{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T18:21:59Z","timestamp":1791397319770,"version":"4.3.3"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,1,2]],"date-time":"2021-01-02T00:00:00Z","timestamp":1609545600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,1,2]],"date-time":"2021-01-02T00:00:00Z","timestamp":1609545600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Parasites Vectors"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The control of onchocerciasis in Ghana started in 1974 under the auspices of the Onchocerciasis Control Programme (OCP). Between 1974 and 2002, a combination of approaches including vector control, mobile community ivermectin treatment, and community-directed treatment with ivermectin (CDTI) were employed. From 1997, CDTI became the main control strategy employed by the Ghana OCP (GOCP). This review was undertaken to assess the impact of the control interventions on onchocerciasis in Ghana between 1974 and 2016, since which time the focus has changed from control to elimination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this paper, we review programme data from 1974 to 2016 to assess the impact of control activities on prevalence indicators of onchocerciasis. This review includes an evaluation of CDTI implementation, microfilaria (Mf) prevalence assessments and rapid epidemiological mapping of onchocerciasis results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This review indicates that the control of onchocerciasis in Ghana has been very successful, with a significant decrease in the prevalence of infection from 69.13% [95% confidence interval) CI 60.24\u201378.01] in 1975 to 0.72% (95% CI 0.19\u20131.26) in 2015. Similarly, the mean community Mf load decreased from 14.48 MF\/skin snip in 1975 to 0.07 MF\/skin snip (95% CI 0.00\u20130.19) in 2015. Between 1997 and 2016, the therapeutic coverage increased from 58.50 to 83.80%, with nearly 100 million ivermectin tablets distributed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite the significant reduction in the prevalence of onchocerciasis in Ghana, there are still communities with MF prevalence above 1%. As the focus of the GOCP has changed from the control of onchocerciasis to its elimination, both guidance and financial support are required to ensure that the latter goal is met.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical Abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1186\/s13071-020-04507-2","type":"journal-article","created":{"date-parts":[[2021,1,2]],"date-time":"2021-01-02T11:02:53Z","timestamp":1609585373000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Onchocerciasis control in Ghana (1974\u20132016)"],"prefix":"10.1186","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5967-5676","authenticated-orcid":false,"given":"Nana-Kwadwo","family":"Biritwum","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dziedzom K.","family":"de Souza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Odame","family":"Asiedu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Marfo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uche Veronica","family":"Amazigo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John Owusu","family":"Gyapong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,1,2]]},"reference":[{"key":"4507_CR1","unstructured":"World Health Organization. Progress report on the elimination of human onchocerciasis, 2017\u20132018. Rapport de situation sur l\u2019\u00e9limination de l\u2019onchocercose humaine, 2017\u20132018. Wkly Epidemiol Rec. 2018;633\u201343."},{"key":"4507_CR2","doi-asserted-by":"publisher","first-page":"e0003664","DOI":"10.1371\/journal.pntd.0003664","volume":"9","author":"YE Kim","year":"2015","unstructured":"Kim YE, Remme JHF, Steinmann P, Stolk WA, Roungou JB, Tediosi F. Control, elimination, and eradication of river blindness: scenarios, timelines, and ivermectin treatment needs in Africa. PLoS Negl Trop Dis. 2015;9:e0003664.","journal-title":"PLoS Negl Trop Dis."},{"key":"4507_CR3","doi-asserted-by":"publisher","first-page":"1528","DOI":"10.1016\/S0140-6736(05)74588-8","volume":"355","author":"K Ahmad","year":"2000","unstructured":"Ahmad K. WHO programme gives hope to blind and partially sighted people in Africa. Lancet. 