Strategies for Suppression and Elimination of Onchocerciasis in Endemic Countries: A Review of the Literature

Abstract

Onchocerciasis is one of the neglected tropical diseases with great public health importance in the Americas and in many African countries. River blindness, can lead to severe dermatologic and ophthalmologic complications that may terminate in blindness and other associated social stigmatizations. Preventive chemotherapy with the use of annual mass drug administration with ivermectin (Mectizan®) has been the only sustainable management and control measure of the disease in Africa, though with limited efficacy. Based on those limitations, there is doubt that suppression and elimination of the disease targeted to take place in 2020 and 2025 respectively may be actualized. The aim of the review is to update knowledge on existing strategies relevant to achieving suppression and probable elimination of onchocerciasis in endemic countries and to highlight identified obstacles militating against such strategies. Review of past and recently published relevant literature on the topic was carried out using electronic databases such as Google scholar. For feasible suppression and elimination in the stipulated years, some strategies may have to be carried out. The suggested strategies include incorporation of insecticides with chemotherapy, adoption of semi-annually or quarterly ivermectin in-take compliance, inclusion of every member of endemic communities in treatment, avoidance of interruption in drug distribution, correction of misconception of onchocerciasis and use of gold standard diagnostic techniques. With adherence to the suggested strategies of control, the story of onchocerciasis as a public health problem would become a history and the disease could be elimination in all transmission foci.