per the definition of
2775-399: Is the second leading cause of blindness from infectious causes. Main disease symptoms, such as blindness and itching, contribute to disease burden by limiting the infected individuals ability to live and work. Individuals most at risk are those who live or work in areas where Simulium blackflies are most common, mostly near rivers and streams. Rural agricultural areas in sub-Saharan Africa see
2886-641: Is thought that the camel was first brought to Egypt after the Persian Empire conquered Egypt in 525 BCE, although large herds did not become common enough in North Africa for camels to be the pack animal of choice for the trans-saharan trade. The Bantu expansion is a major migration movement that originated in West Central Africa (possibly around Cameroon) around 2500 BCE, reaching East and Central Africa by 1000 BCE and Southern Africa by
2997-581: Is thought to irreversibly activate these channel receptors in the worm, eventually causing an inhibitory postsynaptic potential . The chance of a future action potential occurring in synapses between neurons decreases and the nematodes experience flaccid paralysis followed by death. Ivermectin is directly effective against the larval stage microfilariae of O. volvulus ; they are paralyzed and can be killed by eosinophils and macrophages . It does not kill adult females (macrofilariae), but does cause them to cease releasing microfilariae, perhaps by paralyzing
3108-637: The Bantu expansion . In Southern Africa, their speakers are the Khoikhoi and San (Bushmen), in Southeast Africa, the Sandawe and Hadza . The Niger–Congo family is the largest in the world in terms of the number of languages (1,436) it contains. The vast majority of languages of this family are tonal , such as Yoruba and Igbo . However, others such as Fulani , Wolof and Kiswahili are not. A major branch of
3219-737: The Dutch East India Company . For most of the 17th and 18th centuries, the slowly expanding settlement was a Dutch possession. In 1795, the Dutch colony was captured by the British during the French Revolutionary Wars . The British intended to use Cape Town as a major port on the route to Australia and India . It was later returned to the Dutch in 1803, but soon afterward the Dutch East India Company declared bankruptcy, and
3330-691: The Ethiopian Empire , and the Geledi Sultanate , whose military dominance forced governors of the Omani empire north of the city of Lamu to pay tribute to the Somali Sultan Ahmed Yusuf . According to the theory of recent African origin of modern humans , the mainstream position held within the scientific community, all humans originate from either Southeast Africa or the Horn of Africa. During
3441-459: The H. erectus species. The fossil and genetic evidence shows Homo sapiens developed in Southern and East Africa by around 350,000 to 260,000 years ago and gradually migrated across the continent in waves. Between 50,000 and 60,000 years ago, their expansion out of Africa launched the colonisation of the planet by modern humans. By 10,000 BCE, Homo sapiens had spread to all corners of
Apoc - Misplaced Pages Continue
3552-578: The Mali Empire , Songhai Empire , the Kanem Empire and the subsequent Bornu Empire . They built stone structures like in Tichit , but mainly constructed in adobe . The Great Mosque of Djenne is most reflective of Sahelian architecture and is the largest adobe building in the world. In the forest zone, several states and empires such as Bono State , Akwamu and others emerged. The Ashanti Empire arose in
3663-650: The Sabaeans , Parthians and Axumites for the wealthy Indo – Greco – Roman trade. In the Middle Ages several powerful Somali empires dominated the region's trade, including the Ajuran Sultanate , which excelled in hydraulic engineering and fortress building, the Sultanate of Adal , whose General Ahmed Gurey was the first African commander in history to use cannon warfare on the continent during Adal's conquest of
3774-545: The Songhai , Zarma and Kanuri . The Old Nubian language is also a member of this family. Major languages of Africa by region, family and number of primary language speakers in millions: Sub-Saharan Africa has several large cities. Lagos is a city in the Nigerian state of Lagos . The city, with its adjoining conurbation , is the most populous in Nigeria , and the second-most populous in Africa after Cairo , Egypt . It
3885-621: The UN Development Programme applies the "sub-Saharan" classification to 46 of Africa's 55 countries, excluding Djibouti, SADR , Somalia, and Sudan. Since around 3900 BCE , the Saharan and sub-Saharan regions of Africa have been separated by the extremely harsh climate of the sparsely populated Sahara, forming an effective barrier that is interrupted only by the Nile in Sudan, though navigation on
