title: Macrofilaricides and onchocerciasis control, mathematical modelling of the prospects for elimination.
abstract: BACKGROUND
  In most endemic parts of the world, onchocerciasis (river blindness) control relies, or will soon rely, exclusively on mass treatment with the microfilaricide ivermectin. Worldwide eradication of the parasite by means of this drug is unlikely. Macrofilaricidal drugs are currently being developed for human use.
  
  
  METHODS
  We used ONCHOSIM, a microsimulation mathematical model of the dynamics of onchocerciasis transmission, to explore the potentials of a hypothetical macrofilaricidal drug for the elimination of onchocerciasis under different epidemiological conditions, as characterized by previous intervention strategies, vectorial capacity and levels of coverage.
  
  
  RESULTS
  With a high vector biting rate and poor coverage, a very effective macrofilaricide would appear to have a substantially higher potential for achieving elimination of the parasite than does ivermectin.
  
  
  CONCLUSIONS
  Macrofilaricides have a substantially higher potential for achieving onchocerciasis elimination than ivermectin, but high coverage levels are still key. When these drugs become available, onchocerciasis elimination strategies should be reconsidered. In view of the impact of control efforts preceding the introduction of macrofilaricides on the success of elimination, it is important to sustain current control efforts.
authors.affiliation: Onchocerciasis Control Programme, World Health Organization, Ouagadougou, Burkina Faso.
authors.forename: W S
authors.initials: WS
authors.lastname: Alley
authors.forename: G J
authors.initials: GJ
authors.lastname: van Oortmarssen
authors.forename: B A
authors.initials: BA
authors.lastname: Boatin
authors.forename: N J
authors.initials: NJ
authors.lastname: Nagelkerke
authors.forename: A P
authors.initials: AP
authors.lastname: Plaisier
authors.forename: J H
authors.initials: JH
authors.lastname: Remme
authors.forename: J
authors.initials: J
authors.lastname: Lazdins
authors.forename: G J
authors.initials: GJ
authors.lastname: Borsboom
authors.forename: J D
authors.initials: JD
authors.lastname: Habbema
mesh_terms: D000818:Animals; D000969:Antinematodal Agents / Q000008:administration & dosage / Q000627:therapeutic use; D003140:Communicable Disease Control; D003198:Computer Simulation; D005369:Filaricides / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007303:Insect Vectors; D007559:Ivermectin / Q000008:administration & dosage / Q000627:therapeutic use; D017181:Onchocerca volvulus / Q000187:drug effects / Q000472:pathogenicity; D009855:Onchocerciasis / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control*; D012984:Software
chemical_list: D000969:Antinematodal Agents; D005369:Filaricides; D007559:Ivermectin