As stated above, onchocerciasis is almost certainly a disease that originated in Africa and has spread to Arabia and the New World as an unintended byproduct of the slave trade. Skin lesions caused by onchocerciasis were first described by J. O'Neill, who detected microfilariae from Africans in the Gold Coast (modern Ghana) suffering from the tormenting itch of "craw-craw." The organism was first described in 1893 by the eminent German parasitologist K. G. Friedrich Rudolf Leuckart, who studied adults in nodules extracted from Gold Coast Africans by a missionary. In 1916 the disease was first recognized in the Americas when the Guatemalan investigator Rodolfo Robles discovered onchocerciasis in the highlands of his country. Robles linked nodules to eye disease and suggested that the distribution of infection implicated two species of Simulium as vectors. D. B. Blacklock, working in Sierra Leone, showed in 1926 that S. damnosum was the vector. In 1931 J. Hissette, working in the Belgian Congo, linked onchocerciasis with blindness for the first time in Africa, but despite confirmation in the Sudan a year later, colonial doctors generally considered onchocerciasis only a skin disease. Just before World War II, French doctors in what is now Burkina Faso began to link the disease with mass blindness and river valley abandonment. Their colleagues across the frontier in the British

Gold Coast did not make a similar discovery until 1949. Although British physicians and administrators were aware of river valley depopulation, onchocerciasis, and substantial blindness in the northern part of the colony, they did not link these phenomena, partly because doctors who became interested in the problem in the 1930s were repeatedly distracted by other duties or transferred. After the war, the association was finally made, especially in a crucial 1949 report by B. B. Waddy. A series of investigations in the 1950s confirmed the widespread incidence and serious consequences of the disease in a number of African countries, and Latin American foci were delimited.

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