Interruption of Onchocerca volvulus Transmission in the Abu Hamed Focus, Sudan

Tarig B. Higazi Department of Biological Sciences, Ohio University, Zanesville, Ohio; Ministry of Health, Khartoum, Sudan; The Carter Center, Khartoum, Sudan; The Carter Center, Atlanta, Georgia; Global Health Infectious Diseases Research Program, College of Public Health, University of South Florida, Tampa, Florida; Michigan State University, East Lansing, Michigan

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Isam M. A. Zarroug Department of Biological Sciences, Ohio University, Zanesville, Ohio; Ministry of Health, Khartoum, Sudan; The Carter Center, Khartoum, Sudan; The Carter Center, Atlanta, Georgia; Global Health Infectious Diseases Research Program, College of Public Health, University of South Florida, Tampa, Florida; Michigan State University, East Lansing, Michigan

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Hanan A. Mohamed Department of Biological Sciences, Ohio University, Zanesville, Ohio; Ministry of Health, Khartoum, Sudan; The Carter Center, Khartoum, Sudan; The Carter Center, Atlanta, Georgia; Global Health Infectious Diseases Research Program, College of Public Health, University of South Florida, Tampa, Florida; Michigan State University, East Lansing, Michigan

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Wigdan A. ElMubark Department of Biological Sciences, Ohio University, Zanesville, Ohio; Ministry of Health, Khartoum, Sudan; The Carter Center, Khartoum, Sudan; The Carter Center, Atlanta, Georgia; Global Health Infectious Diseases Research Program, College of Public Health, University of South Florida, Tampa, Florida; Michigan State University, East Lansing, Michigan

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Tong Chor M. Deran Department of Biological Sciences, Ohio University, Zanesville, Ohio; Ministry of Health, Khartoum, Sudan; The Carter Center, Khartoum, Sudan; The Carter Center, Atlanta, Georgia; Global Health Infectious Diseases Research Program, College of Public Health, University of South Florida, Tampa, Florida; Michigan State University, East Lansing, Michigan

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Nabil Aziz Department of Biological Sciences, Ohio University, Zanesville, Ohio; Ministry of Health, Khartoum, Sudan; The Carter Center, Khartoum, Sudan; The Carter Center, Atlanta, Georgia; Global Health Infectious Diseases Research Program, College of Public Health, University of South Florida, Tampa, Florida; Michigan State University, East Lansing, Michigan

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Moses Katabarwa Department of Biological Sciences, Ohio University, Zanesville, Ohio; Ministry of Health, Khartoum, Sudan; The Carter Center, Khartoum, Sudan; The Carter Center, Atlanta, Georgia; Global Health Infectious Diseases Research Program, College of Public Health, University of South Florida, Tampa, Florida; Michigan State University, East Lansing, Michigan

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Hassan K. Hassan Department of Biological Sciences, Ohio University, Zanesville, Ohio; Ministry of Health, Khartoum, Sudan; The Carter Center, Khartoum, Sudan; The Carter Center, Atlanta, Georgia; Global Health Infectious Diseases Research Program, College of Public Health, University of South Florida, Tampa, Florida; Michigan State University, East Lansing, Michigan

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Thomas R. Unnasch Department of Biological Sciences, Ohio University, Zanesville, Ohio; Ministry of Health, Khartoum, Sudan; The Carter Center, Khartoum, Sudan; The Carter Center, Atlanta, Georgia; Global Health Infectious Diseases Research Program, College of Public Health, University of South Florida, Tampa, Florida; Michigan State University, East Lansing, Michigan

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Charles D. Mackenzie Department of Biological Sciences, Ohio University, Zanesville, Ohio; Ministry of Health, Khartoum, Sudan; The Carter Center, Khartoum, Sudan; The Carter Center, Atlanta, Georgia; Global Health Infectious Diseases Research Program, College of Public Health, University of South Florida, Tampa, Florida; Michigan State University, East Lansing, Michigan

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Frank Richards Department of Biological Sciences, Ohio University, Zanesville, Ohio; Ministry of Health, Khartoum, Sudan; The Carter Center, Khartoum, Sudan; The Carter Center, Atlanta, Georgia; Global Health Infectious Diseases Research Program, College of Public Health, University of South Florida, Tampa, Florida; Michigan State University, East Lansing, Michigan

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Kamal Hashim Department of Biological Sciences, Ohio University, Zanesville, Ohio; Ministry of Health, Khartoum, Sudan; The Carter Center, Khartoum, Sudan; The Carter Center, Atlanta, Georgia; Global Health Infectious Diseases Research Program, College of Public Health, University of South Florida, Tampa, Florida; Michigan State University, East Lansing, Michigan

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Abu Hamed, Sudan, the northernmost location of onchocerciasis in the world, began community-directed treatment with ivermectin (CDTI) in 1998, with annual treatments enhanced to semiannual in 2007. We assessed the status of the parasite transmission in 2011 entomologically, parasitologically, and serologically. O-150 pool screening showed no parasite DNA in 17,537 black flies collected in 2011 (95% confidence interval upper limit [95% CI UL] = 0.023). Skin microfilariae, nodules, and signs of skin disease were absent in 536 individuals in seven local communities. Similarly, no evidence of Onchocerca volvulus Ov16 antibodies was found in 6,756 school children ≤ 10 years (95% CI UL = 0.03%). Because this assessment of the focus meets the 2001 World Health Organization (WHO) criteria for interrupted transmission, treatment was halted in 2012, and a post-treatment surveillance period was initiated in anticipation of declaration of disease elimination in this area. We provide the first evidence in East Africa that long-term CDTI alone can interrupt transmission of onchocerciasis.

Author Notes

* Address correspondence to Tarig B. Higazi, Department of Biological Sciences, Ohio University, 249 Elson Hall, 1425 Newark Road, Zanesville, OH 43701. E-mail: Higazi@ohio.edu

Authors' addresses: Tarig B. Higazi, Department of Biological Sciences, Ohio University, Zanesville, OH, E-mail: higazi@ohio.edu. Isam M. A. Zarroug, Entomology, Ministry of Health, Khartoum, Sudan, E-mail: izarroug@yahoo.com. Hanan A. Mohamed, Wigdan A. ElMubark, and Tong Chor M. Deran, Ministry of Health, Khartoum, Sudan, E-mails: hanan.mohamed@gmail.com, wigdanelmubark@hotmail.com, and tong_schewitaak@yahoo.co.uk. Nabil Aziz, The Carter Center—Sudan, Khartoum, Sudan, E-mail: nabilazizm@hotmail.com. Moses Katabarwa, The Carter Center, Emory University, Atlanta, GA, E-mail: mkataba@emory.edu. Hassan K. Hassan and Thomas R. Unnasch, Global Health, University of South Florida, Tampa, FL, E-mails: hhassan@health.usf.edu and tunnasch@health.usf.edu. Charles D. Mackenzie, Pathobiology, Michigan State University, East Lansing, MI, E-mail: mackenz8@msu.edu. Frank Richards, Health Programs, The Carter Center, Atlanta, GA, E-mail: frich01@emory.edu. Kamal Hashim, Eye Hospital, Ministry of Health, Khartoum, Sudan, E-mail: kamalbinnawi@yahoo.com.

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