Elimination of Onchocercia volvulus Transmission in the Santa Rosa Focus of Guatemala

Kim A. Lindblade Division of Parasitic Diseases, National Center for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala; Onchocerciasis Elimination Program of the Americas, Guatemala City, Guatemala; Division of Geographic Medicine, University of Alabama, Birmingham, Alabama; Ministerio de Salud Publica y Asistencia Social, Guatemala City, Guatemala; Carter Center, Atlanta, Georgia

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Byron Arana Division of Parasitic Diseases, National Center for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala; Onchocerciasis Elimination Program of the Americas, Guatemala City, Guatemala; Division of Geographic Medicine, University of Alabama, Birmingham, Alabama; Ministerio de Salud Publica y Asistencia Social, Guatemala City, Guatemala; Carter Center, Atlanta, Georgia

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Guillermo Zea-Flores Division of Parasitic Diseases, National Center for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala; Onchocerciasis Elimination Program of the Americas, Guatemala City, Guatemala; Division of Geographic Medicine, University of Alabama, Birmingham, Alabama; Ministerio de Salud Publica y Asistencia Social, Guatemala City, Guatemala; Carter Center, Atlanta, Georgia

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Nidia Rizzo Division of Parasitic Diseases, National Center for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala; Onchocerciasis Elimination Program of the Americas, Guatemala City, Guatemala; Division of Geographic Medicine, University of Alabama, Birmingham, Alabama; Ministerio de Salud Publica y Asistencia Social, Guatemala City, Guatemala; Carter Center, Atlanta, Georgia

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Charles H. Porter Division of Parasitic Diseases, National Center for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala; Onchocerciasis Elimination Program of the Americas, Guatemala City, Guatemala; Division of Geographic Medicine, University of Alabama, Birmingham, Alabama; Ministerio de Salud Publica y Asistencia Social, Guatemala City, Guatemala; Carter Center, Atlanta, Georgia

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Alfredo Dominguez Division of Parasitic Diseases, National Center for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala; Onchocerciasis Elimination Program of the Americas, Guatemala City, Guatemala; Division of Geographic Medicine, University of Alabama, Birmingham, Alabama; Ministerio de Salud Publica y Asistencia Social, Guatemala City, Guatemala; Carter Center, Atlanta, Georgia

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Nancy Cruz-Ortiz Division of Parasitic Diseases, National Center for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala; Onchocerciasis Elimination Program of the Americas, Guatemala City, Guatemala; Division of Geographic Medicine, University of Alabama, Birmingham, Alabama; Ministerio de Salud Publica y Asistencia Social, Guatemala City, Guatemala; Carter Center, Atlanta, Georgia

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Thomas R. Unnasch Division of Parasitic Diseases, National Center for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala; Onchocerciasis Elimination Program of the Americas, Guatemala City, Guatemala; Division of Geographic Medicine, University of Alabama, Birmingham, Alabama; Ministerio de Salud Publica y Asistencia Social, Guatemala City, Guatemala; Carter Center, Atlanta, Georgia

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George A. Punkosdy Division of Parasitic Diseases, National Center for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala; Onchocerciasis Elimination Program of the Americas, Guatemala City, Guatemala; Division of Geographic Medicine, University of Alabama, Birmingham, Alabama; Ministerio de Salud Publica y Asistencia Social, Guatemala City, Guatemala; Carter Center, Atlanta, Georgia

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Jane Richards Division of Parasitic Diseases, National Center for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala; Onchocerciasis Elimination Program of the Americas, Guatemala City, Guatemala; Division of Geographic Medicine, University of Alabama, Birmingham, Alabama; Ministerio de Salud Publica y Asistencia Social, Guatemala City, Guatemala; Carter Center, Atlanta, Georgia

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Mauricio Sauerbrey Division of Parasitic Diseases, National Center for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala; Onchocerciasis Elimination Program of the Americas, Guatemala City, Guatemala; Division of Geographic Medicine, University of Alabama, Birmingham, Alabama; Ministerio de Salud Publica y Asistencia Social, Guatemala City, Guatemala; Carter Center, Atlanta, Georgia

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Julio Castro Division of Parasitic Diseases, National Center for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala; Onchocerciasis Elimination Program of the Americas, Guatemala City, Guatemala; Division of Geographic Medicine, University of Alabama, Birmingham, Alabama; Ministerio de Salud Publica y Asistencia Social, Guatemala City, Guatemala; Carter Center, Atlanta, Georgia

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Eduard Catú Division of Parasitic Diseases, National Center for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala; Onchocerciasis Elimination Program of the Americas, Guatemala City, Guatemala; Division of Geographic Medicine, University of Alabama, Birmingham, Alabama; Ministerio de Salud Publica y Asistencia Social, Guatemala City, Guatemala; Carter Center, Atlanta, Georgia

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Orlando Oliva Division of Parasitic Diseases, National Center for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala; Onchocerciasis Elimination Program of the Americas, Guatemala City, Guatemala; Division of Geographic Medicine, University of Alabama, Birmingham, Alabama; Ministerio de Salud Publica y Asistencia Social, Guatemala City, Guatemala; Carter Center, Atlanta, Georgia

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Frank O. Richards Jr Division of Parasitic Diseases, National Center for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala; Onchocerciasis Elimination Program of the Americas, Guatemala City, Guatemala; Division of Geographic Medicine, University of Alabama, Birmingham, Alabama; Ministerio de Salud Publica y Asistencia Social, Guatemala City, Guatemala; Carter Center, Atlanta, Georgia

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To eliminate transmission of Onchocerca volvulus, semiannual mass treatment with ivermectin (Mectizan; donated by Merck & Co) has been underway in Guatemala since 2000. We applied the 2001 World Health Organization (WHO) elimination criteria in the Santa Rosa focus of onchocerciasis transmission in Guatemala (10,923 persons at risk). No evidence of parasite DNA was found in 2,221 Simulium ochraceum vectors (one-sided 95% confidence interval [CI], 0–0.086%), and no IgG4 antibody positives to recombinant antigen OV16 were found in a sample of 3,232 school children (95% CI, 0–0.009%). We also found no evidence of microfilariae in the anterior segment of the eye in 363 area residents (95% CI, 0–0.08%). Our interpretation of these data, together with historical information, suggest that transmission of O. volvulus is permanently interrupted in Santa Rosa and that ivermectin treatments there can be halted.

Author Notes

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