ArticleParasites & vectors2015
Relationship between oral declaration on adherence to ivermectin treatment and parasitological indicators of onchocerciasis in an area of persistent transmission despite a decade of mass drug administration in Cameroon.
Article in Parasites & vectors, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
37 citing papers in PubMed, 1 synthesis or guideline pooled it, 177 citations in OpenAlex.
- Elimination of transmission of onchocerciasis (river blindness) with long-term ivermectin mass drug administration with or without vector control in sub-Saharan Africa: a systematic review and meta-analysis.The Lancet. Global health · 2024Pooled it
- Assessing the efficacy of high-dose rifampicin plus albendazole against onchocerciasis.PLoS neglected tropical diseases · 2026Trial
- Trial
- Epidemiology of helminth infections in adults in rural rainforest communities of the Nkam-Wouri River Basin, Littoral Region of Cameroon: Implications for NTDs elimination using preventive chemotherapies.PLoS neglected tropical diseases · 2026Article
- Significant gap between Point participation and long‑term treatment adherence: An evaluation of ivermectin MDA in the Kwanware‑Ottou persistent onchocerciasis transmission focus, Wenchi, Ghana.PLoS neglected tropical diseases · 2026Article
- Model-Based Geostatistical Mapping of the Prevalence of Onchocerca volvulus in Cameroon between 1971 and 2020.PLoS neglected tropical diseases · 2025Article
- Pregnant Women, a Potential Reservoir for Onchocerca volvulus? A Cross Sectional Study in Maridi County, South Sudan.Journal of epidemiology and global health · 2025Article
- Impact of repeated mass ivermectin administration using a community directed approach onParasite epidemiology and control · 2024Article
- Impact of annual community-directed treatment with ivermectin on the incidence of epilepsy in Mvolo, a two-year prospective study.PLoS neglected tropical diseases · 2024Article
- Optimized strategy for real-time qPCR detection of Onchocerca volvulus DNA in pooled Simulium sp. blackfly vectors.PLoS neglected tropical diseases · 2023Article
- Non-adherence to ivermectin in onchocerciasis-endemic communities with persistent infection in the Bono Region of Ghana: a mixed-methods study.BMC infectious diseases · 2023Article
- Can mass drug administration of moxidectin accelerate onchocerciasis elimination in Africa?Philosophical transactions of the Royal Society of London. Series B, Biological sciences · 2023Article
- Application of loop mediated isothermal amplification (LAMP) assays for the detection ofFrontiers in tropical diseases · 2023Article
- The preparatory phase for ground larviciding implementation for chocerciasis control in the Meme River Basin in South West Cameroon: the COUNTDOWN Consortium alternative strategy implementation trial.Parasites & vectors · 2022Article
- Single-Nucleotide Polymorphism Associates' β-Tubulin Isotype-1 Gene in Onchocerca volvulus Populations in Ivermectin-Treated Communities in Taraba State, Nigeria.Acta parasitologica · 2022Article
- Capture of high numbers of Simulium vectors can be achieved with Host Decoy Traps to support data acquisition in the onchocerciasis elimination endgame.Acta tropica · 2021Article
- Eliminating onchocerciasis within the Meme River Basin of Cameroon: A social-ecological approach to understanding everyday realities and health systems.PLoS neglected tropical diseases · 2021Article
- Why onchocerciasis transmission persists after 15 annual ivermectin mass drug administrations in South-West Cameroon.BMJ global health · 2021Article
- Status of parasitological indicators and morbidity burden of onchocerciasis after years of successive implementation of mass distribution of ivermectin in selected communities of Yeki and Asosa districts, Ethiopia.BMC public health · 2020Article
- Prevalence of onchocerciasis after seven years of continuous community-directed treatment with ivermectin in the Ntui health district, Centre region, Cameroon.The Pan African medical journal · 2020Article
Corrections and comments
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Authors and funding
11 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOnchocerciasis control for years has been based on mass drug administration (MDA) with ivermectin (IVM). Adherence to IVM repeated treatment has recently been shown to be a confounding factor for onchocerciasis elimination precisely in rain forest areas where transmission continues and Loa loa co-exists with Onchocerca volvulus. In this study, participants' oral declarations were used as proxy to determine the relationship between adherence to IVM treatment and parasitological indicators of onchocerciasis in the rain forest area of Cameroon with more than a decade of MDA.
methodsParticipants were recruited based on their IVM intake profile with the aid of a semi-structured questionnaire. Parasitological examinations (skin sniping and nodule palpation) were done on eligible candidates. Parasitological indicators were calculated and correlated to IVM intake profile.
resultsOf 2,364 people examined, 15.5% had never taken IVM. The majority (40.4%) had taken the drug 1-3 times while only 18% had taken ≥ 7 times. Mf and nodule prevalence rates were still high at 47%, 95% CI [44.9-49.0%] and 36.4%, 95% CI [34.4-38.3%] respectively. There was a treatment-dependent reduction in microfilaria prevalence (rs =-0.986, P = 0.01) and intensity (rs =-0.96, P = 0.01). The highest mf prevalence (59.7%) was found in the zero treatment group and the lowest (33.9%) in the ≥ 7 times treatment group (OR = 2.8; 95% CI [2.09-3.74]; P < 0.001). Adults with ≥ 7 times IVM intake were 2.99 times more likely to have individuals with no microfilaria compared to the zero treatment group (OR = 2.99; 95% CI [2.19-4.08], P < 0.0001). There was no clear correlation between treatment and nodule prevalence and intensity.
conclusionAdherence to ivermectin treatment is not adequate in this rain forest area where L. loa co-exists with O. volvulus. The prevalence and intensity of onchocerciasis remained high in individuals with zero IVM intake after more than a decade of MDA. Our findings show that using parasitological indicators, reduction in prevalence is IVM intake-dependent and that participants' oral declaration of treatment adherence could be relied upon for impact studies. The findings are discussed in the context of challenges for the elimination of onchocerciasis in this rain forest area.
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