Operationalization of the test and not treat strategy to accelerate the elimination of onchocerciasis and lymphatic filariasis in Central Africa.

Abstract:

:After 30 years of treatment with Mectizan (ivermectin), cutaneous and ocular complications of Onchocerca volvulus infection are now scarce in endemic communities. Indeed, transmission has been interrupted and the O. volvulus- associated disease has disappeared in some African foci. Despite this success, onchocerciasis elimination in Loa loa co-endemic areas is still constrained by severe adverse events (SAEs) occurring after ivermectin treatment in some individuals harbouring very high L. loa microfilaremia. One approach towards the prevention of these SAEs is to identify individuals with high L. loa microfilaremia and exclude them from ivermectin treatment. The development of the LoaScope has provided the tool that underlies this test and not treat (TaNT) strategy. The first successful TaNT campaign was conducted in a L. loa highly endemic focus in Cameroon in 2015 without any SAEs. To accomplish this within a research setting, 60 people were deployed for this campaign, making this 'research' strategy not sustainable from a cost perspective. We describe here a way of reducing the cost of the TaNT strategy with a smaller team (three people) selected within affected communities. We also suggest the organization of a TaNT campaign in affected countries.

journal_name

Int Health

journal_title

International health

authors

Kamgno J,Nana-Djeunga HC,Pion SD,Chesnais CB,Klion AD,Mackenzie CD,Nutman TB,Boussinesq M

doi

10.1093/inthealth/ihx051

subject

Has Abstract

pub_date

2018-03-01 00:00:00

pages

i49-i53

issue

suppl_1

eissn

1876-3413

issn

1876-3405

pii

4868659

journal_volume

10

pub_type

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