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How is onchocerciasis treated?
Treatment is done by giving the patient ivermectin, an antiparasitic drug once
or twice per year for about 10-15 years (the life span of adult worms). This
drug is effective in killing the microfilariae but does not kill the adult
worms. The mature worms may remain alive for 10-15 years in the patient. Most
clinicians recommend that subcutaneous nodules should be excised, if possible,
thereby removing the adult worms that may reproduce more microfilariae over
time. Some clinicians recommend that after ivermectin treatment, patients may
benefit from a six-week dose of doxycycline antibiotic. Doxycycline damages and
kills Wolbachia bacteria that are inside the microfilariae and adult worms,
resulting in the death of microfilariae and ineffective microfilariae
produced by the surviving adult worms. This may slow or halt further disease
The use of diethylcarbamazine (a treatment used before ivermectin became
available) is contraindicated; it may cause severe or fatal patient reactions
in individuals with onchocerciasis.
A new drug capable of killing the adult worms of onchocerciasis is under study
for use in humans; it's named moxidectin but has not yet been approved for use