2000;355:1528.","journal-title":"Lancet."},{"key":"4507_CR4","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1016\/j.pt.2012.04.005","volume":"28","author":"A Crump","year":"2012","unstructured":"Crump A, Morel CM, Omura S. The onchocerciasis chronicle: from the beginning to the end? Trends Parasitol. 2012;28:280\u20138.","journal-title":"Trends Parasitol."},{"key":"4507_CR5","unstructured":"WHO\/APOC. Report of the external mid-term evaluation of the African programme for onchocerciasis control. JAF16.8. 2010. http:\/\/www.who.int\/apoc\/MidtermEvaluation_29Oct2010_final_printed.pdf. Accessed 28 Oct 2020."},{"key":"4507_CR6","unstructured":"World Health Organization. Expert Committee on Onchocerciasis. Third report. Tech Rep Ser 752. Geneva, Switzerland; 1987."},{"key":"4507_CR7","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1016\/S0169-4758(98)01342-8","volume":"14","author":"SEO Meredith","year":"1998","unstructured":"Meredith SEO, Dull HB. Onchocerciasis: the first decade of Mectizan treatment. Parasitol Today. 1998;14:472\u20134.","journal-title":"Parasitol Today."},{"key":"4507_CR8","doi-asserted-by":"publisher","first-page":"S69","DOI":"10.1080\/00034983.1998.11813368","volume":"92","author":"HB Dull","year":"1998","unstructured":"Dull HB, Meredith SEO. The Mectizan donation programme\u2014a 10-year report. Ann Trop Med Parasitol. 1998;92:S69\u201371.","journal-title":"Ann Trop Med Parasitol."},{"key":"4507_CR9","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1016\/0035-9203(94)90172-4","volume":"88","author":"ES Alley","year":"1994","unstructured":"Alley ES, Plaisier AP, Boatin BA, Dadzie KY, Remme J, Zerbo G, et al. The impact of five years of annual ivermectin treatment on skin microfilarial loads in the onchocerciasis focus of Asubende, Ghana. Trans R Soc Trop Med Hyg. 1994;88:581\u20134.","journal-title":"Trans R Soc Trop Med Hyg."},{"key":"4507_CR10","doi-asserted-by":"crossref","unstructured":"Taylor MJ, Awadzi K, Bas\u00e1\u0303ez MG, Biritwum N, Boakye D, Boatin B, et al. Onchocerciasis control: vision for the future from a Ghanaian perspective. Parasites Vectors. 2009;2:7.","DOI":"10.1186\/1756-3305-2-7"},{"key":"4507_CR11","doi-asserted-by":"publisher","first-page":"i14","DOI":"10.1093\/inthealth\/ihx052","volume":"10","author":"MP Rebollo","year":"2018","unstructured":"Rebollo MP, Zoure H, Ogoussan K, Sodahlon Y, Ottesen EA, Cantey PT. Onchocerciasis: shifting the target from control to elimination requires a new first-step-elimination mapping. Int Health. 2018;10:i14\u20139.","journal-title":"Int Health."},{"key":"4507_CR12","unstructured":"Falling Rain Genomics Incorporated. Directory of cities and towns in the world [Internet]. Global Gazette version 2.1. 2019. p. Copyright 1996\u20132006. http:\/\/www.fallingrain.com\/world\/. Accessed 28 Oct 2020."},{"key":"4507_CR13","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1186\/s13071-014-0511-9","volume":"7","author":"PHL Lamberton","year":"2014","unstructured":"Lamberton PHL, Cheke RA, Walker M, Winskill P, Osei-Atweneboana MY, Tirados I, et al. Onchocerciasis transmission in Ghana: biting and parous rates of host-seeking sibling species of the Simulium damnosum complex. Parasites Vectors. 2014;7:511.","journal-title":"Parasites Vectors."},{"key":"4507_CR14","doi-asserted-by":"publisher","first-page":"e0003688","DOI":"10.1371\/journal.pntd.0003688","volume":"9","author":"PHL Lamberton","year":"2015","unstructured":"Lamberton PHL, Cheke RA, Winskill P, Tirados I, Walker M, Osei-Atweneboana MY, et al. Onchocerciasis transmission in Ghana: persistence under different control strategies and the role of the simuliid vectors. PLoS Negl Trop Dis. 2015;9:e0003688.","journal-title":"PLoS Negl Trop Dis."},{"key":"4507_CR15","doi-asserted-by":"publisher","first-page":"432","DOI":"10.1186\/s13071-016-1703-2","volume":"9","author":"PHL Lamberton","year":"2016","unstructured":"Lamberton PHL, Cheke RA, Walker M, Winskill P, Crainey JL, Boakye DA, et al. Onchocerciasis transmission in Ghana: the human blood index of sibling species of the Simulium damnosum complex. Parasites Vectors. 