Transmission of Onchocerca volvulus by Simulium neavei in Mount Elgon Focus of Eastern Uganda Has Been Interrupted

Moses Katabarwa The Carter Center, Atlanta, Georgia; Ministry of Health, Vector Control Division, Kampala, Uganda; The Carter Center Uganda, Kampala, Uganda; Ministry of Health, Kampala, Uganda; Kabarole District Health Services, Kabarole, Uganda; Mbale District Health Services, Mbale, Uganda; Strengthening Decentralization Systems (SDS), Mbale, Uganda; ENVISION/Research Triangle International, Vector Control Division, Ministry of Health, Kampala, Uganda; Lytham St. Anne's, Lancashire, United Kingdom; Global Health Infectious Disease Research, College of Public Health, University of South Florida, Tampa, Florida

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Tom Lakwo The Carter Center, Atlanta, Georgia; Ministry of Health, Vector Control Division, Kampala, Uganda; The Carter Center Uganda, Kampala, Uganda; Ministry of Health, Kampala, Uganda; Kabarole District Health Services, Kabarole, Uganda; Mbale District Health Services, Mbale, Uganda; Strengthening Decentralization Systems (SDS), Mbale, Uganda; ENVISION/Research Triangle International, Vector Control Division, Ministry of Health, Kampala, Uganda; Lytham St. Anne's, Lancashire, United Kingdom; Global Health Infectious Disease Research, College of Public Health, University of South Florida, Tampa, Florida

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Peace Habomugisha The Carter Center, Atlanta, Georgia; Ministry of Health, Vector Control Division, Kampala, Uganda; The Carter Center Uganda, Kampala, Uganda; Ministry of Health, Kampala, Uganda; Kabarole District Health Services, Kabarole, Uganda; Mbale District Health Services, Mbale, Uganda; Strengthening Decentralization Systems (SDS), Mbale, Uganda; ENVISION/Research Triangle International, Vector Control Division, Ministry of Health, Kampala, Uganda; Lytham St. Anne's, Lancashire, United Kingdom; Global Health Infectious Disease Research, College of Public Health, University of South Florida, Tampa, Florida

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Stella Agunyo The Carter Center, Atlanta, Georgia; Ministry of Health, Vector Control Division, Kampala, Uganda; The Carter Center Uganda, Kampala, Uganda; Ministry of Health, Kampala, Uganda; Kabarole District Health Services, Kabarole, Uganda; Mbale District Health Services, Mbale, Uganda; Strengthening Decentralization Systems (SDS), Mbale, Uganda; ENVISION/Research Triangle International, Vector Control Division, Ministry of Health, Kampala, Uganda; Lytham St. Anne's, Lancashire, United Kingdom; Global Health Infectious Disease Research, College of Public Health, University of South Florida, Tampa, Florida

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Edson Byamukama The Carter Center, Atlanta, Georgia; Ministry of Health, Vector Control Division, Kampala, Uganda; The Carter Center Uganda, Kampala, Uganda; Ministry of Health, Kampala, Uganda; Kabarole District Health Services, Kabarole, Uganda; Mbale District Health Services, Mbale, Uganda; Strengthening Decentralization Systems (SDS), Mbale, Uganda; ENVISION/Research Triangle International, Vector Control Division, Ministry of Health, Kampala, Uganda; Lytham St. Anne's, Lancashire, United Kingdom; Global Health Infectious Disease Research, College of Public Health, University of South Florida, Tampa, Florida

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David Oguttu The Carter Center, Atlanta, Georgia; Ministry of Health, Vector Control Division, Kampala, Uganda; The Carter Center Uganda, Kampala, Uganda; Ministry of Health, Kampala, Uganda; Kabarole District Health Services, Kabarole, Uganda; Mbale District Health Services, Mbale, Uganda; Strengthening Decentralization Systems (SDS), Mbale, Uganda; ENVISION/Research Triangle International, Vector Control Division, Ministry of Health, Kampala, Uganda; Lytham St. Anne's, Lancashire, United Kingdom; Global Health Infectious Disease Research, College of Public Health, University of South Florida, Tampa, Florida

