What Is the Treatment of Onchocerciasis (River Blindness)?

Onchocerciasis, also known as river blindness, is a parasitic infection caused by Onchocerca volvulus. It requires specific antiparasitic treatment to control the infection and prevent disease progression.

Treatment Goals

The aims of treatment are resolution of the clinical signs of onchocerciasis and a meaningful reduction in the number of O. volvulus microfilariae.

Treatment Approach (Overview)

Management relies on a well-established antiparasitic agent administered as a single dose — this is the drug of choice. In appropriate circumstances, an alternative agent from a different drug class may be used to achieve more sustained parasite reduction. One agent is specifically contra-indicated in this infection and must be avoided.

Full regimen details — including drug selection, dosing, sequencing, and contraindication guidance — are available in the complete structured protocol.

Instant Access to Structured Evidence-Based Regimens

References

  1. Ivermectin PO is the drug of choice: 150 micrograms/kg single dose; a 2nd dose should be administered after 3 months if clinical signs persist.
  2. Doxycycline PO (200 mg once daily for 4 weeks; if possible 6 weeks) kills a significant percentage of adult worms and progressively reduces the number of O. volvulus microfilariae.
  3. Diethylcarbamazine is contra-indicated (risk of severe ocular lesions).
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