Introduction
filarial diseases
RIVER BLINDNESS, ONCHOCERCIASIS, DISEASE, LYMPHATIC FILARIASIS, DISEASES
The filarial diseases onchocerciasis (“river blindness”) and lymphatic filariasis (LF) represent major health problems in affected countries, responsible for respectively 1.34 and 1.36 million disability-adjusted life years lost in 2017 [Control and treatment of the two diseases currently rely on mass drug administration (MDA), with ivermectin for onchocerciasis in sub-Saharan Africa, ivermectin in association with albendazole for LF in sub-Saharan Africa, and diethylcarbamazine in association with albendazole in other parts of the world [Moreover, MDA entails considerable logistic efforts and financial commitments, and there are ethical considerations regarding treating entire populations, including uninfected individuals. Cost effectiveness may also be an issue since success requires sustained coordination of supply logistics to ensure that treatment reaches all target recipients. Because of these challenges, interruption of transmission and disease elimination has proven more difficult than initially expected. In addition, MDA given for long periods carries the risk of resistance, described for ivermectin in animal health use, together with suboptimal responses in humans [The parasitic filariae responsible for onchocerciasis and for LF are host to an endosymbiotic bacterium, The anti-Flubentylosin (ABBV-4083), a semisynthetic analog of the macrolide antibiotic tylosin A, demonstrated strong potential as an anti-wolbachial agent in preclinical studies, in terms of its activity and safety, and a possible reduction in treatment duration compared to doxycycline [