The need for evidence-based strategies and tools for onchocerciasis elimination in Africa.

In a recent article we discussed the feasibility of onchocerciasis elimination in Africa by 2025. We expressed concern that elimination may be impeded by failure to build on the lessons learned in the African onchocerciasis control programmes and the introduction of strategies and tools from the Americas. Richards et al.

Is onchocerciasis elimination in Africa feasible by 2025: a perspective based on lessons learnt from the African control programmes.

Background: Onchocerciasis is found predominantly in Africa where large scale vector control started in 1974. Registration and donation of ivermectin by Merck & Co in 1987 enabled mass treatment with ivermectin in all endemic countries in Africa and the Americas. Although elimination of onchocerciasis with ivermectin was considered feasible only in the Americas, recently it has been shown possible in Africa too, necessitating fundamental changes in technical and operational approaches and procedures.

A model for evaluating the sustainability of community-directed treatment with ivermectin in the African Program for Onchocerciasis Control.

Onchocerciasis is controlled by mass treatment of at-risk populations with ivermectin. Ivermectin is delivered through community-directed treatment (CDTI) approach. A model has been developed to evaluate the sustainability of the approach and has been tested at 35 projects in 10 countries of the African Program for Onchocerciasis Control (APOC).

African Programme for Onchocerciasis Control (APOC): sociological study in three foci of central Africa before the implementation of treatments with ivermectin (Mectizan).

The African Programme for Onchocerciasis Control (APOC) has put in place a study to assess the long-term impact of the community-directed treatments with ivermectin on various clinical and entomological indicators of onchocerciasis. As the results obtained would depend on community participation in the treatments, surveys were also conducted at the study sites to assess the people's knowledge, attitudes and practices regarding onchocerciasis and its treatment. This article presents the anthropological observations made before the implementation of the treatments in three sites: one in the Central African Republic, and two in the Democratic Republic of Congo.

Performance of predictors: evaluating sustainability in community-directed treatment projects of the African programme for onchocerciasis control.

The predictors of sustainability of community-directed treatment with ivermectin (CDTI) at four implementation levels were evaluated in 41 African Programme for Onchocerciasis Control (APOC) projects, encompassing 492 communities in 10 countries. A model protocol provided information on indicators corresponding to nine aspects of a project that is likely to be sustainable at community level after the cessation of external support. Six of the nine aspects had components of community ownership as predictors of project sustainability.

Evaluation of the diethylcarbamazine patch to evaluate onchocerciasis endemicity in Central Africa.

Objective: As part of a baseline data collection for assessing the impact of the African Programme for Onchocerciasis Control, to evaluate the diethylcarbamazine (DEC) patch test in determining the endemicity of onchocerciasis.

Method: A total of 226 untreated children aged 3-5, living in four selected endemic foci, in Cameroon, Gabon and Central African Republic, were tested. Observed graded skin reactions to the patch were analysed and compared with the prevalence of onchocercal nodules and reactive skin disease in the corresponding community.

[Vector capacities of Similium damsnosum s.l and risk for Onchocerca volvulus transmission in Inga (Democratic Republic of Congo)].

This article analyzes the results of a one-year entomological survey conducted near the Yalala rapids in the Inga region, Democratic Republic of Congo, prior to the implementation of Community-Directed Treatment with Ivermectin (CDTI). A vector control program had been undertaken from October 1969 to December 1980, 20 kilometers upstream from the study site. The results of the present study show that during 122 collection days, 5,824 females were captured, of which 3,899 were dissected; 2,001 (51.