Epidemiological impact of vector control. I. Incidence and changes in prevalence and intensity of Onchocerca volvulus infection.

Since 1974, the Onchocerciasis Control Programme (OCP) has been engaged in a large scale attempt to control the savanna species of the vector of onchocerciasis in seven West African countries. The effect of the vector control effort has been measured by epidemiological evaluation. For this purpose 474 villages have been examined by means of skin snip surveys between 1975 and 1983 and of these, 184 have been retained to-date for follow-up surveys which have documented over the years the reduction of the parasite population. The latest results of the epidemiological evaluation clearly demonstrate an outstanding success of the vector control campaign. The parasite has been or is close to being eliminated from the hyperendemic foci of the core area of the Programme. Major improvements have been registered in the reinvaded areas located at the Western and Eastern borders of the Programme. A major improvement has been found along the river Marahoué, the only focus of the intermediate area between the savanna and the forest where at the previous survey, the endemic situation was still similar to the pre-control situation. The exceptions to this gratifying picture are foci along the Dienkoa and Kulpawn rivers, both located in the core area, where transmission has relapsed and several more years of an effective vector control will be needed to eliminate the local parasite population.