In the fight against river blindness, the distribution of medicines is not enough

Kangawode is 75 years old and has spent most of his life in Tagwa, in the north-west of the Democratic Republic of Congo (DRC). His house is just 50 metres from the Ubangi River, which marks the border with the Central African Republic. Kangawode has been blind for many years due to river blindness. His two eldest sons – aged 40 and 45 – are also blind as a result of the disease. While Kangawode's other three sons were spared this fate, they suffered from other symptoms of onchocerciasis, as the disease is officially called – severe itching and the characteristic “lizard skin”.

Despite several years of annual treatment with ivermectin to control the parasites, there is evidence that transmission continues in Tagwa and that additional preventive measures are needed to eradicate the disease. Numerous people have been found to have nodules under the skin, indicating the presence of adult worms that multiply and release millions of microfilariae into the bloodstream.

Equally disturbing was the discovery that nearly three percent of those surveyed in the village suffered from epilepsy, often associated with onchocerciasis. This includes two of Kangawode's grandchildren.

Many families affected

There are many families like Kangawode's in the Democratic Republic of Congo and many obstacles to overcome in the fight against river blindness. A study in Kasai province in the south of the Democratic Republic of Congo in 2022 showed that simply distributing drugs to the population is not enough: preventive chemotherapy with ivermectin did not seem to be as effective as expected. Further research showed that half of the residents were excluded from treatment due to local conflict.

The Christian Blind Mission (CBM) provided additional funding in 2023 to support community communication and awareness-raising during the mass distribution campaign. The aim of this initiative was to strengthen community engagement and improve treatment rates and thus impact for the whole village. A follow-up visit in January 2024 showed encouraging signs of progress.

CBM has been a committed partner in supporting the Neglected Tropical Diseases (NTD) programme in the Democratic Republic of Congo since 1989, initially through the African Programme for Onchocerciasis Control (APOC) and more recently throughthrough direct support of the national NTD programme in various regions.

CBM continues to strive to strengthen the onchocerciasis program in the country, focusing on expanding access to treatment options to prevent conditions such as skin lesions, blindness and epilepsy. Incorporating studies on epilepsy prevalence in onchocerciasis endemic areas and ongoing improvement of treatment coverage studies are important steps in this effort.

Enan Adamani is NTD Project Leader for the Accelerating Onchocerciasis and Lymphatic Filariasis Elimination in Nigeria (AOLFEIN) project at CBM.
[email protected]

Michel Mandro-Ndahura is CBM’s NTD Program Manager for West Africa.
[email protected]