3996-481: The United Nations (UN). This is considered a non-standardised geographical region with the number of countries included varying from 46 to 48 depending on the organisation describing the region (e.g. UN , WHO , World Bank , etc.). The African Union (AU) uses a different regional breakdown, recognising all 55 member states on the continent—grouping them into five distinct and standard regions. The term serves as
4107-748: The Walls of Benin , which is the largest man-made structure in the world. In the 18th century, the Oyo and the Aro confederacy were responsible for most of the slaves exported from modern-day Nigeria, selling them to European slave traders . Following the Napoleonic Wars , the British expanded their influence into the Nigerian interior. In 1885, British claims to a West African sphere of influence received international recognition, and in
4218-455: The World Health Organization , to provide free ivermectin to those who need it in endemic areas. Due to the joint efforts of NGOs and WHO, onchocerciasis is no longer an obstacle in socio-economic development. In 2015 William C. Campbell and Satoshi Ōmura were co-awarded half of that year's Nobel Prize in Physiology or Medicine for the discovery of the avermectin family of compounds,
4329-611: The medieval period used the general term bilâd as-sûdân ("Land of the Blacks") for the vast Sudan region (an expression denoting Central and West Africa ), or sometimes extending from the coast of West Africa to Western Sudan . Its equivalent in Southeast Africa was Zanj ("Country of the Blacks"), which was situated in the vicinity of the Great Lakes region. The geographers drew an explicit ethnographic distinction between
4440-581: The 14th and 15th centuries, large medieval Southeast African kingdoms and states emerged, such as the Buganda , Bunyoro and Karagwe kingdoms of Uganda and Tanzania. During the early 1960s, the Southeast African nations achieved independence from colonial rule. Settlements of Bantu -speaking peoples, who were iron -using agriculturists and herdsmen, were already present south of the Limpopo River by
4551-585: The 18th century in modern-day Ghana . The Kingdom of Nri , was established by the Igbo in the 11th century. Nri was famous for having a priest-king who wielded no military power. Nri was a rare African state which was a haven for freed slaves and outcasts who sought refuge in their territory. Other major states included the kingdoms of Ifẹ and Oyo in the western block of Nigeria which became prominent about 700–900 and 1400 respectively, and center of Yoruba culture. The Yoruba built massive mud walls around their cities,
Apoc - Misplaced Pages Continue
4662-520: The 1950s and early 1960s, most sub-Saharan African nations achieved independence from colonial rule. According to the 2022 revision of the World Population Prospects , the population of sub-Saharan Africa was 1.1 billion in 2019. The current growth rate is 2.3%. The UN predicts for the region a population between 2 and 2.5 billion by 2050 with a population density of 80 per km compared to 170 for Western Europe, 140 for Asia and 30 for
4773-526: The 4th or 5th century displacing and absorbing the original Khoisan speakers. They slowly moved south, and the earliest ironworks in modern-day KwaZulu-Natal Province are believed to date from around 1050. The southernmost group was the Xhosa people , whose language incorporates certain linguistic traits from the earlier Khoisan inhabitants. They reached the Fish River in today's Eastern Cape Province . Monomotapa
4884-630: The Americas, the objective of ESPEN is working with Government Health Ministries and partner non-governmental organizations, toward elimination of transmission of onchocerciasis. This requires consistent annual treatment of 80% of the population in endemic areas for at least 10–12 years, the life span of the adult worm. No African country has so far verified elimination of onchocerciasis, but treatment has stopped in some areas (e.g. Nigeria), following epidemiological and entomological assessments that indicated that no ongoing transmission could be detected. In 1992,
4995-716: The Americas. Sub-Saharan African countries top the list of countries and territories by fertility rate with 40 of the highest 50, all with TFR greater than 4 in 2008. All are above the world average except South Africa and Seychelles . More than 40% of the population in sub-Saharan countries is younger than 15 years old, as well as in Sudan , with the exception of South Africa. GDP per Capita (PPP) (2016, 2017 (PPP, US$ )) , Life (Exp.) (Life Expectancy 2006) , Literacy (Male/Female 2006) , Trans (Transparency 2009) , HDI (Human Development Index) , EODBR (Ease of Doing Business Rank June 2008 through May 2009) , SAB ( Starting
5106-505: The DALYs. Infection reduces the host's immunity and resistance to other diseases, which results in an estimated reduction in life expectancy of 13 years. In 2017, the Global Burden of Disease study said that an estimated 220 million people needed preventive chemotherapy for onchocerciasis. Of those infected, 14.6 million had skin disease and 1.15 million experienced vision loss. Onchocerciasis
