@article{fdi:010068374,
  title = {{S}till mesoendemic onchocerciasis in two {C}ameroonian community-directed treatment with ivermectin projects despite more than 15 years of mass treatment},
  author = {{K}amga, {G}. {R}. and {D}issak-{D}elon, {F}. {N}. and {N}ana-{D}jeunga, {H}. {C}. and {B}iholong, {B}. {D}. and {M}bigha-{G}hogomu, {S}. and {S}ouopgui, {J}. and {Z}oure, {H}. {G}. {M}. and {B}oussinesq, {M}ichel and {K}amgno, {J}. and {R}obert, {A}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {A}fter more than a decade of community-directed treatment with ivermectin ({CDTI}) in {C}entre and {L}ittoral {R}egions of {C}ameroon, onchocerciasis endemicity was still high in some communities according to the 2011 epidemiological evaluations. {S}ome corrective measures were undertaken to improve the {CDTI} process and therefore reduce the burden of the disease. {T}he objective of the present study was to assess the progress made towards the elimination of onchocerciasis in the {C}entre 1 and {L}ittoral 2 {CDTI} projects where the worst performances were found in 2011. {T}o this end, a cross-sectional survey was conducted in {A}pril 2015 in eight communities in two health districts ({HD}), {B}afia in {C}entre 1 and {Y}abassi in {L}ittoral 2, chosen because assessed at baseline and in 2011. {A}ll volunteers living for at least five years in the community, aged five years or more, underwent clinical and parasitological examinations. {I}ndividual compliance to ivermectin treatment was also assessed. {A}nalyses of data were weighted proportionally to age and gender distribution in the population. {R}esults: {I}n the {B}afia and {Y}abassi {HD}, 514 and 242 individuals were examined with a mean age of 35.1 (standard deviation, {SD}: 20.7) and 44.6 ({SD}: 16.3) years, respectively. {I}n the {B}afia {HD}, the weighted prevalences varied from 24.4 to 57.0 % for microfilaridermia and from 3.6 to 37.4 % for nodule presence across the surveyed communities. {T}he community microfilarial load ({CMFL}), expressed in microfilariae/skin snip (mf/ss), significantly dropped from 20.84-114. 50 mf/ss in 1991 to 0.31-1.62 mf/ss in 2015 in all the surveyed communities. {I}n the {Y}abassi {HD}, the weighted prevalences varied from 12.3 to 59.3 % for microfilaridermia and from 1.5 to 3.7 % for nodule presence across the surveyed communities, while a significant drop was observed in {CMFL}, from 20.40-28.50 mf/ss in 1999 to 0.48-1.74 mf/ss in 2015. {T}he 2014 weighted therapeutic coverage of participants varied from 65.8 % (95 % {CI}: 58.4-73.2) in {Y}abassi {HD}, to 68.0 % (95 % {CI}: 63.3-72.7) in {B}afia {HD}, with important variations among communities. {C}onclusions: {A}fter more than 15 years of {CDTI}, onchocerciasis is still mesoendemic in the surveyed communities. {F}urther studies targeting therapeutic coverage, socio-anthropological considerations of {CDTI} implementation and entomological studies would bring more insights to the persistence of the disease as observed in the present study.},
  keywords = {{O}nchocerciasis ; {I}vermectin ; {P}ersistence ; {E}limination ; {B}afia ; {Y}abassi ; {C}ameroon ; {CAMEROUN}},
  booktitle = {},
  journal = {{P}arasites and {V}ectors},
  volume = {9},
  numero = {},
  pages = {art. 581 [12 p.]},
  ISSN = {1756-3305},
  year = {2016},
  DOI = {10.1186/s13071-016-1868-8},
  URL = {https://www.documentation.ird.fr/hor/fdi:010068374},
}