01 The round does not erase the kilogram
A village list is not a license to guess tablets. Each person still sits on the onchocerciasis grid reprinted on the ivermectin leaf: one 3 mg tablet at 15-25 kg, up to four at 65-84 kg, and a calculated 150 mcg/kg at 85 kg and above. Under 15 kg the printed grid is empty.
Empty stomach, water only, still applies when the swallow happens under a tree. Food in the queue is how exposure drifts from the fasting PK the insert used. This margin will not invent a "campaign exception" to the fasting line.
Strongyloides is a different table on the same leaflet. A community oncho round should not borrow the strongyloides counts because someone in line also has abdominal pain. Indication first, then kilograms, then tablets.
02 How a scale error still gets caught before anyone swallows 3 mg
Zero the scale on a flat board, not on a tent fold. Recheck a child who just drank a bottle of water. Recheck an adult who kept boots on. Guessed kilograms are how a 15 kg child and a 90 kg adult share a folk two-tablet story.
If the backup scale disagrees by more than a small wobble, stop that person and reweigh. Do not average the two numbers into a fantasy band. The oncho grid on the ivermectin leaf is 150 mcg/kg, not a bowl habit.
Write the kilogram next to the tablet count. A register without kilograms is how next year's crate gets raided as souvenirs. Pregnancy status next year is not this year's.
Empty-stomach water still applies when the scale line is long. Breakfast in the queue is a reschedule, not a half-dose. Write the hour so Mazzotti later is not mistaken for a missed swallow.
Loa geography is not optional trivia. Incomplete screening is a stop. Elise files the interval pair. She does not approve a district by email at [email protected].
03 Twelve months is the usual campaign interval
The insert's mass-distribution sentence is 12 months as the most commonly used interval. Individual treatment may be as soon as 3 months. Those two clocks exist so programs do not treat a yearly MDA like a weekly vitamin.
Skin microfilariae drop after a 150 mcg/kg swallow. They return. That return, plus new bites, is why onchocerciasis programs repeat. It is not why a household repeats next Tuesday.
Mazzotti symptoms after a round - itch, fever, tender nodes - need a local plan. They are not proof the next interval should shrink. Shrinking without a reason piles adverse events onto a population that already queued in heat.
| Clock | Insert or program use |
|---|---|
| 12 months | Most common MDA interval named on the Stromectol insert |
| 3 months | Shortest individual retreatment interval on that insert |
| Monthly | Not the labeled community rhythm |
04 After the line closes
Count remaining tablets against the register. Mismatches are how private monthly rounds get born. Fix the count the same day.
Write Mazzotti advice in the language the queue speaks. Itch and fever can start later. A second swallow is not the home remedy.
Eye complaints go to whoever owns the oncho follow-up, not to a leftover crate. Anterior-chamber shifts are first-days business.
If mites appear in a household after an oncho round, that is the scabies ink, often off-label in the US, not a reason to reopen next year's box tonight.
Mail the desk only if this margin drifted from the insert's 12-month / 3-month pair.
05 What a traveler should not take home from a community table
Do not pocket leftover 3 mg strips as personal monthly prevention. Monthly swallows are not the insert's MDA sentence. Souvenir medicine is how Loa-risk travelers and pregnant people get a tablet that was never weighed for them.
Do not mix strongyloides table leftovers into an oncho queue. Different insert tables. The 150 mcg/kg lock stays oncho. Scabies work, when a clinician chooses it, is a different file.
FDA-labeled US uses remain onchocerciasis and intestinal strongyloides. A community crate does not create a US scabies indication. Say that out loud if someone files this page as a license.
Horse paste is poison control. It is not a rustic substitute when the 3 mg crate runs out.
Program medicine stays program medicine. The volunteer reads the leaf and stops pocketing stock.
06 How a late arriver still gets a counted swallow
Late arrivals still get weighed. They do not get "whatever is left in the bowl." If the 3 mg count for their band is gone, they wait for the next supply or they skip. Under-dosing a 70 kg adult with one tablet is not kindness.
If they already ate, wait. The insert's PK is fasting. A late arriver with a full stomach is tomorrow's empty-stomach slot, not a special exception.
