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Single-dose Phase II and III clinical trials demonstrated moxidectin's superiority over ivermectin for prolonged clearance of O. volvulus microfilariae. We used the stochastic, individual-based EPIONCHO-IBM model to compare the probabilities of reaching EoT between ivermectin and moxidectin MDA for a range of endemicity levels (30 to 70% baseline microfilarial prevalence), treatment frequencies (annual and biannual) and therapeutic coverage\/adherence values (65 and 80% of total population, with, respectively, 5 and 1% of systematic non-adherence). EPIONCHO-IBM's projections indicate that biannual (six-monthly) moxidectin MDA can reduce by half the number of years necessary to achieve EoT in mesoendemic areas and might be the only strategy that can achieve EoT in hyperendemic areas. Data needed to improve modelling projections include (i) the effect of repeated annual and biannual moxidectin treatment; (ii) inter- and intra-individual variation in response to successive treatments with moxidectin or ivermectin; (iii) the effect of moxidectin and ivermectin treatment on L3 development into adult worms; and (iv) patterns of adherence to moxidectin and ivermectin MDA.<\/jats:p>\n                  <jats:p>This article is part of the theme issue \u2018Challenges in the fight against neglected tropical diseases: a decade from the London Declaration on NTDs\u2019.<\/jats:p>","DOI":"10.1098\/rstb.2022.0277","type":"journal-article","created":{"date-parts":[[2023,8,20]],"date-time":"2023-08-20T19:05:40Z","timestamp":1692558340000},"update-policy":"https:\/\/doi.org\/10.1098\/crossmark-policy","source":"Crossref","is-referenced-by-count":32,"title":["Can mass drug administration of moxidectin accelerate onchocerciasis elimination in Africa?"],"prefix":"10.1098","volume":"378","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0008-1440","authenticated-orcid":true,"given":"Klodeta","family":"Kura","sequence":"first","affiliation":[{"name":"London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, School of Public Health 1 , ,"},{"name":"Imperial College London 1 , ,"},{"name":"London W2 1PG, UK 1 , ,"},{"name":"MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health 2 , ,"},{"name":"Imperial College London 2 , ,"},{"name":"London W2 1PG, UK 2 , ,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Milton","sequence":"additional","affiliation":[{"name":"London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, School of Public Health 1 , ,"},{"name":"Imperial College London 1 , ,"},{"name":"London W2 1PG, UK 1 , ,"},{"name":"MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health 2 , ,"},{"name":"Imperial College London 2 , ,"},{"name":"London W2 1PG, UK 2 , ,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan I. 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