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• W2098064184 abstract "The prevalence of skin depigmentation in the pretibial region is closely correlated in the adult Congolese population with conventional indices (microfilarial index, mean microfilarial density, cyst index) for the evaluation of endemic onchocerciasis. Individuals over 15 years of age in endemic villages who had a microfilarial index of 80-90%, had a cystic index of 60-70% and a pretibial depigmentation index about 20% (30-40% for individuals aged > 50 years). Thus, in Africa, this new evaluation index offers a simple, noninvasive, quick and cheap way to identify areas where the level of endemic onchocerciasis is probably high and which are likely to benefit from an anti-onchocerciasis campaign.Skin depigmentation is a classic diagnostic sign of onchocerciasis and presents typically as an irregular, flat spot surrounded by slightly hyperpigmented zones. The depigmentation occurs mainly on the shins. The prevalence of skin depigmentation has been proposed as a marker for evaluating the endemicity of onchocerciasis in Nigeria, but has been contested for use in South America on the grounds of non-specificity. The microfilarial index currently used to assess the level of onchocerciasis endemicity is relatively time-consuming, costly, and harbors the risk of transmitting viral infections during mass screenings. 991 people over 15 years of age of mean age 55.4 years in five villages in the Congo endemic for onchocerciasis participated in this study. Individuals who had a microfilarial index of 80-90% had a cystic index of 60-70% and a pretibial depigmentation index of approximately 20%. The authors conclude that the existence of shin depigmentation as an evaluation index in Africa offers a simple, noninvasive, quick, and inexpensive way to identify areas where the level of endemic onchocerciasis is probably high and which are likely to benefit from an anti-onchocerciasis campaign. Although the new index does not allow total specificity, the incidence of shin depigmentation among patients with African onchocerciasis is such that there is probably little risk of confusing holo- or hyperendemic zones with an area where leprosy or treponema are endemic. In the absence of onchocerciasis, bites from Simulium spp. flies may also be responsible for skin depigmentation, as may be streptocerciasis. In this latter condition, however, the predominant site of depigmentation is not the shin. The authors have observed no notable prevalence of shin depigmentation in northern Congo, which is infested with S. albivirgulatum flies, but with no onchocerciasis transmission, and where there are also zones of streptocerciasis." @default.
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• W2098064184 title "Prevalence of depigmentation of the shins: a simple and cheap way to screen for severe endemic onchocerciasis in Africa." @default.
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