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Nigeria is highly endemic for onchocerciasis, and seven million people are infected, 40 million at risk of infection and 0.2 million blind from the disease.1 Disease control is through mass distribution of ivermectin (Mectizan) “ a drug that has revolutionized the treatment of onchocerciasis and other nematode diseases of man”.2 What is needed therefore, is to put in place an effective system of drug delivery and distribution that can be sustained by the endemic countries themselves.3 An approach for ivermectin distribution is through community self treatment, where the communities themselves are actively involved in planning, designing and executing the ivermectin delivery system. This has been termed community directed treatment with ivermectin (CDTI) by the African Programme for Onchocerciasis Control, APOC. CDTI schemes are currently being tested in Africa to decide on the best approach. However, the danger …
Funding: this study received financial support from the UNDP/World Bank/WHO Special Programme for Research and Training in Tropical diseases.
Conflicts of interest: none.