Onchocerciasis, or river blindness, has historically been one of the most important causes of blindness worldwide, and a major cause of socio-economic disruption, particularly in sub-Saharan Africa. Its importance as a cause of morbidity and an impediment to economic development in some of the poorest countries in the world motivated the international community to implement several programs to control or eliminate this scourge. Initially, these involved reducing transmission of the causative agent Onchocerca volvulus through controlling the vector population. When ivermectin was found to be a very effective drug for treating onchocerciasis, the strategy shifted to mass drug administration (MDA) of endemic communities. In some countries, both vector control and ivermectin MDA have been used together. However, traditional vector control methods involve treating rivers in which the black fly vectors breed with insecticides, a process which is expensive, requires trained personnel to administer, and can be ecologically harmful. In this review, we discuss recent research into alternatives to riverine insecticide treatment, which are inexpensive, ecologically less harmful, and can be implemented by the affected communities themselves. These can dramatically reduce vector densities and, when combined with ivermectin MDA, can accelerate the time to elimination when compared to MDA alone.

中文翻译：

---

社区指导的病媒控制加速消除盘尾丝虫病

盘尾丝虫病或河盲症历来是全世界失明的最重要原因之一，也是社会经济混乱的主要原因，特别是在撒哈拉以南非洲地区。它是世界上一些最贫穷国家的发病原因和经济发展的障碍，这促使国际社会实施多项计划来控制或消除这一祸害。最初，这些措施涉及通过控制媒介种群来减少盘尾丝虫的病原体传播。当发现伊维菌素是治疗盘尾丝虫病非常有效的药物时，策略转向对流行社区进行大规模药物管理（MDA）。在一些国家，病媒控制和伊维菌素 MDA 已一起使用。然而，传统的病媒控制方法涉及使用杀虫剂对黑蝇病媒繁殖的河流进行处理，这一过程成本高昂，需要经过培训的人员进行管理，并且可能对生态造成危害。在这篇综述中，我们讨论了河流杀虫剂处理替代方案的最新研究，这些替代方案价格低廉，对生态危害较小，并且可以由受影响的社区自己实施。这些可以显着降低载体密度，并且与伊维菌素 MDA 结合使用时，与单独使用 MDA 相比，可以加快消除时间。