New treatment strategies for mansonellosis: an expert overview.

Abstract

Introduction: Mansonellosis, a filarial disease caused by Mansonella genus parasites, affects hundreds of millions globally and represents a growing public health challenge. Currently, there are no coordinated international mansonellosis management programs or guidelines, but there is a growing recognition that mansonellosis control interventions do need to be formulated.

Areas covered: Between 1 January 2025 and 1 September 2025, the search-terms 'Mansonellosis' and 'Mansonella' were used to identify literature concerning macrofilaricidal and microfilaricidal chemotherapeutic treatment of mansonellosis in the PubMed and Web-of-Science databases. Identified literature revealed Mansonella ozzardi susceptibility and regional community-support levels make mass drug administration with ivermectin (MDAi) viable for mansonellosis control in the Americas. Macrofilaricidal test-and-treat programs were found to be more appealing for African mansonellosis control because of sub-optimal M. perstans and M. streptocerca microfilaricidal responses. Shortening treatment times could, however, make curative macrofilaricides the best option in Africa and the Americas.

Expert opinion: The susceptibility of M. ozzardi to ivermectin and the growing appeal of MDAi for malaria control will present opportunities for synergistic malaria-mansonellosis control programs in the Americas. New short course curative macrofilaricides, which are in development for onchocerciasis and lymphatic filariasis, will likely be useful for mansonellosis treatment and will make the disease much easier to manage.