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Site selection was based on the trial capacity established for the moxidectin Phase 3 study and SmfD measured among 1373 and 36 individuals screened in HZ Logo and Nyarambe, respectively, in 2010. We compared the SmfD measured in 2010 and 2021\u20132023 in Logo HZ where ivermectin mass administration was never implemented and provide descriptive statistics for SmfD from Nyarambe HZ.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Four skin snips from each consenting\/assenting individual\u2009\u2265\u200912\u00a0years old were weighed and incubated in isotonic saline for\u2009\u2265\u20098\u00a0h. Emerged microfilariae were counted and SmfD calculated as the mean of the microfilariae\/mg skin of each snip. Other data collected included age, gender, village of residence, and history of ivermectin treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In 2010 and 2021\u20132023, respectively, adults (18\u201393\u00a0years old) represented 92.1% and 73.2%, and women 36.9% and 46.6% of the 1373 and 7547 volunteers from Logo HZ without reported prior ivermectin treatment. Among these adults and adolescents (12\u201317\u00a0years), no microfilariae were detected in snips from 23.3% and 26.9% in 2010 and 89.8% and 96.8% in 2021\u20132023, respectively, with mean \u00b1\u2009standard deviation SmfD being 24.30\u2009\u00b1\u200935.52 and 11.8\u2009\u00b1\u200918.37 in 2010 and 1.1\u2009\u00b1\u20096.44 and 0.3\u2009\u00b1\u20092.62 in 2021\u20132023, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Given that the reduction in infection prevalence and intensity in Logo HZ cannot be attributed to ivermectin distribution, it has to be due to reduction in infective vector biting rates, possibly linked to a recently proposed change in vector species triggered by land-use changes. Because SmfD reflects transmission events approximately 2\u201315\u00a0years earlier, infective vector biting rate assessment is needed to determine current transmission rates. Reduced transmission shifts macrofilariae age distribution toward older macrofilariae with lower reproductive capacity. Comparison of the results from the Phase 3 and the ongoing efficacy study might help determine whether drug susceptibility changes significantly with macrofilariae age. Should that be the case, transmission models evaluating the impact of mass drug administrations could be adjusted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical Abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1186\/s13071-025-07199-8","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T15:47:04Z","timestamp":1773676024000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Onchocerca volvulus infection prevalence and intensity in Logo and Nyarambe Health Zones in Ituri, Democratic Republic of the Congo in 2010 and in 2021\u20132023: results of screening for clinical trials of moxidectin versus ivermectin"],"prefix":"10.1186","volume":"19","author":[{"given":"Fran\u00e7oise N.","family":"Ngave","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deogratias U.","family":"Wonyarossi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Germain M.","family":"Abhafule","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00ebl L.","family":"Mande","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amos","family":"Nyathirombo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claude B.","family":"Uvon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anuarite A.","family":"Raciu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Mandro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal T.","family":"Adroba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tony O.","family":"Ukety","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Innocent A.","family":"Mananu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gis\u00e8le L.","family":"Abeditho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jules U.","family":"Upenjirwoth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carine M.","family":"Aliang\u2019o","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"de Dieu N. 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Approvals for the P3 study were obtained from the Ethics Committee of the Ecole de la Sant\u00e9 Publique Universit\u00e9 de Kinshasa and the MoH [\n                      \n                      ,\n                      \n                      ,\n                      \n                      ]. All documents were also approved by the WHO Ethics Review Committee. Participants documented their consent or assent with parental consent to study participation through signature or thumbprint in the presence of a literate witness in or near their villages.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"BM was and MuMu and SK are staff of MDGH, Australia. In 2014, WHO licensed all data on moxidectin at its disposal to MDGH to prepare the New Drug Application for moxidectin to the US-FDA and make moxidectin available at an affordable cost. MDGH remains the regulatory sponsor of moxidectin. MDGH co-funded studies MDGH-MOX-3001 and MDGH-MOX-3002. ACK and CMH work for WHO, which funded the work of all co-authors on the P3 study through its department UNICEF\/UNDP\/World Bank\/WHO Special Programme for Research and Training in Tropical Diseases (WHO\/TDR). ACK retired from the WHO in March 2023 and is continuing to work for TDR as a consultant, including on studies MDGH-MOX-3001 and MDGH-MOX-3002.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"140"}}