Successful Interruption of Transmission of Onchocerca volvulus in the Escuintla-Guatemala Focus, Guatemala
Successful Interruption of Transmission of Onchocerca volvulus in the Escuintla-Guatemala Focus, Guatemala
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DOI：
10.1371/journal.pntd.0000404
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发表时间：
2009-03-01
影响因子：
3.8
通讯作者：
Lindblade, Kim A.
中科院分区：
文献类型：
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作者：
Gonzalez, Rodrigo J.;Cruz-Ortiz, Nancy;Lindblade, Kim A.
背景资料：在六个流行盘尾丝虫病的拉丁美洲国家，通过大规模施用伊维菌素消除盘尾丝虫病（河盲症）被认为是可行的，因为地方病疫源地面积相对较小，地理位置孤立。我们评估了是否已中断在埃斯昆特拉，危地马拉的地方病重点的盘尾丝虫病的传播，根据世界卫生组织的认证标准，消除的盘尾丝虫病。方法/主要调查结果：我们进行了评估，眼睛的发病率和过去的接触盘尾丝虫扭转在人群中，而潜在的载体（Simuerichochraceum）被捕获和测试O。扭转DNA;所有评价均在重点地区内的潜在地方病社区（PEC;有实际或疑似传播史的社区或目前正在接受伊维菌素半年一次大规模治疗的社区）进行。329名个体（≥ 7岁，在PEC居住至少5年）眼前段微丝蚴的患病率为0%（单侧95%置信区间[CI] 0-0.9%）。重组O. 6,432名学龄儿童（6 - 12岁）的肠扭转抗原（OV-16）为0%（单侧95%IC 0-0.05%）。在总共14，099 S中。ochraceum为O.扭转DNA阳性率为0 ~ 0.01%（95%CI 0 ~ 0.01%）。季节性传播的潜力，因此，0感染阶段幼虫每人每season.Conclusions/意义：根据这些评价，在埃斯昆特拉-危地马拉重点盘尾丝虫病的传播已被成功地中断。虽然这是拉丁美洲第二个证实传播中断的盘尾丝虫病疫源地，但它是第一个有充分记录的强烈传播史的疫源地，消除了O。肠扭转
Background: Elimination of onchocerciasis (river blindness) through mass administration of ivermectin in the six countries in Latin America where it is endemic is considered feasible due to the relatively small size and geographic isolation of endemic foci. We evaluated whether transmission of onchocerciasis has been interrupted in the endemic focus of Escuintla-Guatemala in Guatemala, based on World Health Organization criteria for the certification of elimination of onchocerciasis.Methodology/Principal Findings: We conducted evaluations of ocular morbidity and past exposure to Onchocerca volvulus in the human population, while potential vectors (Simulium ochraceum) were captured and tested for O. volvulus DNA; all of the evaluations were carried out in potentially endemic communities (PEC; those with a history of actual or suspected transmission or those currently under semiannual mass treatment with ivermectin) within the focus. The prevalence of microfilariae in the anterior segment of the eye in 329 individuals (>= 7 years old, resident in the PEC for at least 5 years) was 0% (one-sided 95% confidence interval [CI] 0-0.9%). The prevalence of antibodies to a recombinant O. volvulus antigen (Ov-16) in 6,432 school children (aged 6 to 12 years old) was 0% (one-sided 95% IC 0-0.05%). Out of a total of 14,099 S. ochraceum tested for O. volvulus DNA, none was positive (95% CI 0-0.01%). The seasonal transmission potential was, therefore, 0 infective stage larvae per person per season.Conclusions/Significance: Based on these evaluations, transmission of onchocerciasis in the Escuintla-Guatemala focus has been successfully interrupted. Although this is the second onchocerciasis focus in Latin America to have demonstrated interruption of transmission, it is the first focus with a well-documented history of intense transmission to have eliminated O. volvulus.