Onchocerciasis control: Moving towards the millennium.

Area of Science:

• Public Health
• Tropical Medicine
• Vector-Borne Diseases

Background:

• Onchocerciasis, a major public health issue in West African savannas, necessitated the Onchocerciasis Control Programme (OCP) established in 1974.
• Initial control strategies focused on weekly larviciding to manage disease vectors.
• The OCP is transitioning to its final phase, integrating new control methods.

Purpose of the Study:

• To describe the latest trends and developments in onchocerciasis control.
• To highlight the evolution of control strategies within the OCP and beyond.
• To discuss the role of ivermectin in current and future onchocerciasis management.

Main Methods:

• The OCP initially employed weekly larviciding for vector control.
• Current OCP strategies incorporate repeated ivermectin treatment alongside vector control or as a standalone measure.
• New programs utilize community-based ivermectin distribution systems.

Main Results:

• Onchocerciasis control has shifted from solely vector control to incorporating effective microfilaricides like ivermectin.
• Ivermectin has proven to be a safe and effective treatment for onchocerciasis.
• Sustainable community systems are crucial for successful ivermectin distribution.

Conclusions:

• Onchocerciasis control programs have evolved significantly, with ivermectin becoming a cornerstone of management.
• The OCP's transition signifies a move towards more integrated and sustainable control approaches.
• Community-based distribution of ivermectin is key for programs in endemic regions outside the OCP and in the Americas.