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    High prevalence of epilepsy in two rural onchocerciasis endemic villages in the Mahenge area, Tanzania, after 20 years of community directed treatment with ivermectin.
    Infect Dis Poverty 2018 Jun 20;7(1):64. Epub 2018 Jun 20.
    Global Health Institute, University of Antwerp, Antwerp, Belgium.
    Background: Epilepsy is a neurological disorder with a multitude of underlying causes, which may include infection with Onchocerca volvulus, the parasitic worm that causes human onchocerciasis. A survey carried out in 1989 revealed a high prevalence of epilepsy (1.02% overall, ranging from 0. Read More

    Audit of the community-directed treatment with ivermectin (CDTI) for onchocerciasis and factors associated with adherence in three regions of Cameroon.
    Parasit Vectors 2018 Jun 19;11(1):356. Epub 2018 Jun 19.
    Institut de Recherche Expérimentale et Clinique, Faculté de santé publique, Université catholique de Louvain, Clos Chapelle-aux-champs 30 bte B1.30.13, BE-1200, Brussels, Belgium.
    Background: After more than 15 years of community-directed treatment with ivermectin (CDTI) in the Centre 1, Littoral 2 and West CDTI projects in Cameroon, the epidemiological evaluation conducted in 2011 revealed that onchocerciasis endemicity was still high in some communities. To investigate the potential reasons explaining this high endemicity, a cluster coverage survey was conducted in April-May 2015 in three health districts (HD), to assess the implementation of the CDTI, the 2014 therapeutic coverage and the five-year adherence to treatment. A two-stage cluster design was considered during analyses, with data weighted proportionally to age and gender distribution in the population. Read More

    Increasing evidence of low lymphatic filariasis prevalence in high risk Loa loa areas in Central and West Africa: a literature review.
    Parasit Vectors 2018 Jun 15;11(1):349. Epub 2018 Jun 15.
    Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK.
    In West and Central Africa, there is a need to establish the prevalence of Wuchereria bancrofti in areas that are co-endemic for Loa loa, in order to implement the appropriate strategies to scale-up interventions for the elimination of lymphatic filariasis (LF). Due to the risk of severe adverse events (SAEs) to ivermectin in individuals with high L. loa microfilaraemia, the current strategy recommended by the World Health Organization (WHO) is twice yearly mass drug administration (MDA) with albendazole, supplemented by vector control targeting the Anopheles vectors. Read More

    Filaricidal properties of Lantana camara and Tamarindus indica extracts, and Lantadene A from L. camara against Onchocerca ochengi and Loa loa.
    PLoS Negl Trop Dis 2018 Jun 13;12(6):e0006565. Epub 2018 Jun 13.
    Department of Biochemistry and Molecular Biology, Faculty of Science, University of Buea, Buea, Cameroon.
    Background: Ivermectin is the only drug currently recommended for the treatment of onchocerciasis, the second leading infectious cause of blindness in the world. This drug kills only the first stage larvae-microfilariae (mf) of Onchocerca volvulus and is to be used cautiously in areas where Loa loa is prevalent because of severe adverse events observed with coinfected patients.

    Methodology/principal Findings: This study investigated the anti-filarial activities of two Cameroonian medicinal plants, Lantana camara and Tamarindus indica locally used to treat onchocerciasis. Read More

    Progress on elimination of lymphatic filariasis in Sierra Leone.
    Parasit Vectors 2018 Jun 4;11(1):334. Epub 2018 Jun 4.
    Helen Keller International, Regional Office for Africa, Dakar, Senegal.
    Background: A baseline survey in 2007-2008 found lymphatic filariasis (LF) to be endemic in Sierra Leone in all 14 districts and co-endemic with onchocerciasis in 12 districts. Mass drug administration (MDA) with ivermectin started in 2006 for onchocerciasis and was modified to add albendazole in 2008 to include LF treatment. In 2011, after three effective MDAs, a significant reduction in microfilaraemia (mf) prevalence and density was reported at the midterm assessment. Read More

    The burden of Neglected Tropical Diseases in Brazil, 1990-2016: A subnational analysis from the Global Burden of Disease Study 2016.
    PLoS Negl Trop Dis 2018 06 4;12(6):e0006559. Epub 2018 Jun 4.
    Institute of Studies in Public Health, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil.
    Background: Neglected Tropical Diseases (NTDs) are important causes of morbidity, disability, and mortality among poor and vulnerable populations in several countries worldwide, including Brazil. We present the burden of NTDs in Brazil from 1990 to 2016 based on findings from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016).

