01150nas a2200157 4500000000100000008004100001653001900042653001100061100001500072245007500087856006200162300001000224490000600234520073800240022001400978 2015 d10aonchocerciasis10aAfrica1 aHopkins AD00aFrom 'control to elimination': a strategic change to win the end game. uhttp://inthealth.oxfordjournals.org/content/7/5/304.full  a304-50 v73 a

Strategies for elimination evolve from early use of available tools, to elaboration of control strategies, through to 'elimination.' Onchocerciasis control in Africa demonstrates this evolution. Early strategies used vector control but later used mass distribution of ivermectin. Elimination in Africa though was not thought to be possible; however, with excellent coverage of ivermectin distribution it was demonstrated that treatment could be stopped on the Senegal Mali border stimulating a new policy of elimination of transmission where possible. This new policy must not be business as usual but will require redefining treatment areas, improving quality of data, and flexibility of strategies to fit the new paradigm.

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