5217-516: The Dutch (now under French control) and the British found themselves at war again. The British captured the Dutch possession yet again at the Battle of Blaauwberg , commanded by Sir David Blair . The Zulu Kingdom was a Southern African tribal state in what is now KwaZulu-Natal in southeastern South Africa. The small kingdom gained world fame during and after their defeat in the Anglo-Zulu War . During
5328-652: The Eastern Baribah or Barbaroi , as the ancestors of the Somalis were referred to by medieval Arab and ancient Greek geographers, respectively. In the 19th and 20th centuries, the populations south of the Sahara were divided into three broad ancestral groups: Hamites and Semites in the Horn of Africa and Sahel related to those in North Africa, who spoke languages belonging to the Afroasiatic family; Negroes in most of
5439-617: The Horn of Africa (Ethiopia, Eritrea). The Chadic branch is distributed in Central and West Africa. Hausa , its most widely spoken language, serves as a lingua franca in West Africa (Niger, Ghana, Togo, Benin, Cameroon, and Chad). The several families lumped under the term Khoi-San include languages indigenous to Southern Africa and Tanzania , though some, such as the Khoi languages , appear to have moved to their current locations not long before
5550-640: The Mediterranean. Growing from the proto-Aksumite Iron Age period ( c. 4th century BCE), it rose to prominence by the 1st century CE. The Aksumites constructed monolithic stelae to cover the graves of their kings, such as King Ezana's Stele . The later Zagwe dynasty , established in the 12th century, built churches out of solid rock. These rock-hewn structures include the Church of St. George at Lalibela . In ancient Somalia , city-states flourished such as Opone , Mosyllon and Malao that competed with
5661-539: The Niger–Congo languages is Bantu , which covers a greater geographic area than the rest of the family. Bantu speakers represent the majority of inhabitants in southern, central and southeastern Africa, though San , Pygmy , and Nilotic groups, respectively, can also be found in those regions. Bantu-speakers can also be found in parts of Central Africa such as the Gabon , Equatorial Guinea and southern Cameroon . Swahili ,
SECTION 50
#17328489927365772-620: The Nile was blocked by the Sudd and the river's cataracts . There is also an evident genetic divide between North Africa and sub-Saharan Africa that dates back to the Neolithic . The Sahara pump theory explains how flora and fauna (including Homo sapiens ) left Africa to penetrate Eurasia and beyond. African pluvial periods are associated with a " Wet Sahara " phase, during which larger lakes and more rivers existed. Geographers historically divided
5883-403: The Onchocerca parasite. Blacklock and others could find no evidence of eye disease in Africa. Jean Hissette , a Belgian ophthalmologist, discovered in 1930 that the organism was the cause of a "river blindness" in the Belgian Congo. Some of the patients reported seeing tangled threads or worms in their vision, which were microfilariae moving freely in the aqueous humor of the anterior chamber of
5994-415: The Onchocerciasis Elimination Programme for the Americas (OEPA), was launched. On July 29, 2013, the Pan American Health Organization (PAHO) announced that after 16 years of efforts, Colombia had become the first country in the world to eliminate onchocerciasis. Countries that received verification of elimination were Colombia in 2013, Ecuador in 2015, and Guatemala in 2016. The key factor in elimination
6105-409: The Sahel (northern Mauritania, northern Mali, northern Niger). The Cushitic branch of Afroasiatic is centered in the Horn, and is also spoken in the Nile Valley and parts of the African Great Lakes region. Additionally, the Semitic branch of the family, in the form of Arabic , is widely spoken in the parts of Africa that are within the Arab world. South Semitic languages are also spoken in parts of
6216-413: The Southeast coast of Kenya and Tanzania encountered by these later Arab and Persian settlers have been variously identified with the trading settlements of Rhapta , Azania and Menouthias referenced in early Greek and Chinese writings from 50 CE to 500 CE. These early writings perhaps document the first wave of Bantu settlers to reach Southeast Africa during their migration. Between
6327-399: The Sudan region and its analogue Zanj, from the area to their extreme east on the Red Sea coast in the Horn of Africa . In modern-day Ethiopia and Eritrea was Al-Habash or Abyssinia, which was inhabited by the Habash or Abyssinians, who were the forebears of the Habesha . In northern Somalia was Barbara or the Bilad al-Barbar ("Land of the Berbers "), which was inhabited by
