{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T21:00:19Z","timestamp":1767733219873,"version":"build-2238731810"},"update-to":[{"DOI":"10.1371\/journal.pntd.0013849","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:00:00Z","timestamp":1767139200000}}],"reference-count":31,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["INV-047164"],"award-info":[{"award-number":["INV-047164"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The control of onchocerciasis currently relies on yearly distribution of ivermectin to at-risk populations. To tackle onchocerciasis in areas of high transmission (so-called hotspots) and achieve elimination of transmission, several complementary\/alternative strategies (biannual ivermectin, doxycycline-based test-and-treat and vector control) were implemented in Massangam Health District (HD) in Cameroon, following World Health Organization (WHO) guidelines. A short-term impact evaluation revealed significant reductions in the endemicity levels in three focal hotspot communities (Makouopsap, Mankakoun, and Njinja-Njingouet). This study aimed to assess the situation of onchocerciasis in the focal hotspot communities five years after the cessation of the short pilot implementation of Alternative Treatment Strategies (ATS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>\n                      A quantitative cross-sectional survey was conducted in December 2023 in three focal hotspot communities of the Massangam Health District. Participants underwent a comprehensive assessment including parasitological examination (skin snipping) to establish\n                      <jats:italic>Onchocerca volvulus<\/jats:italic>\n                      microfilaridermia.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Principal findings<\/jats:title>\n                    <jats:p>\n                      The overall prevalence of\n                      <jats:italic>O. volvulus<\/jats:italic>\n                      infection in the three focal communities was 18.7% (95% confidence interval CI: 14.1-24.3), significantly higher in the Mankakoun (30.8%) and Makouopsap (24.0%) communities compared to the Njinja-Njingouet community (7.0%) (p\u2009=\u20090.001). The intensity of infection was 3.136 (standard deviation, SD: 19.3099) mf\/ss, ranging from 5.218 mf\/ss (Mankakoun community) to 2.840 mf\/ss (Njinja-Njingouet community). Parasitological indicators significantly increased five years after the cessation of ATS in all three focal communities (p\u2009=\u20090.0409).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion\/Significance<\/jats:title>\n                    <jats:p>These findings indicate a rebound in onchocerciasis transmission and underscore the need for coordinated and sustained efforts, implemented at the scale of a transmission zone per WHO recommendations, to achieve elimination goals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pntd.0013849","type":"journal-article","created":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T18:33:54Z","timestamp":1766428434000},"page":"e0013849","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Rebound in prevalence and intensity of Onchocerca volvulus infection five years after cessation of alternative treatment strategies in the Massangam Health District, West Region, Cameroon: need for coordinated and sustained efforts"],"prefix":"10.1371","volume":"19","author":[{"given":"Gabriella S.","family":"Ondoua Nganjou","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurentine","family":"Sumo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arnauld","family":"Efon Ekangouo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Narcisse Nzune","family":"Toche","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean","family":"Bopda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeanne C.","family":"Sondi Dissake","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivana","family":"Youmbi Kammogne","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andr\u00e9","family":"Domche","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yannick","family":"Niamsi Emalio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Th\u00e9ophile M.","family":"Mpaba Minkat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georges B.","family":"Nko\u2019Ayissi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shannon M.","family":"Hedtke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Warwick N.","family":"Grant","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Flobert","family":"Njiokou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Kamgno","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4496-6048","authenticated-orcid":true,"given":"Hugues C.","family":"Nana Djeunga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,12,22]]},"reference":[{"key":"pntd.0013849.ref001","author":"World Health Organization"},{"key":"pntd.0013849.ref002","author":"World Health Organization. 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