    Methodology: We extracted data from GBD 2016 to assess years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) for NTDs by sex, age group, causes, and Brazilian states, from 1990 to 2016. Read More

    How Can Onchocerciasis Elimination in Africa Be Accelerated? Modeling the Impact of Increased Ivermectin Treatment Frequency and Complementary Vector Control.
    Clin Infect Dis 2018 Jun;66(suppl_4):S267-S274
    Department of Public Health, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
    Background: Great strides have been made toward onchocerciasis elimination by mass drug administration (MDA) of ivermectin. Focusing on MDA-eligible areas, we investigated where the elimination goal can be achieved by 2025 by continuation of current practice (annual MDA with ivermectin) and where intensification or additional vector control is required. We did not consider areas hypoendemic for onchocerciasis with loiasis coendemicity where MDA is contraindicated. Read More

    Efficacy and tolerability of moxidectin alone and in co-administration with albendazole and tribendimidine versus albendazole plus oxantel pamoate against Trichuris trichiura infections: a randomised, non-inferiority, single-blind trial.
    Lancet Infect Dis 2018 May 29. Epub 2018 May 29.
    Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland. Electronic address:
    Background: The recommended anthelmintics show low efficacy in a single-dose regimen against Trichuris trichiura. Moxidectin, a new treatment for river blindness, might complement the drug armamentarium for the treatment and control of soil-transmitted helminthiasis. However, its efficacy against T trichiura has not yet been studied. Read More

    Modelling the impact of larviciding on the population dynamics and biting rates of Simulium damnosum (s.l.): implications for vector control as a complementary strategy for onchocerciasis elimination in Africa.
    Parasit Vectors 2018 May 29;11(1):316. Epub 2018 May 29.
    MRC Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine (St Mary's campus), Imperial College London, Norfolk Place, London, W2 1PG, UK.
    Background: In 2012, the World Health Organization set goals for the elimination of onchocerciasis transmission by 2020 in selected African countries. Epidemiological data and mathematical modelling have indicated that elimination may not be achieved with annual ivermectin distribution in all endemic foci. Complementary and alternative treatment strategies (ATS), including vector control, will be necessary. Read More

    Onchocerciasis prevalence, human migration and risks for onchocerciasis elimination in the Upper Mouhoun, Nakambé and Nazinon river basins in Burkina Faso.
    Acta Trop 2018 May 18;185:176-182. Epub 2018 May 18.
    BP 2938, Ouagadougou 01, Burkina Faso.
    Historically, the whole of Burkina Faso was considered to be endemic for onchocerciasis (except a small area in the far north of the country) with prevalence rates 60-80%, but all endemic areas were included in the World Health Organisation Onchocerciasis Control Programme, which operated a system of vector control by larviciding beginning in 1974. In Burkina Faso larviciding had been phased out by 1989 when it was considered that onchocerciasis had been reduced to levels below the transmission breakpoint (and any residual infections would disappear without further intervention). There was never any mass drug administration against onchocerciasis in Burkina Faso, except in the Bougouriba and Comoé river basins (from 1996 and 2011 to present respectively) because in each of these two areas there was a resurgence of infection, and in parts of the Nakambé River basin and Sissili River basin from 1992 to 1998. Read More

    Parasitic Infections in Individuals Travelling to America and Precautionary Measures.
    Turkiye Parazitol Derg 2018 Mar;42(1):81-89
    Ege Üniversitesi Tıp Fakültesi, Parazitoloji Anabilim Dalı, İzmir, Türkiye.
    Over the past decade, the number of international travels has increased. Hence, the risk of transmission of parasitic diseases has also increased. One of the risk infections is malaria; Plasmodium vivax and P. Read More

    Parasitic Diseases that can Infect Travelers to Africa.
    Turkiye Parazitol Derg 2018 May 21. Epub 2018 May 21.
    Ege Üniversitesi Tıp Fakültesi, Parazitoloji Anabilim Dalı, İzmir, Türkiye.
    Travel is important in the spread of diseases, and the number of travelers is increasing daily. Therefore, the importance of the diseases that occur during or after travel is increasing. In underdeveloped countries in particular, parasitic diseases are epidemic or endemic, and these diseases lead to high numbers of deaths. Read More