If they have a Loa slip that is incomplete, they do not swallow. Incomplete screening is a stop, not a queue-speed problem.
If they want tablets for a relative at home, no. Weight bands are not transferable. The relative comes or they do not get a count.
If they have a fever already, the team decides. Mazzotti on top of malaria is a clinic problem. This margin will not invent a standing order.
07 Do not run a scabies MDA off this oncho clock
Scabies mass work, when public-health teams do it, uses different intervals and often a second dose. It is also off-label for Stromectol in the US. Mixing that protocol into an oncho 12-month speech is how people under-treat mites and over-treat Onchocerca.
Read the two-dose scabies ink if mites are the actual problem. Keep this file for river-blindness rounds and the 3-month individual floor.
Mail [email protected] if a sentence here drifts from the insert's 12-month / 3-month pair. Do not mail a village GPS pin and ask for a crate size.
08 Mazzotti later is not a second swallow from the leftover crate
Itch, fever, and tender nodes can start after a correct 150 mcg/kg swallow. That is a clinic follow-up, not a reason to open tomorrow's box tonight. A second 3 mg tablet is not the home remedy.
Eye complaints go to whoever owns the oncho follow-up. Anterior-chamber shifts are first-days business. Do not treat a red eye with another counted tablet from a volunteer pocket.
If malaria or another fever is already in the village, the team decides. This margin will not invent a standing order that covers both stories.
If mites appear in a household after an oncho round, that is the scabies ink, often off-label in the US, not a reason to reopen next year's campaign stock.
Count remaining tablets against the register the same afternoon. Mismatches are how private monthly rounds get born.
09 Draw the Loa loa map before the first blister crate
High Loa loa microfilarial loads have been tied to encephalopathy after ivermectin in community work. Programs in overlapping zones use geography and, where required, blood films. A Bordeaux margin cannot clear a district.
A returned traveler who "helped with a round" last year is not automatically safe to swallow a leftover 3 mg strip for an unrelated itch. Ask where they were. The leaf already says veterinary paste is not Stromectol. This margin adds: a campaign leftover is not a souvenir medicine.
Pregnancy, breastfeeding, and very sick adults in the queue are local protocol, not a Virena checkbox. Elise files the interval and the 150 mcg/kg lock. She does not staff a distribution.
10 What the registrar writes before the first crate opens
A community round still needs a written infection, a written interval, and a written exclusion list. Onchocerciasis is not scabies. Twelve months is not three. Loa geography is not optional trivia. If those lines are missing, the crate is early.
Scales break. Have a backup. Guessed kilograms are how a 15 kg child and a 90 kg adult share a folk "two tablets each." The oncho grid on the ivermectin leaf is per person at 150 mcg/kg.
Empty-stomach water still applies under a tent. Breakfast in the queue is a reschedule, not a half-dose. Write the hour so Mazzotti later is not mistaken for a missed swallow.
Do not let leftover strips walk home as souvenirs. Pregnancy status next year is not this year's. Destroy or return unused stock.
Elise files the interval pair. She does not approve a district by email at [email protected].
11 One weighed swallow, then leave the calendar alone
Weigh, count 3 mg tablets at 150 mcg/kg, keep the stomach empty, and put the next round on a 12-month or clinician-set 3-month mark. That is the whole margin.
Reviewed 21 August 2026, Dr. Elise Moreau, Bordeaux.
A community round still needs a written infection, a written interval, and a written exclusion list before the first 3 mg blister leaves the crate. Onchocerciasis is not scabies. Twelve months is not three. Loa geography is not a footnote you skip because the line is long.
Weigh each person. Write the kilogram next to the tablet count. Empty-stomach water still applies under a tent. Breakfast in the queue is tomorrow's slot. Mazzotti later is a clinic story, not a second swallow from a volunteer pocket.
FDA-labeled US indications remain onchocerciasis and intestinal strongyloides. A village crate does not create a US mite indication. If mites appear after an oncho day, open the scabies ink and say off-label when that is the US truth.
Do not let leftover strips walk home. Do not invent a monthly personal prevention from campaign stock. Horse paste is poison control. Mail [email protected] only if this margin drifted from the insert's interval pair.