Pregnant Women, a Potential Reservoir for Onchocerca volvulus? A Cross Sectional Study in Maridi County, South Sudan
Abstract Background Onchocerciasis, a neglected tropical disease (NTD) caused by Onchocerca volvulus, is hyperendemic in many parts of Africa, including South Sudan. Pregnant women may be a parasite reservoir as they are not included in routine ivermectin (IVM) treatments due to unassessed drug safe...
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2025-02-01
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| Series: | Journal of Epidemiology and Global Health |
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| Online Access: | https://doi.org/10.1007/s44197-025-00357-2 |
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| author | Chiara Trevisan Amber Hadermann Stephen Raimon Jada Raphael A. Abong Yak Yak Bol Joseph N. Siewe Fodjo Katja Polman Robert Colebunders |
| author_facet | Chiara Trevisan Amber Hadermann Stephen Raimon Jada Raphael A. Abong Yak Yak Bol Joseph N. Siewe Fodjo Katja Polman Robert Colebunders |
| author_sort | Chiara Trevisan |
| collection | DOAJ |
| description | Abstract Background Onchocerciasis, a neglected tropical disease (NTD) caused by Onchocerca volvulus, is hyperendemic in many parts of Africa, including South Sudan. Pregnant women may be a parasite reservoir as they are not included in routine ivermectin (IVM) treatments due to unassessed drug safety. In our study we determined the proportion of pregnant women infected with Onchocerca volvulus and assessed the knowledge and practices on IVM use during pregnancy. Methodology/Principal Findings A hospital-based cross-sectional study was conducted in 2023 at Maridi hospital in Maridi County, an onchocerciasis endemic area in South Sudan. All pregnant or one-week post-partum women willing to participate were interviewed, clinically examined, tested with the Ov16 Bioline rapid diagnostic test (RDT) and skin snipped for O. volvulus detection. A total of 317 women aged between 14 and 44 years participated in the study [median age: 23 years (IQR: 19–29)]. Of 290 women who were tested, 179 (61.7%) were Ov16 RDT positive (SD Bioline). Of the 162 women skin snipped, 51 (31.5%) were positive for O. volvulus microfilarial worm following microscopic examination. The microfilaridemia (skin parasite load) ranged between one microfilaria per skin snip (1mf/ss) and 300 mf/ss with a mean value of value of 12.4 (sd: ± 49.1) mf/ss. Most pregnant women (87.8% (274/312)) knew that it was not advised to take IVM during pregnancy. Out of 309 women, 54 (17.5%) had never taken IVM, and 6.4% (16/251) inadvertently took IVM during pregnancy. Of the 16 women who took IVM during pregnancy, 50% (8/16) knew that they were pregnant. Out of 248 women with children, 9 (3.6%) had children suffering from epilepsy; two of them had two children with epilepsy. No abnormalities were reported in the children of the women who took IVM. Conclusions Our study is the first to investigate the prevalence and level of O. volvulus infection among pregnant women in onchocerciasis-endemic areas in Africa. Our results showed a high infection rate of O. volvulus among pregnant women, which may pose a risk for adverse materno-foetal outcomes. Pregnant women in South Sudan are a reservoir for parasite transmission. A clinical trial evaluating the potential beneficial effect of treating O. volvulus infected pregnant women with IVM should be considered, as our preliminary results and the literature suggest that IVM intake might not affect the newborn. |
| format | Article |
| id | doaj-art-6977457d4207401d9fc37fbd59279d7c |
| institution | Kabale University |
| issn | 2210-6014 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Springer |
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| series | Journal of Epidemiology and Global Health |
