Where onchocerciasis is suspected, a medical skin test is necessary to determine its presence. Also, the disease can be detected with an eye examination.

When the nodules appear on the body, they can be removed by surgery. Early removal lowers the number of worms in the body. However, when the nodules are inside the body and not easily detected, this measure is not useful. Removal of nodules from all people with the disease would be very time-consuming and virtually impossible.

Another possibility is to use drugs to treat people with the disease. There are drugs which kill the larval parasites in the body and drugs that kill the adult worm. No drug does both. The problem with drug use is:

• Drugs have severe side effects.

• Drug treatment can only stop the symptoms and prevent further damage.

• Drug treatment is expensive and not practical over large areas.

To control river blindness, it is very important to eliminate breeding places. People should be taught about the disease and how it is spread. Once an awareness of the disease is created, people will be more interested in cooperating in blackfly control programs. Community members should participate in and take responsibility for spraying programs and brush clearing. Instruct people in the importance of using netting when sleeping outdoors, especially during the daytime when the files bite. Above all, help people to recognize the symptoms of the disease so that they can get medical help quickly.

With kind regards

Sophia

Managing Editor

Journal of Community Medicine & Health Education