2016;9:432.","journal-title":"Parasites Vectors."},{"key":"4507_CR16","unstructured":"World Health Organization. Onchocerciasis Guidelines for Stopping Mass Drug Administration and verifying Elimination of Human onchocerciasis Criteria and Procedures. Geneva: World Health Organization; 2016. http:\/\/www.who.int\/onchocerciasis\/resources\/9789241510011\/en\/. Accessed 28 Oct 2020."},{"key":"4507_CR17","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1179\/136485908X337445","volume":"120","author":"L Yam\u00e9ogo","year":"2008","unstructured":"Yam\u00e9ogo L. Special intervention zones. Ann Trop Med Parasitol. 2008;120:23\u20134.","journal-title":"Ann Trop Med Parasitol."},{"key":"4507_CR18","doi-asserted-by":"publisher","first-page":"e0005280","DOI":"10.1371\/journal.pntd.0005280","volume":"11","author":"NK Biritwum","year":"2017","unstructured":"Biritwum NK, de Souza DK, Marfo B, Odoom S, Alomatu B, Asiedu O, et al. Fifteen years of programme implementation for the elimination of lymphatic filariasis in Ghana: impact of MDA on immunoparasitological indicators. PLoS Negl Trop Dis. 2017;11:e0005280.","journal-title":"PLoS Negl Trop Dis."},{"key":"4507_CR19","doi-asserted-by":"crossref","unstructured":"Biritwum N-K, de Souza DK, Marfo B, Odoom S, Alomatu B, Asiedu O, et al. Fifteen years of programme implementation for the elimination of lymphatic filariasis in Ghana: impact of MDA on immunoparasitological indicators. PLoS Negl Trop Dis. 2017;11.","DOI":"10.1371\/journal.pntd.0005280"},{"key":"4507_CR20","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1179\/000349802125000637","volume":"96","author":"M Noma","year":"2002","unstructured":"Noma M, Nwoke BEB, Nutall I, Tambala PA, Enyong P, Namsenmo A, et al. Rapid epidemiological mapping of onchocerciasis (REMO): its application by the African Programme for Onchocerciasis Control (APOC). Ann Trop Med Parasitol. 2002;96:29\u201339.","journal-title":"Ann Trop Med Parasitol."},{"key":"4507_CR21","first-page":"51","volume":"29","author":"Key H Schulz","year":"1978","unstructured":"Schulz Key H. A simple technique to assess the total number of Onchocerca volvulus microfilariae in skin snips. Tropenmed Parasitol. 1978;29:51\u20134.","journal-title":"Tropenmed Parasitol."},{"key":"4507_CR22","doi-asserted-by":"publisher","first-page":"343","DOI":"10.3109\/09286586.2010.528132","volume":"17","author":"ME Gyasi","year":"2010","unstructured":"Gyasi ME, Nsiire A, Yayemain D, Debrah OA, Asamani D, Gyapong J, et al. Trachoma in Northern Ghana: a need for further studies. Ophthalmic Epidemiol. 2010;17:343\u20138.","journal-title":"Ophthalmic Epidemiol."},{"key":"4507_CR23","doi-asserted-by":"publisher","first-page":"e0006099","DOI":"10.1371\/journal.pntd.0006099","volume":"11","author":"O Debrah","year":"2017","unstructured":"Debrah O, Mensah EO, Senyonjo L, de Souza DK, Hervie TE, Agyemang D, et al. Elimination of trachoma as a public health problem in Ghana: providing evidence through a pre-validation survey. PLoS Negl Trop Dis. 2017;11:e0006099.","journal-title":"PLoS Negl Trop Dis."},{"key":"4507_CR24","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1098\/rstb.1979.0061","volume":"287","author":"R Le Berre","year":"1979","unstructured":"Le Berre R, Garms R, Davies JB, Walsh JF, Philippon B, Johnson CG, et al. Displacements of Simulium damnosum and strategy of control against onchocerciasis. Philos Trans R Soc Lond B Biol Sci. 1979;287:277\u201388.","journal-title":"Philos Trans R Soc Lond B Biol Sci."},{"key":"4507_CR25","first-page":"731","volume":"328","author":"RH Baker","year":"1990","unstructured":"Baker RH, Guillet P, S\u00e9k\u00e9t\u00e9li A, Poudiougo P, Boakye D, Wilson MD, et al. Progress in controlling the reinvasion of windborne vectors into the western area of the Onchocerciasis Control Programme in West Africa. Philos Trans R Soc Lond Ser B Biol Sci. 1990;328:731\u201350.","journal-title":"Philos Trans R Soc Lond Ser B Biol Sci."},{"key":"4507_CR26","doi-asserted-by":"publisher","first-page":"2021","DOI":"10.1016\/S0140-6736(07)60942-8","volume":"369","author":"MY Osei-Atweneboana","year":"2007","unstructured":"Osei-Atweneboana MY, Eng JK, Boakye DA, Gyapong JO, Prichard RK. Prevalence and intensity of Onchocerca volvulus infection and efficacy of ivermectin in endemic communities in Ghana: a two-phase epidemiological study. Lancet. 