The incidence of eye lesions and visual impairment in onchocerciasis in relationship to the intensity of infection.

Data from follow-up surveys of onchocerciasis, conducted in the rain-forest and savanna areas of the United Cameroon Republic, are used to fit equations relating the incidence of eye lesions and visual impairment to microfilaria concentration in skin-snips. The incidence of lesions in those aged under 45 appears to be directly proportional to concentration, though the association is less clear in females over 25 in the savanna. The incidence of visual impairment appears also to be directly proportional to concentration among those under 45, but only in the savanna. Predictions of changes in incidence rates under transmission control are made, using hypothetical values for the rate of decline of infection. They are compared with reported incidence of lesions from the Onchocerciasis Control Programme: they are in good agreement for those aged under 30 years, but they understate the observed decline in older subjects.