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Richard Ndyomugyenyi The Carter Center, Atlanta, Georgia; Ministry of Health, Vector Control Division, Kampala, Uganda; The Carter Center Uganda, Kampala, Uganda; Ministry of Health, Kampala, Uganda; Kabarole District Health Services, Kabarole, Uganda; Mbale District Health Services, Mbale, Uganda; Strengthening Decentralization Systems (SDS), Mbale, Uganda; ENVISION/Research Triangle International, Vector Control Division, Ministry of Health, Kampala, Uganda; Lytham St. Anne's, Lancashire, United Kingdom; Global Health Infectious Disease Research, College of Public Health, University of South Florida, Tampa, Florida

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Ephraim Tukesiga The Carter Center, Atlanta, Georgia; Ministry of Health, Vector Control Division, Kampala, Uganda; The Carter Center Uganda, Kampala, Uganda; Ministry of Health, Kampala, Uganda; Kabarole District Health Services, Kabarole, Uganda; Mbale District Health Services, Mbale, Uganda; Strengthening Decentralization Systems (SDS), Mbale, Uganda; ENVISION/Research Triangle International, Vector Control Division, Ministry of Health, Kampala, Uganda; Lytham St. Anne's, Lancashire, United Kingdom; Global Health Infectious Disease Research, College of Public Health, University of South Florida, Tampa, Florida

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Galex Orukan Ochieng The Carter Center, Atlanta, Georgia; Ministry of Health, Vector Control Division, Kampala, Uganda; The Carter Center Uganda, Kampala, Uganda; Ministry of Health, Kampala, Uganda; Kabarole District Health Services, Kabarole, Uganda; Mbale District Health Services, Mbale, Uganda; Strengthening Decentralization Systems (SDS), Mbale, Uganda; ENVISION/Research Triangle International, Vector Control Division, Ministry of Health, Kampala, Uganda; Lytham St. Anne's, Lancashire, United Kingdom; Global Health Infectious Disease Research, College of Public Health, University of South Florida, Tampa, Florida

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Francis Abwaimo The Carter Center, Atlanta, Georgia; Ministry of Health, Vector Control Division, Kampala, Uganda; The Carter Center Uganda, Kampala, Uganda; Ministry of Health, Kampala, Uganda; Kabarole District Health Services, Kabarole, Uganda; Mbale District Health Services, Mbale, Uganda; Strengthening Decentralization Systems (SDS), Mbale, Uganda; ENVISION/Research Triangle International, Vector Control Division, Ministry of Health, Kampala, Uganda; Lytham St. Anne's, Lancashire, United Kingdom; Global Health Infectious Disease Research, College of Public Health, University of South Florida, Tampa, Florida

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Ambrose Onapa The Carter Center, Atlanta, Georgia; Ministry of Health, Vector Control Division, Kampala, Uganda; The Carter Center Uganda, Kampala, Uganda; Ministry of Health, Kampala, Uganda; Kabarole District Health Services, Kabarole, Uganda; Mbale District Health Services, Mbale, Uganda; Strengthening Decentralization Systems (SDS), Mbale, Uganda; ENVISION/Research Triangle International, Vector Control Division, Ministry of Health, Kampala, Uganda; Lytham St. Anne's, Lancashire, United Kingdom; Global Health Infectious Disease Research, College of Public Health, University of South Florida, Tampa, Florida

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Dennis W. K. Lwamafa The Carter Center, Atlanta, Georgia; Ministry of Health, Vector Control Division, Kampala, Uganda; The Carter Center Uganda, Kampala, Uganda; Ministry of Health, Kampala, Uganda; Kabarole District Health Services, Kabarole, Uganda; Mbale District Health Services, Mbale, Uganda; Strengthening Decentralization Systems (SDS), Mbale, Uganda; ENVISION/Research Triangle International, Vector Control Division, Ministry of Health, Kampala, Uganda; Lytham St. Anne's, Lancashire, United Kingdom; Global Health Infectious Disease Research, College of Public Health, University of South Florida, Tampa, Florida

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Frank Walsh The Carter Center, Atlanta, Georgia; Ministry of Health, Vector Control Division, Kampala, Uganda; The Carter Center Uganda, Kampala, Uganda; Ministry of Health, Kampala, Uganda; Kabarole District Health Services, Kabarole, Uganda; Mbale District Health Services, Mbale, Uganda; Strengthening Decentralization Systems (SDS), Mbale, Uganda; ENVISION/Research Triangle International, Vector Control Division, Ministry of Health, Kampala, Uganda; Lytham St. Anne's, Lancashire, United Kingdom; Global Health Infectious Disease Research, College of Public Health, University of South Florida, Tampa, Florida

