symptoms and the infection being generally asymptomatic, little has formally been done to control the disease. Treatment There is no consensus on optimal therapeutic approach. The most commonly used drug is diethylcarbamazine (DEC), but it is, however, often ineffective. Although other drugs have been tried such as praziquantel, ivermectin, and albendozole, none has proven to be reliably and rapidly effective. Mebendazole appeared more active than DEC in eliminating the infection, and had comparable overall responses. Thiabendazole evidenced a small, but significant activity against the infection. A combination of treatments, DEC plus mebendazole, was much more effective than single drug doses. Epidemiology Mansonelliasis is found in Latin America from the Yucatán peninsula to northern Argentina, in the Caribbean, and in Africa from Senegal to Kenya and south to Angola and Zimbabwe. M. ozzardi is found only in the New World, M. steptocerca is found only in the Congo Basin, and M. perstans is found in both the previously described areas of Africa and Latin America. Prevalence rates vary from a few percent to as much as 90% in areas like Trinidad, Guyana and Colombia. Infection is more common and has a higher microfilarial dose with age, though studies have found microfilarial dose not to be correlated with symptoms. In parts of rural South America, men have been found more susceptible than women, possibly due to more outdoors work by males as children, and possibly due to cooking fires serving as deterrents to vectors for women who perform more domestic duties. One study in central Africa found M. perstans to be a much more common cause of filariasis symptoms compared to Loa loa and Wuchereria bancrofti. Since most Mansonelliasis is asymptomatic, it has been considered a relatively minor filarial disease, and has a very low, if any, mortality, though there is little data on which to base estimates. History Mansonelliasis, in the form of M. ozzardi, was first documented in 1897. See also Filariasis Mansonella References Further reading Insect-borne diseases Helminthiases