United Front Against Riverblindness (UFAR) is a Non-Governmental Development Organization (NGDO) [1] that provides technical, managerial and financial support for the elimination of riverblindness, or onchocerciasis, in the Kasongo region of Maniema province in the east-southern region of the Democratic Republic of the Congo (DRC).
UFAR and its partners use the community-directed treatment with ivermectin (CDTI) approach recommended by the African Programme for Onchocerciasis Control (APOC), a branch of the World Health Organization (WHO). Each year UFAR ensures the treatment of about one million people in what is referred to as the CDTI Kasongo project to prevent the further transmission of the parasitic disease onchocerciasis to uninfected persons and to halt the progression of the disease in those already infected.
United Front Against Riverblindness was formed in 2004 and recognized as a 501(c)(3) nonprofit organization by the U.S. Internal Revenue Service. The organization was founded by and is currently led by Executive Director Dr. Daniel Shungu. UFAR has a small headquarters office in Lawrenceville, NJ and operational offices in Kinshasa and Kasongo, DRC. The CDTI Kasongo includes eight health zones.
In 2007 treatment was initiated in the health zone of Kasongo, in 2008 it was initiated in the health zones of Kunda, Lusangi, Salamabila and Samba, [2] and in 2009 it was initiated in the remaining health zones of Kabambare, Kampene and Pangi. [3]
Since the community-wide mass treatment of all eligible people must be repeated once a year for 10–15 years, approximately three million tablets of Mectizan (ivermectin) were distributed in 2009 in all eight health zones by some 4,540 trained community workers.
UFAR is governed by a volunteer board of directors that oversees the organization's activities and promotes its objectives and goals. The board is chaired by Jeffrey Yuan, PhD. The board includes members from medicine, academia and industry and includes: Daniel L. Shungu, PhD (Clinical Microbiology & Infectious Diseases), Roger Youmans, MD (Associate Executive Director, Surgeon & General Practitioner, Former Medical Missionary to DRC and Ghana, Author), Dr. Dennis Bowers (CEO of Life Force Technologies, Inc.), Mrs. Jean Jacobsohn (UFAR Treasurer), Dr. John McGlaughlin (Mathematics Instructor - Philadelphia School District), Dr. Elsie McKee (Church History, Historical Theology - Princeton Theological Seminary), Mr. Charles C. Phillips (Past-Chair, Information Technology, Resource Development, Isles, Inc.), Dr. Robin Rusciano (Political Science, Current Social World Issues - Rider University), Robert J. Vosatka, MD, Ph.D (Board Chair Emeritus, Physician, Teacher, Scientist), Jeffrey Yuan, PhD (Board Chair, Pharmaceutical Regulatory Affairs Scientist, Merck & Co., Inc.)
An advisory council includes private-sector professionals who lend their expertise in support of the United Front Against Riverblindness organization. Executive Director Dr. Daniel Shungu manages the day-to-day operations and works with the field staff as well as APOC, [4] WHO, the DRC Ministry of Health and other local and international public and private organizations that share in the mission of eradicating onchocerciasis.
Onchocerciasis is a neglected tropical disease. [5] The primary strategy to control onchocerciasis is to interrupt the life cycle of the parasite. [6] Ivermectin, known by its trade name Mectizan, is the only drug available for treating onchocerciasis without severe side effects. The drug rapidly kills microfilariae (immature worms) but not the adult worms. A single oral dose of ivermectin, taken annually for the 10-15 year life span of the adult worms, protects individuals from further progression of onchocerciasis. Merck & Co. manufactures the drug and provides it free [7] worldwide for the treatment of onchocerciasis.
Onchocerciasis is a parasitic disease transmitted through the bite of the small black fly that breeds along the banks of fast-flowing rivers. People acquire the disease during their regular trips to infested rivers for their routine daily activities such as farming, hunting, fishing and fetching water. Larvae, transmitted to humans through the bite of the small black fly, mature under the skin into adult worms forming visible nodules throughout the body. Pairs of adult worms produce millions of microfilariae during their entire 10-15 year life span. The microfilariae initially cause a rash, severe itching, thickening and depigmentation of the skin, followed by visual impairment and eventually blindness.
Annual treatment requires annual training of community distributors (one distributor per 100-200 people), and requires that trained local medical staff be on hand during the annual treatment phase for handling any treatment-related severe adverse reactions.
Eight health zones and 116 health centers comprise the CDTI Kasongo region. The people are served by three hospitals and there are 136 medical doctors and nurses in the region. More than 1,700 villages, ranging in size from 100 to more than 65,000 people, are included in the CDTI Kasongo.
The Community Directed Treatment with Ivermectin (CDTI) program is the strategy whereby people in endemic communities are empowered to play a major role in managing their own health. CDTI has been adopted worldwide as the primary method for mass distribution of Mectizan to control onchocerciasis. UFAR works with these adult volunteers in partnership with APOC, the World Health Organization, and the Democratic Republic of the Congo national government.
