ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
Feasibility of Onchocerciasis Elimination Using a "Test-and-not-treat" Strategy in Loa loa Co-endemic Areas.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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11 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Human Filariasis in Africa (2000-2025): Changing epidemiology, uneven diagnostic progress, and persistent neglect.PLoS neglected tropical diseases · 2026Pooled it
- Trial
- Effect of a single dose of 8 mg moxidectin or 150 μg/kg ivermectin on O. volvulus skin microfilariae in a randomized trial: Differences between areas in the Democratic Republic of the Congo, Liberia and Ghana and impact of intensity of infection.PLoS neglected tropical diseases · 2022Trial
- Comparison of 6-Week Doxycycline vs 6-Week Rifampicin or 3 Weeks of Doxycycline Plus Rifampicin in the Treatment of Onchocerciasis: A Randomized, Placebo-Controlled, Double-Blind, Phase 2 Trial.Open forum infectious diseases · 2026Article
- Model-Based Geostatistical Mapping of the Prevalence of Onchocerca volvulus in Cameroon between 1971 and 2020.PLoS neglected tropical diseases · 2025Article
- Assessing the Burden of Neglected Tropical Diseases in Low-Income Communities: Challenges and Solutions.Viruses · 2024Review
- Prevalence and Sociodemographic Risk Factors of Soil-Transmitted Helminths in Rural Communities Living in Endemic Foci of Onchocerciasis in Southern Gabon.Pathogens (Basel, Switzerland) · 2024Article
- Accelerating Progress Towards the 2030 Neglected Tropical Diseases Targets: How Can Quantitative Modeling Support Programmatic Decisions?Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- UnexpectedOpen forum infectious diseases · 2023Article
- Control programs for strongyloidiasis in areas of high endemicity: an economic analysis of different approaches.Infectious diseases of poverty · 2021Article
- The impact of mass drug administration expansion to low onchocerciasis prevalence settings in case of connected villages.PLoS neglected tropical diseases · 2021Article
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Authors and funding
13 authors at 5 institutions in 3 countries.
Funding
Abstract
backgroundMass drug administration (MDA) with ivermectin is the main strategy for onchocerciasis elimination. Ivermectin is generally safe, but is associated with serious adverse events in individuals with high Loa loa microfilarial densities (MFD). Therefore, ivermectin MDA is not recommended in areas where onchocerciasis is hypo-endemic and L loa is co-endemic. To eliminate onchocerciasis in those areas, a test-and-not-treat (TaNT) strategy has been proposed. We investigated whether onchocerciasis elimination can be achieved using TaNT and the required duration.
methodsWe used the individual-based model ONCHOSIM to predict the impact of TaNT on onchocerciasis microfilarial (mf) prevalence. We simulated precontrol mf prevalence levels from 2% to 40%. The impact of TaNT was simulated under varying levels of participation, systematic nonparticipation, and exclusion from ivermectin resulting from high L loa MFD. For each scenario, we assessed the time to elimination, defined as bringing onchocerciasis mf prevalence below 1.4%.
resultsIn areas with 30% to 40% precontrol mf prevalence, the model predicted that it would take between 14 and 16 years to bring the mf prevalence below 1.4% using conventional MDA, assuming 65% participation. TaNT would increase the time to elimination by up to 1.5 years, depending on the level of systematic nonparticipation and the exclusion rate. At lower exclusion rates (≤2.5%), the delay would be less than 6 months.
conclusionsOur model predicts that onchocerciasis can be eliminated using TaNT in L loa co-endemic areas. The required treatment duration using TaNT would be only slightly longer than in areas with conventional MDA, provided that participation is good.
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