6438-685: The affected area become opaque . Over time, the entire cornea may become opaque, thus leading to blindness. Some evidence suggests the effect on the cornea is caused by an immune response to bacteria present in the worms. The Mazzotti reaction, first described in 1948, is a symptom complex seen in patients after undergoing treatment of onchocerciasis with the medication diethylcarbamazine (DEC). Mazzotti reactions can be life-threatening, and are characterized by fever , urticaria , swollen and tender lymph nodes , tachycardia , hypotension , arthralgias , oedema , and abdominal pain that occur within seven days of treatment of microfilariasis. The phenomenon
6549-437: The affected areas. Ivermectin kills the parasite by interfering with the nervous system and muscle function, in particular, by enhancing inhibitory neurotransmission . The drug binds to and activates glutamate-gated chloride channels . These channels, present in neurons and myocytes , are not invertebrate -specific, but are protected in vertebrates from the action of ivermectin by the blood–brain barrier . Ivermectin
6660-421: The application of animal husbandry towards carrying water, food, and supplies across the desert. Prior to the introduction of the camel , the use of oxen, mule, and horses for desert crossing was common, and trade routes followed chains of oases that were strung across the desert. The trans-saharan trade was in full motion by 500 BCE with Carthage being a major economic force for its establishment. It
6771-508: The area through the OCP. Other effective prevention efforts include personal protection from black fly bites. Recommended protection measures from the CDC include using insect repellents and wearing long sleeves and pants to eliminate exposed skin. Using insect repellent that contains N,N-Diethyl-meta-toluamide ( DEET ) as well as clothing treated with permethrin . In 1995, the African Programme for Onchocerciasis Control (APOC) initiated to eliminate onchocerciasis from African countries in which
SECTION 60
#17328489927366882-411: The art of making fire. They were the first hominids to leave Africa, going on to colonise the entire Old World , and perhaps later on giving rise to Homo floresiensis . Although some recent writers suggest that H. georgicus , a H. habilis descendant , was the first and most primitive hominid to ever live outside Africa, many scientists consider H. georgicus to be an early and primitive member of
6993-625: The body using blood vessels in connective tissues and will even settle behind the cornea. The life of the parasite can be traced through the black fly and the human hosts in the following steps: It is possible for the larvae to move through the body without triggering a response from the host's immune system, so some people who are infected with the parasite experience no symptoms; the Global Burden of Disease Study estimated that in 2017 there were at least 20.9 million people infected worldwide, of which 14.6 million had skin disease symptoms and 1.15 million experienced symptoms that impacted vision. After
7104-476: The carcasses of animals killed by other predators, both for their meat and their marrow. In hunting, H. habilis was most likely not capable of competing with large predators and was more prey than hunter, although H. habilis likely did steal eggs from nests and may have been able to catch small game and weakened larger prey such as cubs and older animals. The tools were classed as Oldowan . Roughly 1.8 million years ago, Homo ergaster first appeared in
7215-433: The common name associated with onchocerciasis, river blindness, and may involve any part of the eye from conjunctiva and cornea to uvea and posterior segment, including the retina and optic nerve . The microfilariae migrate to the surface of the cornea . Punctate keratitis occurs in the infected area. This clears up as the inflammation subsides. However, if the infection is chronic, sclerosing keratitis can occur, making
7326-548: The disease are individuals age 61+ years. Onchocerca originated in Africa and was exported to the Americas by the slave trade, as part of the Columbian exchange that introduced other old world diseases such as yellow fever into the New World. Findings of a phylogenetic study in the mid-90s are consistent with an introduction to the New World in this manner. DNA sequences of savannah and rainforest strains in Africa differ, while American strains are identical to savannah strains in western Africa. The microfilarial parasite that causes
7437-413: The disease by treating entire groups of people twice a year are ongoing in a number of areas of the world. Treatment of those infected is with the medication ivermectin every six to twelve months. This treatment kills the larvae but not the adult worms. The antibiotic doxycycline weakens the worms by killing an associated bacterium, Wolbachia , and is recommended by some as well. The lumps under
7548-505: The disease was brought by the slave trade. The international scientific community was initially skeptical of Hisette's findings, but they were confirmed by the Harvard African Expedition of 1934, led by Richard P. Strong , an American physician of tropical medicine. Since 1987, ivermectin has been provided free of charge for use in humans by Merck through the Mectizan donation program (MDP). The MDP works together with ministries of health and nongovernmental development organisations, such as