Communities choose their own community distributors. [8] These village-based volunteers serve as health care workers who are trained to take full control of the ivermectin treatment program in their respective communities. The training includes providing accurate basic information on the disease and the drug in the local languages, instructions on taking the census, ordering and collecting ivermectin from the health center, preparing and conducting community-wide distribution of the drug, submitting treatment reports back to the health center, and monitoring and reporting any unusual adverse reactions. Such active community involvement greatly improves both the therapeutic and the geographic coverage of ivermectin mass distribution programs.
Effective treatment includes more than distribution of medicine. It also requires education to address long-held myths about the causes of onchocerciasis. This educational process begins with enlisting the cooperation and participation of the village chief and tribal elders.
The United Front Against Riverblindness (UFAR) announces a landmark partnership with Sightsavers, an international development charity. Sightsavers will fund riverblindness prevention and elimination in two remote areas of the Democratic Republic of the Congo (DRC). More than 1.2 million people and 2,728 villages will be added to UFAR's existing program.
Dr. Daniel Shungu, founder of UFAR, says that UFAR will now be able to bring lifesaving medicine to Ituri Nord and Lubutu, in Oriental and Maniema provinces, respectively. "I thank Sightsavers on behalf of UFAR and especially for those in the two new regions whose lives will be positively changed forever as a result of this arrangement. We have a few more challenges to face but, fortunately, finances for these two projects will not be one of them," he says. [9]
General:
Loa loa filariasis is a skin and eye disease caused by the nematode worm Loa loa. Humans contract this disease through the bite of a deer fly or mango fly, the vectors for Loa loa. The adult Loa loa filarial worm migrates throughout the subcutaneous tissues of humans, occasionally crossing into subconjunctival tissues of the eye where it can be easily observed. Loa loa does not normally affect one's vision but can be painful when moving about the eyeball or across the bridge of the nose. The disease can cause red itchy swellings below the skin called "Calabar swellings". The disease is treated with the drug diethylcarbamazine (DEC), and when appropriate, surgical methods may be employed to remove adult worms from the conjunctiva. Loiasis belongs to the so-called neglected diseases.
Loa loa is the filarial nematode (roundworm) species that causes Loa loa filariasis. Loa loa actually means "worm worm", but is commonly known as the "eye worm", as it localizes to the conjunctiva of the eye. Loa loa is commonly found in Africa. It mainly inhabits rain forests in West Africa and has native origins in Ethiopia. The disease caused by Loa loa is called loiasis and belongs to the so-called neglected diseases.
Diethylcarbamazine (DEC) is a medication used in the treatment of filariasis including lymphatic filariasis, tropical pulmonary eosinophilia, and loiasis. It may also be used for prevention of loiasis in those at high risk. While it has been used for onchocerciasis, ivermectin is preferred. It is taken by mouth.
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.
Filariasis is a parasitic disease caused by an infection with roundworms of the Filarioidea type. These are spread by blood-feeding insects such as black flies and mosquitoes. They belong to the group of diseases called helminthiases.
Wuchereria bancrofti is a human parasitic worm (Filariworm) that is the major cause of lymphatic filariasis. It is one of the three parasitic worms, together with Brugia malayi and B. timori, that infect the lymphatic system to cause lymphatic filariasis. These filarial worms are spread by a variety of mosquito vector species. W. bancrofti is the most prevalent of the three and affects over 120 million people, primarily in Central Africa and the Nile delta, South and Central America, the tropical regions of Asia including southern China, and the Pacific islands. If left untreated, the infection can develop into a chronic disease called Lymphatic filariasis. In rare conditions, it also causes tropical eosinophilia, an asthmatic disease. No vaccine is commercially available, but high rates of cure have been achieved with various antifilarial regimens and lymphatic filariasis is the target of the WHO Global Program to Eliminate Lymphatic Filariasis with the aim to eradicate the disease as a public-health problem by 2020.
Ivermectin is a medication used to treat many types of parasite infestations. This includes head lice, scabies, river blindness (onchocerciasis), strongyloidiasis, trichuriasis, ascariasis, and lymphatic filariasis. It can be taken by mouth or applied to the skin for external infestations. Use in the eyes should be avoided.
Onchocerca volvulus is a nematode that causes onchocerciasis, and is the second-leading cause of blindness worldwide after trachoma. It is one of the 20 neglected tropical diseases listed by the World Health Organization, with elimination from certain countries expected by 2020.
Brian Oliver Lyndhurst Duke CBE M.D., ScD was an expert in tropical diseases who extensively studied River Blindness and other parasitic diseases. His work helped to develop an anti parasitic drug to combat them.
Lymphatic filariasis is a human disease caused by parasitic worms known as filarial worms. Most cases of the disease have no symptoms. Some people, however, develop a syndrome called elephantiasis, which is marked by severe swelling in the arms, legs, breasts, or genitals. The skin may become thicker as well, and the condition may become painful. The changes to the body have the potential to harm the person's social and economic situation.
