02334nas a2200337   4500000000100000008004100001653003900042653001900081653003200100653001200132653001600144653001300160653001400173653002800187653001500215653001100230100001800241700001600259700001300275700001100288700001500299700001400314700001700328700001400345245007700359856007700436300000700513490000600520520145600526022001401982       2018                            d10aNeglected tropical diseases (NTDs)10aonchocerciasis10aCommunity drug distributors10aControl10aElimination10aEpilepsy10aIncidence10aMonitoring & evaluation10aPrevalence10aAfrica1 aColebunders R1 aBasáñez M1 aSiling K1 aPost R1 aRotsaert A1 aMmbando B1 aSuykerbuyk P1 aHopkins A00aFrom river blindness control to elimination: bridge over troubled water.  uhttps://idpjournal.biomedcentral.com/track/pdf/10.1186/s40249-018-0406-7  a210 v73 a<p><strong>BACKGROUND: </strong>An estimated 25 million people are currently infected with onchocerciasis (a parasitic infection caused by the filarial nematode Onchocerca volvulus and transmitted by Simulium vectors), and 99% of these are in sub-Saharan Africa. The African Programme for Onchocerciasis Control closed in December 2015 and the World Health Organization has established a new structure, the Expanded Special Project for the Elimination of Neglected Tropical Diseases for the coordination of technical support for activities focused on five neglected tropical diseases in Africa, including onchocerciasis elimination.</p>

<p><strong>AIMS: </strong>In this paper we argue that despite the delineation of a reasonably well-defined elimination strategy, its implementation will present particular difficulties in practice. We aim to highlight these in an attempt to ensure that they are well understood and that effective plans can be laid to solve them by the countries concerned and their international partners.</p>

<p><strong>CONCLUSIONS: </strong>A specific concern is the burden of disease caused by onchocerciasis-associated epilepsy in hyperendemic zones situated in countries experiencing difficulties in strengthening their onchocerciasis control programmes. These difficulties should be identified and programmes supported during the transition from morbidity control to interruption of transmission and elimination.</p>
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