ArticlePLoS neglected tropical diseases2025
Rebound in prevalence and intensity of Onchocerca volvulus infection five years after cessation of alternative treatment strategies in the Massangam Health District, West Region, Cameroon: need for coordinated and sustained efforts.
Article in PLoS neglected tropical diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe control of onchocerciasis currently relies on yearly distribution of ivermectin to at-risk populations. To tackle onchocerciasis in areas of high transmission (so-called hotspots) and achieve elimination of transmission, several complementary/alternative strategies (biannual ivermectin, doxycycline-based test-and-treat and vector control) were implemented in Massangam Health District (HD) in Cameroon, following World Health Organization (WHO) guidelines. A short-term impact evaluation revealed significant reductions in the endemicity levels in three focal hotspot communities (Makouopsap, Mankakoun, and Njinja-Njingouet). This study aimed to assess the situation of onchocerciasis in the focal hotspot communities five years after the cessation of the short pilot implementation of Alternative Treatment Strategies (ATS). METHODOLOGY: A quantitative cross-sectional survey was conducted in December 2023 in three focal hotspot communities of the Massangam Health District. Participants underwent a comprehensive assessment including parasitological examination (skin snipping) to establish Onchocerca volvulus microfilaridermia. PRINCIPAL
findingsThe overall prevalence of O. volvulus infection in the three focal communities was 18.7% (95% confidence interval CI: 14.1-24.3), significantly higher in the Mankakoun (30.8%) and Makouopsap (24.0%) communities compared to the Njinja-Njingouet community (7.0%) (p = 0.001). The intensity of infection was 3.136 (standard deviation, SD: 19.3099) mf/ss, ranging from 5.218 mf/ss (Mankakoun community) to 2.840 mf/ss (Njinja-Njingouet community). Parasitological indicators significantly increased five years after the cessation of ATS in all three focal communities (p = 0.0409). CONCLUSION/SIGNIFICANCE: These findings indicate a rebound in onchocerciasis transmission and underscore the need for coordinated and sustained efforts, implemented at the scale of a transmission zone per WHO recommendations, to achieve elimination goals.
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