Southgate B A
Ciba Found Symp. 1987;127:32-45. doi: 10.1002/9780470513446.ch4.
The descriptive epidemiology of onchocerciasis is well understood in the major foci of infection; a great stimulus to epidemiological research has been the implementation of the first control programme, which led to the eradication of infection in Kenya and, more recently, the vast Onchocerciasis Control Programme in the Volta River Basin of West Africa. However, there are still significant gaps in epidemiological knowledge which hamper the planning of future control programmes and the evaluation of current programmes. The four most important unsolved problems are: the refinement of field diagnostic techniques to identify skin microfilariae at the ultra-low densities that will become common in the late stages of vector-control campaigns; the definitive identification of Onchocerca volvulus infective larvae in Simulium species; strain analysis in the field of microfilariae from humans and of developing stages from Simulium, to determine their potential for ocular pathogenicity; determination of the lifespan, or maximum fecundity span, of adult female O. volvulus after the interruption of transmission. Three other unsolved problems are of enormous interest epidemiologically, although less urgent in practical importance. They are the identification of factors causing severe disease as opposed to heavy infection; the effects of seasonal as opposed to perennial transmission; and the importance of transplacental transmission of microfilariae or soluble antigens.
盘尾丝虫病的描述性流行病学在主要感染病灶已得到充分了解；首个控制项目的实施极大地推动了流行病学研究，该项目使肯尼亚的感染得以根除，最近又使西非沃尔特河流域的大规模盘尾丝虫病控制项目得以开展。然而，流行病学知识仍存在重大空白，这阻碍了未来控制项目的规划和当前项目的评估。四个最重要的未解决问题是：改进现场诊断技术，以识别在病媒控制运动后期将常见的超低密度皮肤微丝蚴；明确在蚋属物种中盘尾丝虫感染性幼虫的鉴定方法；对来自人类的微丝蚴以及来自蚋属发育阶段的样本进行现场菌株分析，以确定它们导致眼部致病性的可能性；确定传播中断后成年雌性盘尾丝虫的寿命或最大繁殖期。另外三个未解决问题在流行病学上也极具研究价值，尽管在实际重要性方面不那么紧迫。它们是识别导致严重疾病而非重度感染的因素；季节性传播与常年性传播的影响；以及微丝蚴或可溶性抗原的胎盘传播的重要性。