Neglected tropical diseases (NTDs) are a diverse group of tropical infections which are common in low-income populations in developing regions of Africa, Asia, and the Americas. They are caused by a variety of pathogens such as viruses, bacteria, protozoa and parasitic worms (helminths). These diseases are contrasted with the big three infectious diseases, which generally receive greater treatment and research funding. In sub-Saharan Africa, the effect of these diseases as a group is comparable to malaria and tuberculosis. NTD co-infection can also make HIV/AIDS and tuberculosis more deadly.
Mansonella perstans is a vector-borne human filarial nematode, transmitted by tiny blood-sucking flies called midges. Mansonella perstans is one of two filarial nematodes that causes serous cavity filariasis in humans. The other filarial nematode is Mansonella ozzardi. M. perstans is widespread in many parts of sub-Saharan Africa, parts of Central and South America, and the Caribbean.
Mansonella ozzardi is a parasite in the phylum of Nematoda. This filarial nematode is one of two that causes serous cavity filariasis in humans. The other filarial nematode that causes it in humans is Mansonella perstans. M. ozzardi is an endoparasite that inhabits the serous cavity of the abdomen in the human host. It lives within the mesenteries, peritoneum, and in the subcutaneous tissue.
Mansonella streptocerca,, is the scientific name of a human parasitic roundworm causing the disease streptocerciasis. It is a common parasite in the skin of humans in the rain forests of Africa, where it is thought to be a parasite of chimpanzees, as well.
Sightsavers is an international non-governmental organisation that works with partners in developing countries to treat and prevent avoidable blindness, and promote equality for people with visual impairments and other disabilities. It is based in Haywards Heath in the United Kingdom, with branches in Sweden, Norway, India, Italy, Republic of Ireland, the United Arab Emirates, and the USA.
The Task Force for Global Health is an international, nonprofit organization that works to improve health of people most in need, primarily in developing countries. Founded in 1984 by global health pioneer Dr. William Foege, The Task Force consists of eight programs focused on neglected tropical diseases, vaccines, field epidemiology, public health informatics, and health workforce development. Those programs include the African Health Workforce Project, the Center for Vaccine Equity, Children Without Worms, International Trachoma Initiative, Mectizan Donation Program, Neglected Tropical Diseases Support Center, Public Health Informatics Institute, and TEPHINET. The Task Force works in partnership with ministries of health and hundreds of organizations, including major pharmaceutical companies that donate billions of dollars annually in essential medicines. Major funders include the Bill & Melinda Gates Foundation, CDC, WHO, Robert Wood Johnson Foundation, de Beaumont Foundation, United States Agency for International Development, Sightsavers, Pfizer, Merck & Co., Johnson & Johnson, and GlaxoSmithKline. The Task Force is affiliated with Emory University, headquartered in Decatur, Georgia, a town in metro Atlanta, and has regional offices in Guatemala and Ethiopia. The Task Force currently supports work in 154 countries.
The London Declaration on Neglected Tropical Diseases is a collaborative disease eradication programme launched on 30 January 2012 in London. It was inspired by the World Health Organization 2020 roadmap to eradicate or prevent transmission for neglected tropical diseases. Officials from WHO, the World Bank, the Bill & Melinda Gates Foundation, the world's 13 leading pharmaceutical companies, and government representatives from US, UK, United Arab Emirates, Bangladesh, Brazil, Mozambique and Tanzania participated in a joint meeting at the Royal College of Physicians to launch this project. The meeting was spearheaded by Margaret Chan, Director-General of WHO, and Bill Gates, Co-Chair of the Bill & Melinda Gates Foundation.
Uche Veronica Amazigo is a professor of Medical Parasitology and public health specialist. She is a fellow of the Nigerian Academy of Science who was elected into the Academy's Fellowship at its Annual General Meeting held in January, 2015. In 2012, she won the Prince Mahidol Award for outstanding contributions to public health. She is best known for her research on onchocerciasis and her consequent contributions to the World Health Organization (WHO).
William Cecil Campbell is an Irish biologist and parasitologist based in the USA known for his work in discovering a novel therapy against infections caused by roundworms, for which he was jointly awarded the 2015 Nobel Prize in Physiology or Medicine. He helped to discover a class of drugs called ivermectins, whose derivatives have been shown to have "extraordinary efficacy" in treating River blindness and Lymphatic filariasis, among other parasitic diseases affecting animals and humans. Campbell worked at the Merck Institute for Therapeutic Research 1957–1990, and is currently a research fellow emeritus at Drew University.
Ekanem Ikpi Braide is a Nigerian Parasitologist who was a Vice-Chancellor of Cross River University of Technology (CRUTECH), Calabar, and pioneer Vice-Chancellor of Federal University of Technology, Lafia. She is credited with a major contribution to the eradication of guinea worm in Nigeria. In 2020, she was made the first female President-elect of the Nigerian Academy of Science. Braide is Chairman of the Board of Trustees, The Leprosy Mission (TLM) Nigeria. She is the Pro-Chancellor of Arthur Jarvis University, Akpabuyo, Nigeria.