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Onchocerciasis (river blindness) - more than a century of research and control
Norbert W Brattig1, Robert A Cheke2, Rolf Garms1
1Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.
Abstract:
This review summarises more than a century of research on onchocerciasis, also known as river blindness, and its control. River blindness is an infection caused by the tissue filaria Onchocerca volvulus affecting the skin, subcutaneous tissue and eyes and leading to blindness in a minority of infected persons. The parasite is transmitted by its intermediate hosts Simulium spp. which breed in rivers. Featured are history and milestones in onchocerciasis research and control, state-of-the-art data on the parasite, its endobacteria Wolbachia, on the vectors, previous and current prevalence of the infection, its diagnostics, the interaction between the parasite and its host, immune responses and the pathology of onchocerciasis. Detailed information is documented on the time course of control programmes in the afflicted countries in Africa and the Americas, a long road from previous programmes to current successes in control of the transmission of this infectious disease. By development, adjustment and optimization of the control measures, transmission by the vector has been interrupted in foci of countries in the Americas, in Uganda, in Sudan and elsewhere, followed by onchocerciasis eliminations. The current state and future perspectives for control, elimination and eradication within the next 20-30 years are described and discussed. This review contributes to a deeper comprehension of this disease by a tissue-dwelling filaria and it will be helpful in efforts to control and eliminate other filarial infections.
Insights
Onchocerciasis, or river blindness, research spans over a century. Control efforts have successfully interrupted transmission and led to elimination in several regions, with future eradication prospects.
Area of Science:
- Medical Parasitology
- Tropical Medicine
- Infectious Disease Epidemiology
Background:
- Onchocerciasis, caused by Onchocerca volvulus, is a filarial infection impacting skin and eyes, potentially causing blindness.
- The parasite is transmitted by Simulium black flies breeding in rivers.
- Research and control efforts have evolved over a century.
Purpose of the Study:
- To review historical and current research on onchocerciasis and its control strategies.
- To provide an overview of the parasite, its vectors, prevalence, diagnostics, and host-pathogen interactions.
- To discuss the progress and future perspectives for onchocerciasis elimination and eradication.
Main Methods:
- Comprehensive literature review of onchocerciasis research and control programs.
- Analysis of historical data, current prevalence, and diagnostic methods.
- Evaluation of control program timelines, successes, and future strategies.
Main Results:
- Transmission of Onchocerca volvulus has been interrupted in various foci, leading to elimination in some regions.
- Significant progress has been made in controlling river blindness through optimized control measures.
- Understanding of parasite biology, vector interactions, and host immune responses has advanced.
Conclusions:
- Onchocerciasis control has achieved notable successes, particularly in the Americas and parts of Africa.
- Elimination and potential eradication of onchocerciasis are feasible within the next 20-30 years.
- This review aids in understanding filarial diseases and informs strategies for controlling other neglected tropical diseases.