    , and infections in rural populations in central and southern Togo.
    Parasite Epidemiol Control 2018 May 13;3(2):77-87. Epub 2018 Mar 13.
    Institute for Tropical Medicine, University Clinics of Tübingen, Germany.
    Background: , and are widespread helminth parasites in the tropics. Their distribution remains difficult to determine as it may change during national disease control programs and with regional mass drug administration (MDA). Epidemiological surveys are of importance to evaluate the geographical distribution of these helminth parasites and the diseases they may cause, however, up to date epidemiological evaluations on and in Togo are rare, and surveys on are important especially under the aspect of MDA of ivermectin which is performed since decades. Read More

    Rapid integrated clinical survey to determine prevalence and co-distribution patterns of lymphatic filariasis and onchocerciasis in a co-endemic area: The Angolan experience.
    Parasite Epidemiol Control 2017 Aug 7;2(3):71-84. Epub 2017 May 7.
    Centre for Neglected Tropical Diseases, and Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK.
    The Republic of Angola is a priority country for onchocerciasis and lymphatic filariasis (LF) elimination, however, the co-distribution of the filarial parasite (loiasis) is a significant impediment, due to the risk of severe adverse events (SAEs) associated with ivermectin used in mass drug administration (MDA) campaigns. Angola has a high risk loiasis zone identified in Bengo Province where alternative interventions may need to be implemented; however, the presence and geographical overlap of the three filarial infections/diseases are not well defined. Therefore, this study conducted a rapid integrated filarial mapping survey based on readily identifiable clinical conditions of each disease in this risk zone to help determine prevalence and co-distribution patterns in a timely manner with limited resources. Read More

    In Southern Nigeria Blood Microfilaria Density is Very Low Even in Areas with High Prevalence of Loiasis: Results of a Survey Using the New LoaScope Technology.
    Am J Trop Med Hyg 2018 May 14. Epub 2018 May 14.
    The Carter Center, Atlanta, Georgia.
    Ivermectin treatment can cause central nervous system adverse events (CNS-AEs) in persons with very high-density microfilaremia (≥ 30,000 mf/mL blood). Hypoendemic onchocerciasis areas where is endemic have been excluded from ivermectin mass drug administration programs (MDA) because of the concern for CNS AEs. The rapid assessment procedure for (RAPLOA) is a questionnaire survey to assess history of eye worm. Read More

    Human Parasitology and Parasitic Diseases: Heading Towards 2050.
    Adv Parasitol 2018 5;100:29-38. Epub 2018 Apr 5.
    National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States; Department of Pediatrics, Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, United States; Department of Biology, Baylor University, Waco, TX, United States. Electronic address:
    By 2050 our civilized planet may be comprised predominantly of networked megacities embedded in warm subtropical and tropical climates, and under stress from climate change and catastrophic weather events. Urban slum areas in these cities, including those found in wealthier middle- and high-income nations (blue marble health), will be especially vulnerable to disease. Moreover, regional conflicts fought over shifting and limited resources, including water, will collapse health systems infrastructures to further promote disease emergence and reemergence. Read More

    Case Report: Probable Case of Spontaneous Encephalopathy Due to Loiasis and Dramatic Reduction of Microfilariaemia with Prolonged Repeated Courses of Albendazole.
    Am J Trop Med Hyg 2018 May 7. Epub 2018 May 7.
    Centre for Research on Filariasis and other Tropical Diseases (CRFilMT), Yaoundé, Cameroon.
    Loiasis is a vector-borne parasitic disease caused by the filarial nematode and transmitted by the tabanid vectors from the genus . infection is associated with clinical manifestations such as pruritus, migratory transient edema, passage of adult worm in the bulbar conjunctiva, retinal damage, glomerular damage, albuminuria, pleural effusion, hydrocele, and endomyocardial fibrosis. Data reporting the occurrence of spontaneous encephalopathy associated with loiasis are very scanty. Read More

    Interruption of onchocerciasis transmission in Bioko Island: Accelerating the movement from control to elimination in Equatorial Guinea.
    PLoS Negl Trop Dis 2018 05 3;12(5):e0006471. Epub 2018 May 3.
    National Centre for Tropical Medicine, Health Institute Carlos III (ISCIII in Spanish), Madrid, Spain.
    Background: Onchocerciasis, also known as river blindness, is a parasitic disease. More than 99 percent of all cases occur in Africa. Bioko Island (Equatorial Guinea) is the only island endemic for onchocerciasis in the world. Read More

