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O. volvulus is transmitted by sandflies, and their role in the transmission of onchocerciasis was discovered by the Scottish parasitologist Breadablane Blacklock in Sierra Leone in the mid-1920s (19). There are accounts of the history of onchocerciasis by Grove (105) and Muller (192).
Patient 2 was a 70 year old woman. She had an acute myocardial infarction in 2002 and was treated with primary coronary intervention. Echocardiography showed an aortic stenosis of medium significance. Anemia was also found. This was due to several angioectasias in the duodenum that was treated repeatedly with argon plasma coagulation. The anemia persisted in spite of treatment and therefore capsule enteroscopy was performed which revealed multiple angioectasias in the jejunum.