02852nas a2200217   4500000000100000008004100001260004400042653001700086653002400103100001500127700001600142700001300158700001200171700001500183700001500198245005000213856009100263490000700354520225900361022001402620       2021                            d  bSpringer Science and Business Media LLC10aParasitology10aInfectious Diseases1 aBiritwum N1 ade Souza DK1 aAsiedu O1 aMarfo B1 aAmazigo UV1 aGyapong JO00aOnchocerciasis control in Ghana (1974–2016)  uhttps://parasitesandvectors.biomedcentral.com/track/pdf/10.1186/s13071-020-04507-2.pdf0 v143 a<jats:title>Abstract</jats:title><jats:sec>
                <jats:title>Background</jats:title>
                <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>
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                <jats:title>Methods</jats:title>
                <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>
              </jats:sec><jats:sec>
                <jats:title>Results</jats:title>
                <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 60.24–78.01] in 1975 to 0.72% (95% CI 0.19–1.26) 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 0.00–0.19) 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>
              </jats:sec><jats:sec>
                <jats:title>Conclusions</jats:title>
                <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>
              </jats:sec>  a1756-3305