    Onchocerca - infected cattle produce strong antibody responses to excretory-secretory proteins released from adult male Onchocerca ochengi worms.
    BMC Infect Dis 2018 May 2;18(1):200. Epub 2018 May 2.
    Bernhard Nocht Institute of Tropical Medicine, Disease Epidemiology Department, Hamburg, Germany.
    Background: The front line molecules from filarial worms and other nematodes or helminthes are their Excretory-Secretory (ES) products. Their interaction with the host cells, proteins and immune system accounts for the skin and eye pathology or hyposensitivity observed in human onchocerciasis. ES products and adult worms' crude extracts from Onchocerca ochengi, a filarial nematode that infects the African zebu cattle, were utilized in the present study as a model for studying Onchocerca volvulus that causes river blindness in man. Read More

    Elimination of onchocerciasis in Ecuador: findings of post-treatment surveillance.
    Parasit Vectors 2018 04 24;11(1):265. Epub 2018 Apr 24.
    Desarrollo Comunitario Vozandes, Hospital Vozandes, Quito, Ecuador.
    Background: The Esmeraldas focus of onchocerciasis in Ecuador expanded geographically during the 1980s and was associated with severe ocular and skin disease. Mass drug administration (MDA) with ivermectin started in 1991, initially once but later twice a year, in the principle endemic focus followed by all satellite foci. Treatment was stopped in 2009 when entomological assessments determined that transmission of Onchocerca volvulus had been interrupted. Read More

    Elimination of onchocerciasis from Colombia: first proof of concept of river blindness elimination in the world.
    Parasit Vectors 2018 04 11;11(1):237. Epub 2018 Apr 11.
    Departamento de Microbiologia, Facultad de Salud, Universidad del Valle, Campus San Fernando, Calle 4B No. 36-00, CP 760043, Cali, Colombia.
    Background: Onchocerciasis is a chronic parasitic infection originally endemic in 13 discrete regional foci distributed among six countries of Latin America (Brazil, Colombia, Ecuador, Guatemala, Mexico and Venezuela). In Colombia, this disease was discovered in 1965 in the Pacific Coast of the country. The National Onchocerciasis Elimination Program was established in 1993 with the aim of eliminating disease morbidity and infection transmission. Read More

    Impact of five annual rounds of mass drug administration with ivermectin on onchocerciasis in Sierra Leone.
    Infect Dis Poverty 2018 Apr 6;7(1):30. Epub 2018 Apr 6.
    European & Developing Countries Clinical Trials Partnership (EDCTP), Medical Research Council, Cape Town, South Africa.
    Background: Onchocerciasis is endemic in 12 of the 14 health districts of Sierra Leone. Good treatment coverage of community-directed treatment with ivermectin was achieved between 2005 and 2009 after the 11-year civil conflict. Sentinel site surveys were conducted in 2010 to evaluate the impact of five annual rounds of ivermectin distribution. Read More

    A real-time PCR tool for the surveillance of zoonotic Onchocerca lupi in dogs, cats and potential vectors.
    PLoS Negl Trop Dis 2018 04 4;12(4):e0006402. Epub 2018 Apr 4.
    Department of Veterinary Medicine, Università degli Studi di Bari, Valenzano, Italy.
    The ocular onchocercosis is caused by the zoonotic parasite Onchocerca lupi (Spirurida: Onchocercidae). A major hindrance to scientific progress is the absence of a reliable diagnostic test in affected individuals. Microscopic examination of skin snip sediments and the identification of adults embedded in ocular nodules are seldom performed and labour-intensive. Read More

    Comparison of PCR Methods for Detection in Skin Snip Biopsies from the Tshopo Province, Democratic Republic of the Congo.
    Am J Trop Med Hyg 2018 May 29;98(5):1427-1434. Epub 2018 Mar 29.
    Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia.
    Defining the optimal diagnostic tools for evaluating onchocerciasis elimination efforts in areas co-endemic for other filarial nematodes is imperative. This study compared three published polymerase chain reaction (PCR) methods: the -specific qPCR-O150, the pan-filarial qPCR melt curve analysis (MCA), and the O150-PCR enzyme-linked immunosorbent assay (ELISA) currently used for vector surveillance in skin snip biopsies (skin snips) collected from the Democratic Republic of the Congo. The pan-filarial qPCR-MCA was compared with species-specific qPCRs for and . Read More