2007;369:2021\u20139.","journal-title":"Lancet."},{"key":"4507_CR27","doi-asserted-by":"publisher","first-page":"e998","DOI":"10.1371\/journal.pntd.0000998","volume":"5","author":"MY Osei-Atweneboana","year":"2011","unstructured":"Osei-Atweneboana MY, Awadzi K, Attah SK, Boakye DA, Gyapong JO, Prichard RK. Phenotypic evidence of emerging ivermectin resistance in Onchocerca volvulus. PLoS Negl Trop Dis. 2011;5:e998.","journal-title":"PLoS Negl Trop Dis."},{"key":"4507_CR28","doi-asserted-by":"publisher","first-page":"1338","DOI":"10.1093\/cid\/ciw144","volume":"62","author":"KK Frempong","year":"2016","unstructured":"Frempong KK, Walker M, Cheke RA, Tetevi EJ, Gyan ET, Owusu EO, et al. Does increasing treatment frequency address suboptimal responses to ivermectin for the control and elimination of river blindness? Clin Infect Dis. 2016;62:1338\u201347.","journal-title":"Clin Infect Dis."},{"key":"4507_CR29","unstructured":"African Programme for Onchocerciasis Control. Conceptual and operational framework of onchocerciasis elimination with ivermectin treatment. WHO\/APOC. 2010. http:\/\/www.who.int\/apoc\/oncho_elimination_report_english.pdf Accessed 28 Oct 2020."},{"key":"4507_CR30","unstructured":"World Health Organization. Criteria for certification of interruption of transmission\/elimination of human onchocerciasis. Report of a meeting held in Geneva, 28\u201329 September 2000. WHO\/CDS\/CPE\/CEE\/2001.18a. Geneva; 2001. http:\/\/www.oepa.net\/Documentos\/CriteriosCertificacionOMS\/WHO_CDS_CPE_CEE_2001.18a.pdf. Accessed 28 Oct 2020."},{"key":"4507_CR31","unstructured":"World Health Organization. Report of the Third Meeting of the WHO Onchocerciasis Technical Advisory Subgroup, Geneva, 26\u201328 February 2019. Geneva; 2020. https:\/\/www.who.int\/publications\/i\/item\/9789240006638. Accessed 28 Oct 2020."},{"key":"4507_CR32","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1179\/000349804225021370","volume":"98","author":"K Awadzi","year":"2004","unstructured":"Awadzi K, Edwards G, Opoku NO, Ardrey AE, Favager S, Addy ET, et al. The safety, tolerability and pharmacokinetics of levamisole alone, levamisole plus ivermectin, and levamisole plus albendazole, and their efficacy against Onchocerca volvulus. Ann Trop Med Parasitol. 2004;98:595\u2013614.","journal-title":"Ann Trop Med Parasitol."}],"container-title":["Parasites &amp; Vectors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13071-020-04507-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13071-020-04507-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13071-020-04507-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,4]],"date-time":"2021-10-04T21:06:38Z","timestamp":1633381598000},"score":1,"resource":{"primary":{"URL":"https:\/\/parasitesandvectors.biomedcentral.com\/articles\/10.1186\/s13071-020-04507-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,2]]},"references-count":32,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["4507"],"URL":"https:\/\/doi.org\/10.1186\/s13071-020-04507-2","relation":{},"ISSN":["1756-3305"],"issn-type":[{"value":"1756-3305","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,2]]},"assertion":[{"value":"4 August 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 November 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 January 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The control of onchocerciasis is managed by the Ghana NTD programme of the Ghana Health Service. As onchocerciasis control in Ghana is a national health service implementation activity, ethical approval was not required. However, in all cases, the onchocerciasis programme obtained oral informed consent from participants of the surveys. Also, due to the programmatic nature of activities together with yearly CDTI and impact assessment surveys conducted in many sites, participants from these communities were aware of the programme. The data presented in this paper do not include any patient identifiable information.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"3"}}