Mectizan and onchocerciasis : a decade of accomplishment and prospects for the future : the evolution of a drug into a development concept

For many years there was no suitable drug available for the control of onchocerciasis. The advent of Mectizan (ivermectin, MSD ; an effective microfilaricide), its registration in October 1987 for the treatment of human onchocerciasis, and its suitability for large-scale application were major break-throughs in the control of human onchocerciasis via chemotherapy. Several studies, both fly-feeding experiments and community trials, have established that Mectizan treatment causes a significant reduction in the transmission of infection. Although long-term treatment in some isolated foci (such as occur in the New World and in some hypo- and meso-endemic areas elsewhere) appears to interrupt transmission, more prolonged treatement is required to prove if transmission can be stopped. Advantage could be taken of the significant impact of Mectizan on transmission by giving treatement while or just before transmission by blackflies is most intense. (Résumé d'auteur