[Human onchocerciasis in Africa]

Area of Science:

• Parasitology
• Clinical Medicine
• Epidemiology
• Diagnostic Development

Context:

• Historically, onchocerciasis control relied solely on blackfly vector elimination, notably in the Onchocerciasis Control Programme in West Africa (OCP).
• The advent of ivermectin revolutionized onchocerciasis treatment, enabling mass drug administration and renewed research interest globally.
• Focus has shifted to areas outside the OCP's former operational scope, necessitating updated control strategies.

Purpose:

• To provide a comprehensive overview of current knowledge on onchocerciasis.
• To highlight advancements in parasitological, clinical, epidemiological, and diagnostic aspects of the disease.
• To inform the development of new control strategies, particularly in regions previously unaddressed by large-scale programs.

Summary:

• Significant progress has been made in understanding Onchocerca volvulus population dynamics and the pathogenesis of cutaneous and ocular onchocerciasis.
• Epidemiological studies are expanding to assess systemic manifestations, while new diagnostic tools offer improved sensitivity over traditional methods.
• Novel diagnostic approaches, including DNA probes and rapid assessment methods, enhance parasite identification and mapping of endemic areas.

Impact:

• Improved diagnostic sensitivity aids in more accurate detection and monitoring of onchocerciasis.
• Enhanced understanding of disease pathogenesis informs clinical management and potentially preventative measures.
• New tools for quantifying disability allow for better assessment of the socio-economic burden of onchocerciasis complications.