Evaluation of Onchocerciasis Transmission in Tanzania: Preliminary Rapid Field Results in the Tukuyu Focus, 2015

Heather N. Paulin Centers for Disease Control and Prevention, Atlanta, Georgia;

Search for other papers by Heather N. Paulin in
Current site
Google Scholar
PubMed
Close
,
Andreas Nshala Neglected Tropical Diseases Control Program, Dar es Salaam, Tanzania;

Search for other papers by Andreas Nshala in
Current site
Google Scholar
PubMed
Close
,
Akili Kalinga National Institute of Medical Research, Tukuyu Medical Research Centre, Tukuyu, Tanzania;

Search for other papers by Akili Kalinga in
Current site
Google Scholar
PubMed
Close
,
Upendo Mwingira Neglected Tropical Diseases Control Program, Dar es Salaam, Tanzania;
National Institute of Medical Research, Neglected Tropical Diseases Control Program, Dar es Salaam, Tanzania

Search for other papers by Upendo Mwingira in
Current site
Google Scholar
PubMed
Close
,
Ryan Wiegand Centers for Disease Control and Prevention, Atlanta, Georgia;

Search for other papers by Ryan Wiegand in
Current site
Google Scholar
PubMed
Close
,
Vitaliano Cama Centers for Disease Control and Prevention, Atlanta, Georgia;

Search for other papers by Vitaliano Cama in
Current site
Google Scholar
PubMed
Close
, and
Paul T. Cantey Centers for Disease Control and Prevention, Atlanta, Georgia;

Search for other papers by Paul T. Cantey in
Current site
Google Scholar
PubMed
Close
Restricted access

To compare diagnostic tests for onchocerciasis in a setting that has suppressed transmission, a randomized, age-stratified study was implemented in an area in Tanzania that had received 15 rounds of annual mass drug administration (MDA) with ivermectin. Study participants (N = 948) from 11 villages underwent a questionnaire, skin examination, skin snips, and blood draw. The burden of symptomatic disease was low. Ov-16 antibody rapid diagnostic test (RDT) results were positive in 38 (5.5%) participants, with 1 (0.5%), 1 (0.4%), and 2 (0.8%) in children aged 0–5, 6–10, and 11–15 years, respectively. Despite significant impact of MDA on transmission, the area would have failed to meet World Health Organization serologic criteria for stopping MDA if a full evaluation had been conducted. The specificity of the RDT, which is 97–98%, may result in the identification of a number of false positives that would exceed the current stop MDA threshold.

Author Notes

Address correspondence to Paul T. Cantey, Department of Control of Neglected Tropical Diseases, World Health Organization, Avenue Appia 20, 1211 Geneva, Switzerland. E-mail: canteyp@who.int

Authors’ addresses: Heather N. Paulin, Ryan Wiegand, and Vitaliano Cama, Centers for Disease Control and Prevention, Parasitic Diseases Branch, Atlanta, GA, E-mails: ydi2@cdc.gov, fwk2@cdc.gov, and vec5@cdc.gov. Andreas Nshala, Neglected Tropical Diseases Control Program, Dar es Salaam, Tanzania, E-mail: andreas.nshala@gmail.com. Akili Kalinga, National Institute of Medical Research, Tukuyu Medical Research Centre, Tukuyu, Tanzania, E-mail: kalingaaka@yahoo.com. Upendo Mwingira, National Institute of Medical Research, Neglected Tropical Diseases Control Program, Dar es Salaam, Tanzania, E-mail: umwingira@yahoo.com. Paul T. Cantey, Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland, E-mail: canteyp@who.int.

  • 1.

    WHO, 2010. Working to Overcome the Global Impact of Neglected Tropical Diseases: First WHO Report on Neglected Tropical Diseases. Geneva, Switzerland: World Health Organization.

    • PubMed
    • Export Citation
  • 2.

    WHO, 2016. Progress report on the elimination of human onchocerciasis, 2015–2016. Wkly Epidemiol Rec 91: 505514.

  • 3.