7659-421: The disease was endemic. The initiative relied primarily on the use of the antiparasitic drug ivermectin . The initiative was to set up community-directed treatment with ivermectin for those at risk of infection. Overall transmission has declined. The APOC ended in 2015 and aspects of its work has been taken over by the WHO Expanded Special Programme for the Elimination of Neglected Tropical Diseases (ESPEN). As in
7770-454: The disease was first identified in 1874 by an Irish naval surgeon, John O'Neill, who was seeking to identify the cause of a common skin disease along the west coast of Africa, known as "craw-craw". Rudolf Leuckart , a German zoologist, later examined specimens of the same filarial worm sent from Africa by a German missionary doctor in 1890 and named the organism Filaria volvulus . Rodolfo Robles and Rafael Pacheco in Guatemala first mentioned
7881-411: The disease was thought to be carried by all residents. Animal models for the disease are somewhat limited, as the parasite only lives in primates, but there are close parallels. Litomosoides sigmodontis , which will naturally infect cotton rats , has been found to fully develop in BALB/c mice. Onchocerca ochengi , the closest relative of O. volvulus , lives in intradermal cavities in cattle, and
7992-439: The drug does not prevent transmission of Onchocerciasis. It however reduces morbidity and has shown promising results to eliminate in some endemic areas of Africa Ivermectin treatment is particularly effective because it only needs to be taken once or twice a year, needs no refrigeration, and has a wide margin of safety , with the result that it has been widely given by minimally trained community health workers. Patients taking
8103-488: The drug for the treatment of onchocerciasis may have adverse effects within 1–2 days after the drug is administered. Symptoms include urticaria, pruritus, fever, dermatitis, myalgia, swelling of face and limbs, or postural hypotension. For the treatment of individuals, doxycycline is used to kill the Wolbachia bacteria that live in adult worms. This adjunct therapy has been shown to significantly lower microfilarial loads in
8214-512: The early centuries CE. The Djenné-Djenno city-state flourished from 250 BCE to 900 CE and was influential to the development of the Ghana Empire . The Nok culture of Nigeria (lasting from 1,500 BCE to 200 CE) is known from a type of terracotta figure. There were a number of medieval empires of the southern Sahara and the Sahel, based on trans-Saharan trade , including the Ghana Empire and
8325-731: The eye. Blacklock and Strong had thought the African worm did not affect the eyes, but Hissette reported that 50% of patients with onchocerciasis near the Sankuru river in the Belgian Congo had eye disease and 20% were blind. Hisette Isolated the microfilariae from an enucleated eye and described the typical chorioretinal scarring, later called the "Hissette-Ridley fundus" after another ophthalmologist, Harold Ridley , who also made extensive observations on onchocerciasis patients in north west Ghana, publishing his findings in 1945. Ridley first postulated that
8436-446: The eyes of patients whose eyes are affected. Antibody tests when available can aid in the diagnosis of Onchocerciasis. Onchocerciasis causes different kinds of skin changes, which vary in different geographic regions; it may be divided into the following phases or types: Additionally, the various skin changes associated with onchocerciasis may be described as follows: Various control programs aim to stop onchocerciasis from being
8547-618: The first millennium BCE. Trade and improved agricultural techniques supported more sophisticated societies, leading to the early civilisations of Sao , Kanem , Bornu , Shilluk , Baguirmi , and Wadai . Following the Bantu Migration into Central Africa, during the 14th century, the Luba Kingdom in southeast Congo came about under a king whose political authority derived from religious, spiritual legitimacy. The kingdom controlled agriculture and regional trade of salt and iron from
8658-534: The first millennium CE, Nilotic and Bantu -speaking peoples moved into the region , and the latter now account for three-quarters of Kenya's population. On the coastal section of Southeast Africa, a mixed Bantu community developed through contact with Muslim Arab and Persian traders, leading to the development of the mixed Arab, Persian and African Swahili City States . The Swahili culture that emerged from these exchanges evinces many Arab and Islamic influences not seen in traditional Bantu culture, as do
8769-558: The following year the Royal Niger Company was chartered under the leadership of Sir George Goldie . In 1900, the company's territory came under the control of the British government, which moved to consolidate its hold over the area of modern Nigeria. On 1 January 1901, Nigeria became a British protectorate as part of the British Empire , the foremost world power at the time. Nigeria was granted its independence in 1960 during
