Depletion of wolbachia endobacteria in Onchocerca volvulus by doxycycline and microfilaridermia after ivermectin treatment

Ivermectin is the drug used for mass chemotherapy of onchocerciasis within the WHO African Programme for Onchocerciasis Control. This approach aims to eliminate the disease as a public health problem but using one dose per ye ar may not completely interrupt transmission since it does not suppress mic rofilaridermia thoroughly enough. Here we show that additional treatment wi th doxycycline, previously shown to sterilise adult female worms for a few months by depletion of symbiotic wolbachia endobacteria, significantly enha nces ivermectin-induced suppression of microfilaridermia, rendering anti-wo lbachia treatment a promising basis for blocking transmission by a drug-bas ed approach.