    Evolution of epilepsy prevalence and incidence in a Tanzanian area endemic for onchocerciasis and the potential impact of community-directed treatment with ivermectin: a cross-sectional study and comparison over 28 years.
    BMJ Open 2018 Mar 31;8(3):e017188. Epub 2018 Mar 31.
    Global Health Institute, University of Antwerp, Wilrijk, Belgium.
    Introduction: Worldwide, there are an estimated 50 million people affected by epilepsy. Its aetiology is manifold, and parasitic infections play an important role, specifically onchocerciasis. In onchocerciasis endemic areas, a distinctive form of epilepsy has been described as nodding syndrome, affecting children and causing nodding seizures, mental retardation and debilitating physical development. Read More

    Safety and mosquitocidal efficacy of high-dose ivermectin when co-administered with dihydroartemisinin-piperaquine in Kenyan adults with uncomplicated malaria (IVERMAL): a randomised, double-blind, placebo-controlled trial.
    Lancet Infect Dis 2018 Jun 27;18(6):615-626. Epub 2018 Mar 27.
    Liverpool School of Tropical Medicine, Liverpool, UK.
    Background: Ivermectin is being considered for mass drug administration for malaria due to its ability to kill mosquitoes feeding on recently treated individuals. However, standard, single doses of 150-200 μg/kg used for onchocerciasis and lymphatic filariasis have a short-lived mosquitocidal effect (<7 days). Because ivermectin is well tolerated up to 2000 μg/kg, we aimed to establish the safety, tolerability, and mosquitocidal efficacy of 3 day courses of high-dose ivermectin, co-administered with a standard malaria treatment. Read More

    Onchocerciasis-associated epilepsy: From recent epidemiological and clinical findings to policy implications.
    Epilepsia Open 2017 Jun 26;2(2):145-152. Epub 2017 Apr 26.
    College of Health SciencesMakerere UniversityKampalaUganda.
    A high prevalence of epilepsy is reported in many onchocerciasis-endemic regions. In this paper we discuss recent epidemiological and clinical aspects as well as public health implications of onchocerciasis-associated epilepsy (OAE) and propose a strategy to reduce the burden of disease. OAE probably presents in a variety of clinical manifestations, including the nodding syndrome and the Nakalanga syndrome. Read More

    From river blindness control to elimination: bridge over troubled water.
    Infect Dis Poverty 2018 Mar 28;7(1):21. Epub 2018 Mar 28.
    Neglected and Disabling diseases of Poverty Consultant, Gravesend, Kent, UK.
    Background: An estimated 25 million people are currently infected with onchocerciasis (a parasitic infection caused by the filarial nematode Onchocerca volvulus and transmitted by Simulium vectors), and 99% of these are in sub-Saharan Africa. The African Programme for Onchocerciasis Control closed in December 2015 and the World Health Organization has established a new structure, the Expanded Special Project for the Elimination of Neglected Tropical Diseases for the coordination of technical support for activities focused on five neglected tropical diseases in Africa, including onchocerciasis elimination.

    Aims: In this paper we argue that despite the delineation of a reasonably well-defined elimination strategy, its implementation will present particular difficulties in practice. Read More

    Report of the first international workshop on onchocerciasis-associated epilepsy.
    Infect Dis Poverty 2018 Mar 22;7(1):23. Epub 2018 Mar 22.
    Makerere University, College of Health Sciences, Kampala, Uganda.
    Background: Recently, several epidemiological studies performed in Onchocerca volvulus-endemic regions have suggested that onchocerciasis-associated epilepsy (OAE) may constitute an important but neglected public health problem in many countries where onchocerciasis is still endemic.