8880-555: The forerunner of ivermectin. The latter has come to decrease the occurrence of lymphatic filariasis and onchocerciasis. Uganda's government, working with the Carter Center river blindness program since 1996, switched strategies for distribution of Mectizan. The male-dominated volunteer distribution system had failed to take advantage of traditional kinship structures and roles. In 2014, the program switched from village health teams to community distributors, primarily selecting women with
8991-517: The form of the Akkadian language of Mesopotamia ( Assyria and Babylonia ) and circa 2500 BCE in the form of the Eblaite language of northeastern Syria . The distribution of the Afroasiatic languages within Africa is principally concentrated in North Africa and the Horn of Africa. Languages belonging to the family's Berber branch are mainly spoken in the north, with its speech area extending into
9102-502: The fossil record in Africa. From Homo ergaster , Homo erectus (upright man) evolved 1.5 million years ago. Some of the earlier representatives of this species were small-brained and used primitive stone tools , much like H. habilis . The brain later grew in size, and H. erectus eventually developed a more complex stone tool technology called the Acheulean . Potentially the first hominid to engage in hunting, H. erectus mastered
9213-431: The genus Simulium bites them. After that, it can take up to three months for the worms to mature under the skin of its host. The worms mainly get nutrients for growth in humans from blood, but they have also been seen to rely on other bodily fluids such as cerebrospinal fluid, and urine. It is common to see nodules formed in the skin where the adult worms reside and mate. However, these worms will often travel throughout
9324-437: The goal of assuring that everyone in the circle of their family and friends received river blindness information and Mectizan . In 2021, Nigeria had the greatest prevalence of onchocerciasis infections globally, and attributed the infection to 30.2% of blindness cases in the country. A study from western Nigeria found that residents believed that the parasitic effects of the disease was necessary to stimulate fertility, and that
9435-664: The host, and may kill the adult worms, due to the symbiotic relationship between Wolbachia and the worm. In four separate trials over ten years with various dosing regimens of doxycycline for individualized treatment, doxycycline was found to be effective in sterilizing the female worms and reducing their numbers over a period of four to six weeks. Research on other antibiotics, such as rifampicin , has shown it to be effective in animal models at reducing Wolbachia both as an alternative and as an adjunct to doxycycline. However, doxycycline treatment requires daily dosing for at least four to six weeks, making it more difficult to administer in
9546-558: The indigenous people of southern Africa. Pygmies are the pre-Bantu indigenous peoples of Central Africa. The Nilo-Saharan languages are concentrated in the upper parts of the Chari and Nile rivers of Central Africa and Southeast Africa. They are principally spoken by Nilotic peoples and are also spoken in Sudan among the Fur , Masalit , Nubian and Zaghawa peoples and in West and Central Africa among
9657-666: The king title, Manikongo . Other significant states and peoples included the Kuba Kingdom , producers of the famous raffia cloth, the Eastern Lunda , Bemba , Burundi , Rwanda , and the Kingdom of Ndongo . Nubia , covered by present-day northern Sudan and southern Egypt , was referred to as " Aethiopia " ("land of the burnt face") by the Greeks . Nubia in her greatest phase is considered sub-Saharan Africa's oldest urban civilisation. Nubia
9768-511: The many Afro-Arab members of the Bantu Swahili people . With its original speech community centered on the coastal parts of Tanzania (particularly Zanzibar ) and Kenya – a seaboard referred to as the Swahili Coast – the Bantu Swahili language contains many Arabic loan-words as a consequence of these interactions. The earliest Bantu inhabitants of
9879-494: The most disease burden by blackfly bites. Onchocerciasis common to tropical environments, like that of sub-Saharan Africa, where more than 99% percent of infected individuals occupy the 31 countries. Onchocerciasis can be linked to impoverished remote areas, as residents who experience symptoms can no longer tend to land or navigate the area. Areas with high infection rates may experience up to one-third of residents affected by onchocerciasis symptoms. The age group most impacted by
