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Feasibility of Onchocerciasis Elimination with Ivermectin Treatment in Endemic Foci in Africa: First Evidence from Studies in Mali and Senegal
- Source :
- PLoS Neglected Tropical Diseases, PLoS Neglected Tropical Diseases, Vol 3, Iss 7, p e497 (2009)
- Publication Year :
- 2009
- Publisher :
- Public Library of Science (PLoS), 2009.
-
Abstract
- Background Mass treatment with ivermectin is a proven strategy for controlling onchocerciasis as a public health problem, but it is not known if it can also interrupt transmission and eliminate the parasite in endemic foci in Africa where vectors are highly efficient. A longitudinal study was undertaken in three hyperendemic foci in Mali and Senegal with 15 to 17 years of annual or six-monthly ivermectin treatment in order to assess residual levels of infection and transmission and test whether ivermectin treatment could be safely stopped in the study areas. Methodology/Principal Findings Skin snip surveys were undertaken in 126 villages, and 17,801 people were examined. The prevalence of microfilaridermia was<br />Author Summary The control of onchocerciasis, or river blindness, is based on annual or six-monthly ivermectin treatment of populations at risk. This has been effective in controlling the disease as a public health problem, but it is not known whether it can also eliminate infection and transmission to the extent that treatment can be safely stopped. Many doubt that this is feasible in Africa. A study was undertaken in three hyperendemic onchocerciasis foci in Mali and Senegal where treatment has been given for 15 to 17 years. The results showed that only few infections remained in the human population and that transmission levels were everywhere below postulated thresholds for elimination. Treatment was subsequently stopped in test areas in each focus, and follow-up evaluations did not detect any recrudescence of infection or transmission. Hence, the study has provided the first evidence that onchocerciasis elimination is feasible with ivermectin treatment in some endemic foci in Africa. Although further studies are needed to determine to what extent these findings can be extrapolated to other areas in Africa, the principle of onchocerciasis elimination with ivermectin treatment has been established.
- Subjects :
- Infectious Diseases/Epidemiology and Control of Infectious Diseases
Adult
Male
Veterinary medicine
lcsh:Arctic medicine. Tropical medicine
Endemic Diseases
lcsh:RC955-962
Helminth genetics
Mali
Onchocerciasis
Polymerase Chain Reaction
Filariasis
law.invention
Young Adult
Ivermectin
law
parasitic diseases
Prevalence
medicine
Animals
Humans
Helminths
Simuliidae
Longitudinal Studies
biology
lcsh:Public aspects of medicine
Public Health, Environmental and Occupational Health
lcsh:RA1-1270
DNA, Helminth
biology.organism_classification
medicine.disease
Onchocerca volvulus
Senegal
Filaricides
Infectious Diseases
Transmission (mechanics)
Vector (epidemiology)
Female
Research Article
medicine.drug
Subjects
Details
- ISSN :
- 19352735
- Volume :
- 3
- Database :
- OpenAIRE
- Journal :
- PLoS Neglected Tropical Diseases
- Accession number :
- edsair.doi.dedup.....f83d20e02e9683f2618379e2eb0535db