    Tamarozzi F, Halliday A, Gentil K, Hoerauf A, Pearlman E, Taylor MJ, 2011. Onchocerciasis: the role of Wolbachia bacterial endosymbionts in parasite biology, disease pathogenesis, and treatment. Clin Microbiol Rev 24: 459468.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Basanez MG, Pion SD, Boakes E, Filipe JA, Churcher TS, Boussinesq M, 2008. Effect of single-dose ivermectin on Onchocerca volvulus: a systematic review and meta-analysis. Lancet Infect Dis 8: 310322.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Lindblade KA, et al., 2007. Elimination of Onchocerca volvulus transmission in the Santa Rosa focus of Guatemala. Am J Trop Med Hyg 77: 334341.

  • 6.

    WHO, 2009. Onchocerciasis: elimination is feasible. Wkly Epidemiol Rec 84: 382383.

  • 7.

    Diawara L, et al., 2009. Feasibility of onchocerciasis elimination with ivermectin treatment in endemic foci in Africa: first evidence from studies in Mali and Senegal. PLoS Negl Trop Dis 3: e497.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Katabarwa MN, et al., 2012. Transmission of onchocerciasis in Wadelai focus of northwestern Uganda has been interrupted and the disease eliminated. J Parasitol Res 2012: 748540.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Tekle AH, Elhassan E, Isiyaku S, Amazigo UV, Bush S, Noma M, Cousens S, Abiose A, Remme JH, 2012. Impact of long-term treatment of onchocerciasis with ivermectin in Kaduna State, Nigeria: first evidence of the potential for elimination in the operational area of the African Programme for Onchocerciasis Control. Parasit Vectors 5: 28.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Traore MO, et al., 2012. Proof-of-principle of onchocerciasis elimination with ivermectin treatment in endemic foci in Africa: final results of a study in Mali and Senegal. PLoS Negl Trop Dis 6: e1825.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Thiele EA, Cama VA, Lakwo T, Mekasha S, Abanyie F, Sleshi M, Kebede A, Cantey PT, 2016. Detection of Onchocerca volvulus in skin snips by microscopy and real-time polymerase chain reaction: implications for monitoring and evaluation activities. Am J Trop Med Hyg 94: 906911.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    WHO, 2016. Guidelines for Stopping Mass Drug Administration and Verifying Elimination of Human Onchocerciasis: Criteria and Procedures. Geneva, Switzerland: WHO.

    • PubMed
    • Export Citation
  • 13.

    Binder DA, 1983. On the variances of asymptotically normal estimators from complex surveys. Int Stat Rev 51: 279292.

  • 14.

    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: 17961799.

  • 15.

    Evans DS, et al., 2014. Status of Onchocerciasis transmission after more than a decade of mass drug administration for onchocerciasis and lymphatic filariasis elimination in central Nigeria: challenges in coordinating the stop MDA decision. PLoS Negl Trop Dis 8: e3113.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Lobos E, Weiss N, Karam M, Taylor HR, Ottesen EA, Nutman TB, 1991. An immunogenic Onchocerca volvulus antigen: a specific and early marker of infection. Science 251: 16031605.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Golden A, et al., 2013. Extended result reading window in lateral flow tests detecting exposure to Onchocerca volvulus: a new technology to improve epidemiological surveillance tools. PLoS One 8: e69231.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Steel C, Golden A, Stevens E, Yokobe L, Domingo GJ, de los Santos T, Nutman TB, 2015. Rapid point-of-contact tool for mapping and integrated surveillance of Wuchereria bancrofti and Onchocerca volvulus infection. Clin Vaccine Immunol 22: 896901.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Lont YL, Coffeng LE, de Vlas SJ, Golden A, de Los Santos T, Domingo GJ, Stolk WA, 2017. Modelling anti-Ov16 IgG4 antibody prevalence as an indicator for evaluation and decision making in Onchocerciasis Elimination Programmes. PLoS Negl Trop Dis 11: e0005314.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    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: 216221.

    • PubMed
    • Search Google Scholar
    • Export Citation
Past two years Past Year Past 30 Days
Abstract Views 619 538 19
Full Text Views 321 6 0
PDF Downloads 115 6 0
 
 
 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save