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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

Article scientifique 2025 Anglais

Résumé

BACKGROUND: 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). METHODOLOGY: 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 Onchocerca volvulus microfilaridermia. PRINCIPAL FINDINGS: The overall prevalence of O. volvulus 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 = 0.001). 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 = 0.0409). CONCLUSION/SIGNIFICANCE: 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.

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Nganjou, G., Sumo, L., Ekangouo, A., Toche, N., Bopda, J., Dissake, J., Kammogne, I., Domché, A., Emalio, Y., Minkat, T., Nko’Ayissi, G., Hedtke, S., Grant, W., Njiokou, F., Kamgno, J., Nana-Djeunga, H. (2025). 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. https://doi.org/10.1371/journal.pntd.0013849

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Auteur(s)

Gabriella S. Ondoua Nganjou Laurentine Sumo Arnauld Efon Ekangouo Narcisse Nzune Toche Jean Bopda Jeanne C. Sondi Dissake Ivana Youmbi Kammogne André Domché Yannick Niamsi Emalio Théophile M. Mpaba Minkat Georges B. Nko’Ayissi Shannon M. Hedtke Warwick N. Grant Flobert Njiokou Joseph Kamgno Hugues C. Nana-Djeunga

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