    Main Text: On October 12-14 2017, the first international workshop on onchocerciasis-associated epilepsy (OAE) was held in Antwerp, Belgium. The workshop was attended by 79 participants from 20 different countries. Read More

    Proof-of-Concept Rapid Diagnostic Test for Onchocerciasis: Exploring Peptide Biomarkers and the Use of Gold Nanoshells as Reporter Nanoparticles.
    ACS Infect Dis 2018 Jun 21;4(6):912-917. Epub 2018 Mar 21.
    Drugs & Diagnostics for Tropical Diseases , 4898 Ronson Ct., Suite C , San Diego , California 92111 , United States.
    Three O. volvulus immunogenic peptide sequences recently discovered by peptide microarray were adapted to a lateral flow assay (LFA). The LFA employs gold nanoshells as novel high-contrast reporter nanoparticles and detects a serological response against the 3 peptides, found in OvOC9384, OvOC198, and OvOC5528, respectively. Read More

    Onchocerca volvulus infection in Tihama region - west of Yemen: Continuing transmission in ivermectin-targeted endemic foci and unveiled endemicity in districts with previously unknown status.
    PLoS Negl Trop Dis 2018 03 5;12(3):e0006329. Epub 2018 Mar 5.
    Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Al-Baha University, Al-Baha, KSA.
    Background: Onchocerciasis in Yemen is one of the most neglected diseases, where baseline estimates of onchocerciasis and monitoring of the impact of ivermectin regularly administered to the affected individuals on its transmission are lacking. Therefore, this study aimed to determine the anti-Ov16 IgG4 seroprevalence among local communities of Hodeidah and Al-Mahwit governorates of Tihama region. The factors possibly associated with previous exposure to infection were also studied. Read More

    Behavioural and clinical predictors for Loiasis.
    J Glob Health 2018 Jun;8(1):010413
    Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria.
    Background: Loiasis is a vector-borne disease in Central and West Africa. While there is still uncertainty to what extent loiasis is responsible for population morbidity, individuals having both loiasis and onchocerciasis have a high risk of fatal encephalopathy when treatment (ie, ivermectin) for onchocerciasis is given. Therefore it is current policy that communities of high loiasis-burden are excluded from mass drug administration programmes of ivermectin. Read More

    Onchocerca volvulus infection and serological prevalence, ocular onchocerciasis and parasite transmission in northern and central Togo after decades of Simulium damnosum s.l. vector control and mass drug administration of ivermectin.
    PLoS Negl Trop Dis 2018 03 1;12(3):e0006312. Epub 2018 Mar 1.
    Onchocerciasis Reference Laboratory, National Institute of Hygiene, Sokodé, Togo.
    Background: Mass drug administration (MDA) of ivermectin has become the main intervention to control onchocerciasis or "river blindness". In Togo, after many years of MDA, Onchocerca volvulus infection has declined dramatically, and elimination appears achievable, but in certain river basins the current situation remains unknown. We have conducted parasitological, serological, ophthalmological, and entomological assessments in northern and central Togo within the river basins of Ôti, Kéran and Mô. Read More

    Refocusing vector assessment towards the elimination of onchocerciasis from Africa: a review of the current status in selected countries.
    Int Health 2018 Mar;10(suppl_1):i27-i32
    The Taskforce for Global Health, Atlanta, GA, USA.
    Measures to control onchocerciasis have been in place for well over 30 years. Recently, programs have turned from disease control towards transmission elimination. The absence of infective larvae in the black fly Simulium sp. Read More

    Establishing quality assured (QA) laboratory support for onchocerciasis elimination in Africa.
    Int Health 2018 Mar;10(suppl_1):i33-i39
    Task Force for Global Health, Atlanta, GA, USA.
    An essential component in achieving accepted successful elimination of a disease or a pathogen involves the acquisition of quality-assured (QA) data that ultimately define the absence of infection or transmission in previously endemic areas. The acquisition of these essential data, in the case of onchocerciasis elimination, requires strong laboratory support for both testing and continuing evaluation/validation of the tools used for the required diagnostic and epidemiology procedures. There is also a need for standardization of the laboratory-based and field-based assays used across the onchocerciasis-endemic countries as well as continuing technical, fiscal and logistical support for laboratory activities. Read More

    Cross-border issues: an important component of onchocerciasis elimination programmes.
    Int Health 2018 Mar;10(suppl_1):i54-i59
    Mectizan Donation Programme, 325 Swanton Way, Decatur, GA 30030, USA.
    Endemic areas that involve national or local borders present an important challenge to the success of elimination of onchocerciasis; such cross-border endemic foci require special attention to ensure that programme activities are unified. It is vital that national programmes and the committees responsible for the oversight of progress towards elimination are aware and address such issues in their current planning and programmatic activities. Although international borders that intersect endemic zones present the biggest challenge, intracountry borders (such as between administrative districts or loiasis endemic and non-loiasis areas) can also pose problems. Read More

