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In addition to the substantial direct benefits from the control of onchocerciasis, there are several indirect advantages, together with the de-worming of children who obtain ivermectin, elevated school attendance, basic enhancements in group and particular person well being, and increased meals production. The drug has a number of other advantages, however, and these have lately been investigated in 5 states in south-eastern Nigeria, where there have been mass remedies with ivermectin, for the management of Onchocerca volvulus, for greater than 10 years. In considering sustainability of programmes in Nigeria, J. Watson (2002, private communication) noticed the willingness of federal, state and local authorities to funds for coaching and supervision of onchocerciasis as an important sustainability indicator. The community distributors will need to have sufficient training for their duties, and be appreciated. The supply infrastructure and treatment strategies associated with Mectizan have resulted in the supply of different health interventions and services, together with Vitamin A, immunizations, the identification of cataracts, training of group health workers and the gathering of census information.
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