Alternative intervention strategies (AIS) are recommended to accelerate onchocerciasis elimination in problematic areas including areas where annual ivermectin (IVM) distributions are unable to interrupt transmission. The aim of this study was to accelerate progress towards elimination in the Massangam health district, West Region of Cameroon, where impact evaluations demonstrated ongoing transmission of onchocerciasis infection and high microfilaria prevalence despite more than 20 years of annual IVM distribution.
The article describes three AIS: testing individuals for onchocerciasis and treating positive individuals with doxycycline, biannual mass drug administration with ivermectin, and ground larviciding of blackfly breeding sites. Together these AIS significantly reduced the prevalence of infection from 35.7% to 12.3%. The authors conclude that AIS are practical and useful and should be considered in areas where IVM has not successfully stopped the spread of onchocerciasis.