@article{fdi:010067767,
  title = {{P}rogress towards onchocerciasis elimination in the participating countries of the {A}frican {P}rogramme for {O}nchocerciasis {C}ontrol : epidemiological evaluation results},
  author = {{T}ekle, {A}. {H}. and {Z}oure, {H}. {G}. {M}. and {N}oma, {M}. and {B}oussinesq, {M}ichel and {C}offeng, {L}. {E}. and {S}tolk, {W}. {A}. and {R}emme, {J}. {H}. {F}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {T}he {A}frican {P}rogramme for {O}nchocerciasis {C}ontrol ({APOC}) was created in 1995 to establish community-directed treatment with ivermectin ({CDT}i) in order to control onchocerciasis as a public health problem in 20 {A}frican countries that had 80 % of the global disease burden. {W}hen research showed that {CDT}i may ultimately eliminate onchocerciasis infection, {APOC} was given in 2008 the additional objective to determine when and where treatment can be safely stopped. {W}e report the results of epidemiological evaluations undertaken from 2008 to 2014 to assess progress towards elimination in {CDT}i areas with >= 6 years treatment. {M}ethods: {S}kin snip surveys were undertaken in samples of first-line villages to determine the prevalence of {O}. volvulus microfilariae. {T}here were two evaluation phases. {T}he decline in prevalence was evaluated in phase 1{A}. {O}bserved and model-predicted prevalences were compared after correcting for endemicity level and treatment coverage. {B}ayesian statistics and {M}onte {C}arlo simulation were used to classify the decline in prevalence as faster than predicted, on track or delayed. {W}here the prevalence approached elimination levels, phase 1{B} was launched to determine if treatment could be safely stopped. {V}illage sampling was extended to the whole {CDT}i area. {S}urvey data were analysed within a {B}ayesian framework to determine if stopping criteria (overall prevalence <1.4 % and maximum stratum prevalence <5 %) were met. {R}esults: {I}n phase 1{A} 127 665 people from 639 villages in 54 areas were examined. {T}he prevalence had fallen dramatically. {T}he decline in prevalence was faster than predicted in 23 areas, on track in another 23 and delayed in eight areas. {I}n phase 1{B} 108 636 people in 392 villages were examined in 22 areas of which 13 met the epidemiological criteria for stopping treatment. {O}verall, 32 areas (25.4 million people) had reached or were close to elimination, 18 areas (17.4 million) were on track but required more years treatment, and in eight areas (10.4 million) progress was unsatisfactory. {C}onclusions: {O}nchocerciasis has been largely controlled as a public health problem. {G}reat progress has been made towards elimination which already appears to have been achieved for millions of people. {F}or most {APOC} countries, nationwide onchocerciasis elimination is within reach.},
  keywords = {{O}nchocerciasis ; {I}vermectin ; {APOC} ; {E}limination ; {C}ommunity-directed ; treatment ; {ONCHOSIM} ; {AFRIQUE}},
  booktitle = {},
  journal = {{I}nfectious {D}iseases of {P}overty},
  volume = {5},
  numero = {},
  pages = {art. 66 [25 p.]},
  ISSN = {2049-9957},
  year = {2016},
  DOI = {10.1186/s40249-016-0160-7},
  URL = {https://www.documentation.ird.fr/hor/fdi:010067767},
}