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Thomas R. Unnasch The Carter Center, Atlanta, Georgia; Ministry of Health, Vector Control Division, Kampala, Uganda; The Carter Center Uganda, Kampala, Uganda; Ministry of Health, Kampala, Uganda; Kabarole District Health Services, Kabarole, Uganda; Mbale District Health Services, Mbale, Uganda; Strengthening Decentralization Systems (SDS), Mbale, Uganda; ENVISION/Research Triangle International, Vector Control Division, Ministry of Health, Kampala, Uganda; Lytham St. Anne's, Lancashire, United Kingdom; Global Health Infectious Disease Research, College of Public Health, University of South Florida, Tampa, Florida

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Frank O. Richards The Carter Center, Atlanta, Georgia; Ministry of Health, Vector Control Division, Kampala, Uganda; The Carter Center Uganda, Kampala, Uganda; Ministry of Health, Kampala, Uganda; Kabarole District Health Services, Kabarole, Uganda; Mbale District Health Services, Mbale, Uganda; Strengthening Decentralization Systems (SDS), Mbale, Uganda; ENVISION/Research Triangle International, Vector Control Division, Ministry of Health, Kampala, Uganda; Lytham St. Anne's, Lancashire, United Kingdom; Global Health Infectious Disease Research, College of Public Health, University of South Florida, Tampa, Florida

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The study determined that Simulium neavei-transmitted onchocerciasis in Mount Elgon onchocerciasis focus had been interrupted. Annual mass treatment with ivermectin changed to two times per year along with vector elimination in 2007. Then, baseline microfilaria (mf) prevalence data of 1994 in five sentinel communities were compared with follow-up data in 2005 and 2011. Blood spots from 3,051 children obtained in 2009 were analyzed for Onchocerca volvulus immunoglobulin G4 antibodies. Fresh water crab host captures and blackflies collected indicated their infestation with larval stages of S. neavei and presence or absence of the vector, respectively. Mf rates dropped from 62.2% to 0.5%, and 1 (0.03%) of 3,051 children was positive for O. volvulus antibodies. Crab infestation dropped from 41.9% in 2007 to 0%, and S. neavei biting reduced to zero. Both remained zero for the next 3 years, confirming interruption of onchocerciasis transmission, and interventions were halted.

Author Notes

* Address correspondence to Moses Katabarwa, The Carter Center, One Copenhill, 453 Freedom Parkway, Atlanta, GA 30307. E-mail: mkataba@emory.edu

Authors' addresses: Moses Katabarwa, The Carter Center, Atlanta, GA, E-mail: mkataba@emory.edu. Tom Lakwo and David Oguttu, Vector Control Division, Ministry of Health, Kampala, Uganda, E-mails: tlakwo@gmail.com and dguttu@gmail.com. Peace Habomugisha, Stella Agunyo, and Edson Byamukama, Health Programs, The Carter Center, Kampala, Uganda, E-mails: provia5@hotmail.com, agunyoegunyu@gmail.com, and edson.navs@gmail.com. Richard Ndyomugyenyi, Ministry of Health, Kampala, Uganda, E-mail: richardndyomugyenyi@gmail.com. Ephraim Tukesiga, Kabarole District Health Services, Fort Portal, Uganda, E-mail: ephraim.tukesiga@gmail.com. Galex Orukan Ochieng, Mbale District Health Services, Mbale, Uganda, E-mail: ochienggalex@yahoo.com. Francis Abwaimo, Health Services, Strengthening Decentralization Systems, Mbale, Uganda, E-mail: fabwaimo@gmail.com. Ambrose Onapa, RTI International, ENVISION, Kampala, Uganda, E-mail: kwibale1@yahoo.co.uk. Dennis W. K. Lwamafa, National Disease Control, Ministry of Health, Kampala, Uganda, E-mail: lwamafa@yahoo.co.uk. Frank Walsh, Entomology, Lythan St. Anne's, Lancashire, United Kingdom, E-mail: frank@walsh.me.uk. Thomas R. Unnasch, Global Health, University of South Florida, Tampa, FL, E-mail: tunnasch@health.usf.edu. Frank O. Richards, Health Programs, The Carter Center, Atlanta, GA, E-mail: frich01@emory.edu.

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