State of knowledge and challenges in the control and eradication of Onchocerciasis in Africa: a mini scoping review

Background: Onchocerciasis is a vector-borne neglected tropical disease (NTD) caused by the filarial worm Onchocerca volvulus. Given the high morbidity and mortality, onchocerciasis control gained great attention from many stakeholders both nationally and internationally. However, there are still the need for further solidified commitments and compelling initiatives across concerned stakeholders including regional bodies in the fight toward controlling its burden and risks. Thus, this review briefly appraised the current understanding and dynamics in the control and eradication efforts of Onchocerciasis in Africa. Methods: A rapid scoping review was used for this paper. Key databases used for this study include Web of Science, Scopus, Science Direct, PubMed and Google Scholar to identify a series of relevant peer-reviewed publications. The search contained just English-language articles. In addition, African government websites and specialized organizations such as WHO, UNAIDS, CDC, etc. were accessed and reviewed to gather important data on national and international control programs, related documentation and consultative expert reports. Results: In Africa, long-standing strides toward the control and elimination measures for onchocerciasis were conducted for several decades. Between 1974 to 2002, OCP had actively led the control and containment efforts for onchocerciasis in the context of 11 West Africa. However, endemic regions and states have switched their policies from controlling to eradication, with the ultimate objective of preventing their territories from parasite spread. Some key challenges are the insufficient identification of all endemic areas, high prevalence of both onchocerciasis and loiasis, potential development of resistance to ivermectin, inconsistent initiatives to address cross-border problems, disagreements and social disturbance. Various challenges, however, impede current efforts to eradicate African onchocerciasis. Conclusion: In the last decades, extensive measures have been taken with specialized state programs, largely efficient in high endemic nations, to manage and control onchocerciasis in African regions. The implications of these and other difficulties at country level control programs must therefore be identified and country-specific contextual remedies used to expedite the elimination of onchocerciasis.