1921
Volume 75, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

World Health Organization certification criteria for onchocerciasis elimination use anterior segment eye lesion prevalence as an indicator of mass ivermectin treatment program success. Lesions either contain visible microfilaria (noninflammatory punctate keratitis [PK] or microfilariae in anterior chamber [MFAC]), or microfilaria obscured by inflammation (inflammatory PK). To assess the utility of these disease indicators, two experienced ophthalmologists independently examined persons from endemic ( = 325) and nonendemic ( = 348) Guatemalan communities. Thirty-six (11.1%) and nine (2.6%) persons from endemic and nonendemic areas respectively had lesions found by either ophthalmologist (prevalence ratio = 4.3, 95% CI 2.1–8.8, < 0.001). All lesions in nonendemic areas were inflammatory PK in whom no persons were seropositive for onchocerciasis. Overall, observer agreement was moderate (Kappa = 0.49), and most (61%) discordance occurred with inflammatory PK lesions. Our findings suggest that inflammatory punctate keratitis is neither a specific nor a reliable indicator of onchocercal eye disease. Future prevalence surveys should rely upon noninflammatory lesions as disease indicators.

Loading

Article metrics loading...

/content/journals/10.4269/ajtmh.2006.75.1058
2006-12-01
2017-11-22
Loading full text...

Full text loading...

/deliver/fulltext/14761645/75/6/0751058.html?itemId=/content/journals/10.4269/ajtmh.2006.75.1058&mimeType=html&fmt=ahah

References

  1. Burnham G, 1998. Onchocerciasis. Lancet 351 : 1341–1346.
  2. World Health Organization, 1995. Onchocerciasis and its Control: Report of a WHO expert committee on Onchocerciasis control. World Health Organ Tech Rep Ser 852 : 1–104.
  3. Taylor HR, Greene BM, 1989. The status of ivermectin the treatment of human onchocerciasis. Am J Trop Med Hyg 41 : 460–466.
  4. Mabey D, Whitworth JA, Eckstein M, Gilbert C, Maude G, Downham M, 1996. The effects of multiple doses of ivermectin on ocular onchocerciasis. A six year follow up. Ophthalmology 103 : 1001–1008.
  5. Richards FO, Boatin B, Sauerbrey M, Sékétéli A, 2001. Control of Onchocerciasis Today: Status and Challenges. Trends Parasitol 17 : 558–563.
  6. Blanks J, Richards F, Beltran R, Collins R, Alvarez E, Zea Flores G, Bauler B, Cedillos R, Heisler M, Brandling-Bennett D, Baldwin M, Klein R, Jacox M, 1998. The Onchocerciasis Elimination Program of the Americas: a history of partnership. Rev Panam Salud Publica 3 : 367–374.
  7. World Health Organization, 2004. Onchocerciasis WHO, (river blindness): Report from the thirteenth InterAmerican Conference on Onchocerciasis, Cartagena de Indias, Colombia Onchocercose (cécité des rivières). Wkly Epidemiol Rec 79 : 310–312.25.
  8. World Health Organization, 2001. Certification of elimination of human onchocerciasis: criteria and procedures, guidelines. Geneva: WHO/CDS/CPE/CEE/2001.18.b.
  9. Onchocerciasis Elimination Program for the Americas, 2003. Report of the 13th InterAmerican Conference on Onchocerciasis. Cartagena, Columbia.
  10. Silva JC, Beltran F, Semba R, 1992. Evaluacion Oftalmologoica de la Onchocercosis en las Americas. Guatemala: Organización Panamericana de la Salud and River Blindness Foundation: 1–14.
  11. Lobos E, Altmann M, Mengod G, Weiss N, Rudin W, Karam M, 1991. An immunogenic Onchocerca volvulus antigen: a specific and early marker of infection. Science 251 : 1603–1605.
  12. Lipner EM, Dembele N, Souleymane S, Alley WS, Prevots DR, Toe L, Boatin B, Weil GJ, Nutman TB, 2006. Field applicability of a rapid-format anti-ov-16 antibody test for the assessment of onchocerciasis control measures in regions of endemicity. J Infect Dis 194 : 216–221.
  13. Weil GJ, Steel C, Liftis F, Li BW, Mearns G, Lobos E, Nutman TB, 2000. A rapid-format antibody card test for diagnosis of onchocerciasis. J Infect Dis 182 : 1796–1799.
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.2006.75.1058
Loading
/content/journals/10.4269/ajtmh.2006.75.1058
Loading

Data & Media loading...

  • Received : 17 Feb 2006
  • Accepted : 10 Aug 2006

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error