Tehran University of Medical Sciences Iranian Journal of Parasitology 1735-7020 21 2 2026 07 12 307 309 Ruqaiyyah Siddiqui 1. Institute of Biological Chemistry, Biophysics and Bioengineering, Heriot-Watt University Edinburgh, EH14 4AS UK 2. Microbiota Research Center, Istinye University, Istanbul, 34010, Turkey Maryam Niyyati Department of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Naveed Khan 1. Institute of Biological Chemistry, Biophysics and Bioengineering, Heriot-Watt University Edinburgh, EH14 4AS UK 2. School of Science, College of Science and Engineering, University of Derby, Derby, DE22 1GB, UK 2026 04 29 2026 07 12 Onchocerciasis is a chronic helminth disease in which morbidity accumulates slowly over years through repeated cycles of microfilarial production, immune activation, and tissue injury. Adult worms of Onchocerca volvulus can survive for more than a decade within the human host, while pathology arises primarily from inflammatory responses to dying microfilariae rather than parasite mass itself. Although large-scale ivermectin programmes have reduced transmission and blindness, individual disease trajectories remain highly variable, and cumulative skin, ocular, and neurological damage may persist despite treatment. A digital twin framework for onchocerciasis, defined as a continuously updated virtual representation integrating parasite longevity, treatment cycles, immune responses, and tissue damage, offers a novel approach to modelling lifelong disease burden. By combining longitudinal clinical data, treatment history, immunological markers, and exposure context, such a system could predict disability trajectories, optimise treatment timing, and support precision strategies for morbidity prevention. Here, we describe the conceptual basis, biological architecture, and translational potential of an onchocerciasis digital twin. https://ijpa.tums.ac.ir/index.php/ijpa/article/view/4911 https://ijpa.tums.ac.ir/index.php/ijpa/article/download/4911/1506