Science, medicine, and the future -: Onchocerciasis

Onchocerciasis, or river blindness, caused by the filaria Onchocerca volvulus, affects more than 17 million people in Africa, Latin America, and Yemen. The microfilaricidal agent ivermectin is the principal means of controlling the disease, through mass treatment. Wolbachia endosymbiotic bacteria in filarias have emerged as a new target for treatment with drugs that lead to long term sterilisation of adult female filarias. Participants at recent international meetings have agreed that anti- Wolbachia chemotherapy with doxycycline (currently for six weeks) could be used to treat infected individuals. This approach holds promise for new developments based on registered antibiotics that are affordable in resource poor settings, as extensive registration processes are not needed. Recent experimental findings also indicate that endotoxin-like molecules from Wolbachia have a role in the pathogenesis of the disease and in adverse reactions after treatment.