9990-506: The most famous being Sungbo's Eredo . Another prominent kingdom in southwestern Nigeria was the Kingdom of Benin , whose power lasted between the 15th and 19th century. Their dominance reached as far as the well-known city of Eko which was named Lagos by the Portuguese traders and other early European settlers. The Edo -speaking people of Benin are known for their famous bronze casting and rich coral, wealth, ancient science and technology and
10101-691: The north and copper from the Zambian/Congo copper belt. Rival kingship factions which split from the Luba Kingdom later moved among the Lunda people, marrying into its elite and laying the foundation of the Lunda Empire in the 16th century. The ruling dynasty centralised authority among the Lunda under the Mwata Yamyo or Mwaant Yaav. The Mwata Yamyo's legitimacy, like that of the Luba king, came from being viewed as
10212-592: The northern focus in Chiapas , Mexico , and the focus in Oaxaca , Mexico, where Onchocerca volvulus existed, was determined, after several years of treatment with ivermectin , as free of the transmission of the parasite . In April 2013, Colombia became the first country to achieve elimination of Onchocerciasis, verified by the World Health Organization. In the following three years, Ecuador and Guatemala, along with Mexico have been verified to have eliminated Onchocerciasis, with
10323-483: The number of blind people due to onchocerciasis dramatically. However, another issue that arises is the fact that onchocerciasis is able to cause epilepsy, most likely because the level of microfilariae load required to develop epilepsy is much lower than to develop blindness. According to a 2002 WHO report, onchocerciasis has not caused a single death, but its global burden is 987,000 disability adjusted life years (DALYs). The severe pruritus alone accounts for 60% of
10434-493: The ocular form of the disease in the Americas about 1915. They described a tropical worm infection with adult Onchocerca that included inflammation of the skin, especially the face ('erisipela de la costa'), and eyes. The disease, commonly called the "filarial blinding disease", and later referred to as "Robles disease", was common among coffee plantation workers. Manifestations included subcutaneous nodules, anterior eye lesions, and dermatitis. Robles sent specimens to Émile Brumpt ,
10545-678: The period of decoloniszation . Archeological finds in Central Africa provide evidence of human settlement that may date back over 10,000 years. According to Zangato and Holl, there is evidence of iron-smelting in the Central African Republic and Cameroon that may date back to 3,000 to 2,500 BCE. Extensive walled sites and settlements have recently been found in Zilum , Chad. The area is located approximately 60 km (37 mi) southwest of Lake Chad, and has been radiocarbon dated to
10656-415: The physician Rodolfo Robles first linked the worm to eye disease. It is listed by the World Health Organization (WHO) as a neglected tropical disease . In 2013 Colombia became the first country to eradicate the disease. Onchocerciasis is a parasitic infection caused by the roundworm species Onchocerca volvulus . The larvae of O. volvulus enter a human host when an infected female adult fly from
10767-557: The region into several distinct ethnographic sections based on each area's respective inhabitants. The concept has been criticised as a racist construction intended to separate North Africa or "European/White Africa" and "Black Africa" or "Africa noire". Critics from various countries have provided arguments supporting the interconnectedness of continental Africa, pointing to historical and cultural connections, as well as trade between North, West, and East Africa . Commentators in Arabic in
10878-452: The reproductive tract. Ivermectin is very effective in reducing microfilarial load and reducing number of punctate opacities in individuals with onchocerciasis. After two decades of research, moxidectin was approved by the U.S. Food and Drug Administration in 2018 for use in ages 12 and older. Ongoing studies are looking to identify doses that will be safe for children ages 4–11. The oral dosage for moxidectin in adults and children 12 and up
10989-732: The rest of the subcontinent (hence, the toponym Black Africa for Africa south of the Sahara ), who spoke languages belonging to the Niger-Congo and Nilo-Saharan families; and Khoisan in Southern Africa , who spoke languages belonging to the Khoisan family. Sub-Saharan Africa has a wide variety of climate zones or biomes . South Africa and the Democratic Republic of the Congo in particular are considered megadiverse countries . It has
11100-414: The rivers. Multiple exposure to Simulium blackflies raise the number of adult worms and microfilariae that are present in the host. Risk of contracting Onchocerciasis for casual travelers is low, since it often takes several exposures, while travelers that stay for longer visits such as missionaries or long-term volunteers have a greater risk of contracting Onchocerciasis. Onchocerciasis was eliminated in
