TREATMENT OF ONCHOCERCIASIS

Onchocerciasis ('river blindness') has for several centuries been the sc of people living in certain areas of the world where the disease is endemic, The treatment available up to 10 years ago, diethylcarbamazi ne, had very severe secondary effects. The availability of ivermectin - a well tolerated and highly effective microfilaricidal drug - has co mpletely changed this scenario. Ivermectin is now considered to be the drug of choice for the treatment of onchocerciasis. The prognosis for people with onchocerciasis has changed greatly. It is now possible to avoid the heavy infection loads seen previously, and patients, especi ally expatriates, may have their symptoms relieved by treatment. Iverm ectin, used in mass treatment, may also improve the epidemiological si tuation, reducing the level of microfilariae in the skin of infected p eople and thus reducing the source for vector infestation. However, th e treatment has to be repeated because the drug has no macrofilaricida l effect. Research today is focused on the finding of a drug able to d estroy the adult worms that go on producing microfilariae for the leng th of their lives.