| spelling | doaj-art-6977457d4207401d9fc37fbd59279d7c2025-02-09T12:09:49ZengSpringerJournal of Epidemiology and Global Health2210-60142025-02-011511710.1007/s44197-025-00357-2Pregnant Women, a Potential Reservoir for Onchocerca volvulus? A Cross Sectional Study in Maridi County, South SudanChiara Trevisan0Amber Hadermann1Stephen Raimon Jada2Raphael A. Abong3Yak Yak Bol4Joseph N. Siewe Fodjo5Katja Polman6Robert Colebunders7Department of Public Health, Institute of Tropical MedicineGlobal Health Institute, University of AntwerpAmref Health AfricaDepartment of Medical Laboratory Sciences, Faculty of Health Sciences, University of BueaNeglected Tropical Diseases Unit, Ministry of HealthGlobal Health Institute, University of AntwerpDepartment of Public Health, Institute of Tropical MedicineGlobal Health Institute, University of AntwerpAbstract Background Onchocerciasis, a neglected tropical disease (NTD) caused by Onchocerca volvulus, is hyperendemic in many parts of Africa, including South Sudan. Pregnant women may be a parasite reservoir as they are not included in routine ivermectin (IVM) treatments due to unassessed drug safety. In our study we determined the proportion of pregnant women infected with Onchocerca volvulus and assessed the knowledge and practices on IVM use during pregnancy. Methodology/Principal Findings A hospital-based cross-sectional study was conducted in 2023 at Maridi hospital in Maridi County, an onchocerciasis endemic area in South Sudan. All pregnant or one-week post-partum women willing to participate were interviewed, clinically examined, tested with the Ov16 Bioline rapid diagnostic test (RDT) and skin snipped for O. volvulus detection. A total of 317 women aged between 14 and 44 years participated in the study [median age: 23 years (IQR: 19–29)]. Of 290 women who were tested, 179 (61.7%) were Ov16 RDT positive (SD Bioline). Of the 162 women skin snipped, 51 (31.5%) were positive for O. volvulus microfilarial worm following microscopic examination. The microfilaridemia (skin parasite load) ranged between one microfilaria per skin snip (1mf/ss) and 300 mf/ss with a mean value of value of 12.4 (sd: ± 49.1) mf/ss. Most pregnant women (87.8% (274/312)) knew that it was not advised to take IVM during pregnancy. Out of 309 women, 54 (17.5%) had never taken IVM, and 6.4% (16/251) inadvertently took IVM during pregnancy. Of the 16 women who took IVM during pregnancy, 50% (8/16) knew that they were pregnant. Out of 248 women with children, 9 (3.6%) had children suffering from epilepsy; two of them had two children with epilepsy. No abnormalities were reported in the children of the women who took IVM. Conclusions Our study is the first to investigate the prevalence and level of O. volvulus infection among pregnant women in onchocerciasis-endemic areas in Africa. Our results showed a high infection rate of O. volvulus among pregnant women, which may pose a risk for adverse materno-foetal outcomes. Pregnant women in South Sudan are a reservoir for parasite transmission. A clinical trial evaluating the potential beneficial effect of treating O. volvulus infected pregnant women with IVM should be considered, as our preliminary results and the literature suggest that IVM intake might not affect the newborn.https://doi.org/10.1007/s44197-025-00357-2PregnancySouth SudanIvermectinOnchocerciasis |
| spellingShingle | Chiara Trevisan Amber Hadermann Stephen Raimon Jada Raphael A. Abong Yak Yak Bol Joseph N. Siewe Fodjo Katja Polman Robert Colebunders Pregnant Women, a Potential Reservoir for Onchocerca volvulus? A Cross Sectional Study in Maridi County, South Sudan Journal of Epidemiology and Global Health Pregnancy South Sudan Ivermectin Onchocerciasis |
| title | Pregnant Women, a Potential Reservoir for Onchocerca volvulus? A Cross Sectional Study in Maridi County, South Sudan |
| title_full | Pregnant Women, a Potential Reservoir for Onchocerca volvulus? A Cross Sectional Study in Maridi County, South Sudan |
| title_fullStr | Pregnant Women, a Potential Reservoir for Onchocerca volvulus? A Cross Sectional Study in Maridi County, South Sudan |
| title_full_unstemmed | Pregnant Women, a Potential Reservoir for Onchocerca volvulus? A Cross Sectional Study in Maridi County, South Sudan |
| title_short | Pregnant Women, a Potential Reservoir for Onchocerca volvulus? A Cross Sectional Study in Maridi County, South Sudan |
| title_sort | pregnant women a potential reservoir for onchocerca volvulus a cross sectional study in maridi county south sudan |
| topic | Pregnancy South Sudan Ivermectin Onchocerciasis |
| url | https://doi.org/10.1007/s44197-025-00357-2 |
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