River blindness: reducing the risk in at-risk populations

Onchocerciasis, an eye and skin disease caused by Onchocerca volvulus, is a leading cause of infectious blindness worldwide. Most onchocercal morbidity occurs in sub-Saharan Africa, while small disease foci exist within Latin America and Yemen. Disease control and elimination campaigns currently rely primarily on mass distribution of ivermectin, a therapy that does not cure the infection, but rather prevents the development of the eye and skin disease. Within Latin America, these strategies have dramatically reduced the incidence of new infection, and blindness attributable to onchocerciasis no longer exists in the region. Within Africa, decreases in ocular disease have also been documented. New therapeutic strategies targeting the endosymbiotic bacteria Wolbachia spp. are currently being evaluated in Africa.