    Onchocerciasis in Yemen: moving forward towards an elimination program.
    Int Health 2018 Mar;10(suppl_1):i89-i96
    Mectizan Donation Program, Task Force for Global Health, Atlanta, GA, USA.
    The onchocerciasis focus in Yemen has been known for many years as an endemic area with unique characteristics, notably the atypical and most severe form of onchodermatitis, known as sowda or reactive onchodermatitis (ROD). The national effort to control the disease began in 1992 as an individual case treatment program by administering ivermectin to those presenting with ROD. The challenging geography of the endemic area and the current political and military unrest both underscore a need for special approaches when attempting to eliminate onchocerciasis from this country. Read More

    Alternative treatment strategies to accelerate the elimination of onchocerciasis.
    Int Health 2018 Mar;10(suppl_1):i40-i48
    UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases, Geneva, Switzerland.
    The use of alternative (or complementary) treatment strategies (ATSs) i.e. differing from annual community-directed treatment with ivermectin (CDTI) is required in some African foci to eliminate onchocerciasis by 2025. Read More

    Onchocerciasis: shifting the target from control to elimination requires a new first-step-elimination mapping.
    Int Health 2018 Mar;10(suppl_1):i14-i19
    World Health Organization, Geneva, Switzerland.
    The meaning of 'mapping' in relation to onchocerciasis has changed at least three times over the past 50 years as the programmatic goals and the assessment tools have changed. With the current goal being global elimination of Onchocerca volvulus (OV), all areas where OV might currently be transmitted and where mass drug administration (MDA) with ivermectin treatment has not been delivered previously must now be identified by careful, detailed 'elimination mapping' as either OV endemic or not, so that appropriate programmatic targets can be established. New tools and strategies for such elimination mapping have become available, though ongoing studies must still be completed to define agreed upon optimal diagnostic evaluation units, sampling strategies and serologic tools. Read More

    Operationalization of the test and not treat strategy to accelerate the elimination of onchocerciasis and lymphatic filariasis in Central Africa.
    Int Health 2018 Mar;10(suppl_1):i49-i53
    IRD UMI 233-INSERM U1175-Montpellier University, Montpellier, France.
    After 30 years of treatment with Mectizan (ivermectin), cutaneous and ocular complications of Onchocerca volvulus infection are now scarce in endemic communities. Indeed, transmission has been interrupted and the O. volvulus- associated disease has disappeared in some African foci. Read More

    The role of the NGDO Coordination Group for the Elimination of Onchocerciasis.
    Int Health 2018 Mar;10(suppl_1):i97-i101
    The Carter Center, Atlanta, GA, USA.
    The NGDO Coordination Group for the Control of Onchocerciasis was launched in 1992, and with the paradigm shift from control of disease to elimination of onchocerciasis transmission, the Group shifted its orientation to that new paradigm in 2013. It also changed its name, replacing 'control' with 'elimination.' In doing so, the Group has repositioned itself to build on the successes of the past to finish the job it began over 25 years ago. Read More

    Transitioning from river blindness control to elimination: steps toward stopping treatment.
    Int Health 2018 Mar;10(suppl_1):i7-i13
    Mectizan Donation Program, Atlanta, GA 30030, USA.
    The transition from onchocerciasis control to elimination requires country programmes to rethink their approach to a variety of activities as they move from addressing morbidity to addressing transmission of the parasite. Although the 2016 WHO guidelines provide extensive recommendations, it was beyond the scope of the document to provide guidance on all aspects of the transition. This paper will discuss some of the important issues that programmes are grappling with as they transition to elimination and provide some potential approaches that programmes can use to address them. Read More

    The role of national committees in eliminating onchocerciasis.
    Int Health 2018 Mar;10(suppl_1):i60-i70
    The Carter Center, One Copenhill, 453 Freedom Parkway, Atlanta, GA30307.
    National onchocerciasis elimination committees (NOECs) serve to help ministries of health complete the pathway to successful verification of elimination of onchocerciasis (river blindness), as outlined in the 2016 World Health Organization guidelines. These guidelines, however, only take effect when the country believes it has reached a point that elimination can be demonstrated, and do not address the preceding milestones. Therefore, NOECs can be of great help with guiding and tailoring earlier planning, programming and assessments to empower national programs to aggressively move toward their countries' elimination goals. Read More

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