11211-518: The skin may also be removed by surgery. According to the Center for Disease Control and Prevention, as of 2017, about 20.9 million people were infected with Onchocerciasis, and an estimated 1.15 million have some amount of loss of vision from the infection. Most infections occur in sub-Saharan Africa , although cases have also been reported in Yemen and isolated areas of Central and South America . In 1915,
11322-415: The treatment for onchocerciasis is ivermectin (trade name: Mectizan). Ivermectin is administered four times a year and will be continually administered for 10–14 years due to the lifespan of the adult worm. Intense skin itching is eventually relieved, and the progression towards blindness is halted. The drug works by reducing the release of larvae from the adult worm but the drug does not kill it. However
11433-992: The two treatments, there was low quality evidence suggesting treatment with doxycycline plus ivermectin showed improvement in iridocyclitis and punctate keratitis, over those treated with ivermectin alone. In 2017, WHO set up the Onchocerciasis Technical Advisory Subgroup (OTS) to further research and establish areas that require drug administration. The OTS also identifies co-endemic areas with lymphatic filariasis to properly treat Onchocerciasis and lymphatic filariasis. WHO priorities research to achieve elimination of onchocerciasis. Research approaches include: improving outreach efforts to marginalized populations, expanding mapping of endemic areas of onchocerciasis, improve and standardize information on mass drug administration, develop diagnostic approaches, surveillance strategies, and therapeutic approaches. Sub-Saharan Africa Sub-Saharan Africa or Subsahara
11544-414: The use of ivermectin. Cities in Nigeria, Cameroon, Ethiopia, Uganda, and the Congo by far have had the largest amount of infected individuals. The efforts of CDTI (Community-Directed Treatment with Ivermectin) was conducted to study Onchocerciasis associations with epilepsy. The results do not go unnoticed as they were able to decrease the number of microfilariae (larvae) loads. This was able to decrease
11655-527: The vector of the disease was the day-biting black fly, Simulium . Scottish physician Donald Blacklock of the Liverpool School of Tropical Medicine confirmed this mode of transmission in studies in Sierra Leone. Blacklock's experiments included the re-infection of Simulium flies exposed to portions of the skin of infected subjects on which nodules were present, which led to elucidation of the life cycle of
11766-509: The world. This dispersal of the human species is suggested by linguistic, cultural and genetic evidence. During the 11th millennium BP , pottery was independently invented in West Africa, with the earliest pottery there dating to about 9,400 BC from central Mali. It spread throughout the Sahel and southern Sahara . After the Sahara became a desert, it did not present a totally impenetrable barrier for travelers between north and south because of
11877-472: Was a major source of gold for the ancient world. Nubians built famous structures and numerous pyramids. Sudan, the site of ancient Nubia, has more pyramids than anywhere else in the world. The Axumite Empire spanned the southern Sahara, south Arabia and the Sahel along the western shore of the Red Sea . Located in northern Ethiopia and Eritrea , Aksum was deeply involved in the trade network between India and
11988-527: Was a medieval kingdom (c. 1250–1629), which existed between the Zambezi and Limpopo rivers of Southern Africa in the territory of modern-day Zimbabwe and Mozambique . Its old capital was located at Great Zimbabwe . In 1487, Bartolomeu Dias became the first European to reach the southernmost tip of Africa. In 1652, a victualling station was established at the Cape of Good Hope by Jan van Riebeeck on behalf of
12099-441: Was drying up, with savanna encroaching on forested areas. This occurred 10 million to 5 million years ago. By 3 million years ago several australopithecine hominid species had developed throughout Southern , East , and Central Africa . They were tool users rather than tool manufacturers. The next major evolutionary step occurred around 2.3 million BCE, when primitive stone tools were used to scavenge
12210-576: Was first described in Tanzania by Louise Jilek-Aall, a Norwegian psychiatric doctor in Tanzanian practice, during the 1960s. It occurs most commonly in Uganda and South Sudan . It manifests itself in previously healthy 5–15-year-old children, is often triggered by eating or low temperatures and is accompanied by cognitive impairment. Seizures occur frequently and may be difficult to control. The electroencephalogram
12321-514: Was mass administration of ivermectin. The OEPA projection was that the disease would be eliminated from all remaining countries in the Americas by 2012. In September 2015, the OEPA announced that onchocerciasis only remained in a remote region on the border of Brazil and Venezuela. The area is home to the Yanomami indigenous people. No vaccine to prevent onchocerciasis infection in humans is available. This
#735264