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July 14, 2025 19 mins

Dr. Jessica Pelletier, Dr. Kakande Reagan, and Dr. Bri Bennett discuss the epidemiology, pathophysiology, clinical presentation, diagnostic workup, management, and prevention of onchocerciasis.

Take-Home Points:

  • Onchocerciasis is the second leading cause of blindness worldwide
  • Transmission occurs via blackfly bites
  • Clinical manifestations are typically dermatologic followed by ocular
  • Diagnosis ideally occurs via PCR of skin snips, or RDT where this is available
  • Treatment is either with ivermectin or doxycycline (which kills the Wolbachia symbiont)
  • Prevention on a large scale involves ivermectin MDA, traps, and vegetation clearing, but individuals living in endemic areas need to avoid blackfly bites at all costs

You can view the full show notes and references here: https://docs.google.com/document/d/1WPhP2hvVHlQClwN6K3lZ1BPM4fjeX2XdIFWcTI_gnV4/edit?usp=sharing

Episode art attribution: image generated using Adobe Firefly and an image of Simulium blackfly By xpda - Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=67748232

Episode sound attributions:

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