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Onchocerciasis: status and progress towards elimination.
Craw craw was first described almost 150 years ago. Since then considerable progress has been made in understanding the Onchocerca volvulus life cycle, its effects on the host (blindness, skin disease and epilepsy) and potential control measures. Early attempts were aimed at controlling the black fly (Simulium) that transmits the disease. This included the early use of DDT in some isolated foci in East Africa. This was followed in the 1970s by the Onchocerciasis Control Programme (OCP) of West Africa using other safer insecticides. In 1987, MSD (known as Merck & Co Inc. in the USA and Canada) announced the donation of Mectizan® (ivermectin MSD) as long as was necessary for onchocerciasis control. This began a new chapter in the control of the disease including the creation of the African Programme for Onchocerciasis Control (APOC) and the Onchocerciasis Elimination Programme for the Americas (OEPA). In the Americas, four countries have now been verified free of transmission of the disease by the World Health Organisation. In Africa where foci are considerably larger, APOC with its partners has succeeded in developing a control programme covering virtually all areas where the prevalence of the disease can cause serious effects. In some disease foci in Africa, elimination of transmission has been achieved. Following surveys on the Mali Senegal border, there was a move in 2009 to change the paradigm from control to elimination. Development has been slow but by 2030, there is hope that most countries will have stopped treatment and others will have completed post-treatment surveillance surveys although some foci in conflict areas will remain.
Year of Publication
CAB Reviews: Perspectives in Agriculture, Veterinary Science, Nutrition and Natural Resources