Reducing onchocerciasis-associated morbidity in onchocerciasis-endemic foci with high ongoing transmission: a focus on the children. (March 2022)

• Record Type: Journal Article
• Authors: Colebunders, Robert; Kaiser, Christoph; Basáñez, Maria-Gloria; Olliaro, Piero; Lakwo, Tom; Siewe Fodjo, Joseph Nelson
• Is Part Of: International journal of infectious diseases. Volume 116(2022)
• Page Start: 302
• Page End: 305
• Publication Date: 2022-03
• Subjects: Onchocerciasis -- epilepsy -- nodding syndrome -- elimination -- ivermectin -- school-age children; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2022.01.042
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: To reduce onchocerciasis-associated morbidity, we need to focus on young children Six-monthly ivermectin treatment may protect school children from developing epilepsy School-based ivermectin distribution should be considered in addition to annual CDTI Onchocerciasis during pregnancy may lead to "parasite tolerance" in the offspring "Parasite tolerance" in children may lead to onchocerciasis-associated epilepsy Abstract: Efforts are being directed toward the elimination of onchocerciasis transmission in endemic areas with community-directed treatment with ivermectin (CDTI) in Africa, which greatly reduces onchocerciasis-associated disease. However, onchocerciasis remains a major public health problem in areas of South Sudan, the Democratic Republic of the Congo, Cameroon, and the Central African Republic. Strengthening onchocerciasis elimination efforts in areas with a high prevalence of disease burden is crucial to decrease transmission, morbidity, and mortality. We argue that clinical trials are needed to investigate the safety and efficacy of ivermectin treatment of Onchocerca volvulus -infected pregnant women and children younger than 5 years. Crucially, 6-monthly administration of ivermectin in school-age children at risk of onchocerciasis-associated epilepsy could be achieved by supplementing annual CDTI with an extra round of ivermectin treatment during Child Health Days in schools and/or other distribution sites every year. These strategies would help achieve the elimination of onchocerciasis and its associated disease burden.