1921
Volume 102, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

Plateau and Nasarawa states in central Nigeria were endemic for onchocerciasis. The rural populations of these two states received annual ivermectin mass drug administration (MDA) for a period of 8–26 years (1992–2017). Ivermectin combined with albendazole was given for 8–13 of these years for lymphatic filariasis (LF); the LF MDA program successfully concluded in 2012, but ivermectin MDA continued in areas known to have a baseline meso-/hyperendemic onchocerciasis. In 2017, serological and entomological assessments were undertaken to determine if MDA for onchocerciasis could be stopped in accordance with the current WHO guidelines. Surveys were conducted in 39 sites that included testing 5- to < 10-year-old resident children by using ELISA for OV16 IgG4 antibodies, and O150 pooled polymerase chain reaction (PCR) testing of s.l. vector heads. Only two of 6,262 children were OV16 positive, and none of 19,056 vector heads were positive for parasite DNA. Therefore, both states were able to meet WHO stop-MDA thresholds of an infection rate in children of < 0.1% and a rate of infective blackflies of <1/2,000, with 95% statistical confidence. Transmission of onchocerciasis was declared interrupted in Plateau and Nasarawa states by the Federal Ministry of Health, and 2.2 million ivermectin treatments/year were stopped in 2018. Post-treatment Surveillance was launched focusing on entomological monitoring on borders with neighboring onchocerciasis-endemic states. An apparent positive impact of the LF MDA program on eliminating hypo-endemic onchocerciasis was observed. This is the first stop-MDA decision for onchocerciasis in Nigeria and the largest single stop-MDA decision for onchocerciasis yet reported. This achievement, along with the process used in adapting and implementing the 2016 WHO stop-MDA guidelines, will be important as a potential model for decision makers and national onchocerciasis elimination committees in other African countries that are charged with advancing their programs.

[open-access] This is an open-access article distributed under the terms of the Creative Commons Attribution (CC-BY) License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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References

  1. WHO, 1995. Onchocerciasis and its control. Report of a WHO expert committee on onchocerciasis control. World Health Organ Tech Rep Ser 852: 1104.
    [Google Scholar]
  2. Boatin BA, Richards FO Jr., 2006. Control of onchocerciasis. Adv Parasitol 61: 349394.
    [Google Scholar]
  3. Richards FO, Miri E, Meredith S, Guderian R, Sauerbrey M, Remme H, Packard R, Ndiaye JM, 1998. Onchocerciasis. Bull World Health Organ 76 (Suppl 2): 147149.
    [Google Scholar]
  4. WHO, 2006. Preventive Chemotherapy in Human Helminthiasis. Coordinated Use of Anthelminthic Drugs in Control Interventions: a Manual for Health Professionals and Programme Managers. Geneva, Switzerland: World Health Organization.
    [Google Scholar]
  5. Basañez 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.
    [Google Scholar]
  6. Plaisier AP, van Oortmarssen GJ, Habbema JD, Remme J, Alley ES, 1990. ONCHOSIM: a model and computer simulation program for the transmission and control of onchocerciasis. Comput Methods Programs Biomed 31: 4356.
    [Google Scholar]
  7. Richards F Jr., Gonzales-Peralta C, Jallah E, Miri E, 1996. Community-based ivermectin distributors: onchocerciasis control at the village level in Plateau State, Nigeria. Acta Trop 61: 137144.
    [Google Scholar]
  8. 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.
    [Google Scholar]
  9. Miri ES, 1998. Problems and perspectives of managing an onchocerciasis control programme: a case study from Plateau state, Nigeria. Ann Trop Med Parasitol 92 (Suppl 1): S121S128.
    [Google Scholar]
  10. Gemade EI, Jiya JY, Nwoke BE, Ogunba EO, Edeghere H, Akoh JI, Omojola A, 1998. Human onchocerciasis: current assessment of the disease burden in Nigeria by rapid epidemiological mapping. Ann Trop Med Parasitol 92 (Suppl 1): S79S83.
    [Google Scholar]
  11. Hopkins DR et al., 2002. Lymphatic filariasis elimination and schistosomiasis control in combination with onchocerciasis control in Nigeria. Am J Trop Med Hyg 67: 266272.
    [Google Scholar]
  12. Richards FO et al., 2011. Epidemiological and entomological evaluations after six years or more of mass drug administration for lymphatic filariasis elimination in Nigeria. PLoS Negl Trop Dis 5: e1346.
    [Google Scholar]
  13. King JD, Eigege A, Umaru J, Jip N, Miri E, Jiya J, Alphonsus KM, Sambo Y, Graves P, Richards F Jr., 2012. Evidence for stopping mass drug administration for lymphatic filariasis in some, but not all local government areas of Plateau and Nasarawa States, Nigeria. Am J Trop Med Hyg 87: 272280.
    [Google Scholar]
  14. Eigege A et al., 2017. Criteria to stop mass drug administration for lymphatic filariasis have been achieved throughout Plateau and Nasarawa states, Nigeria. Am J Trop Med Hyg 97: 677680.
    [Google Scholar]
  15. Eigege A et al., 2013. Long-lasting insecticidal nets are synergistic with mass drug administration for interruption of lymphatic filariasis transmission in Nigeria. PLoS Negl Trop Dis 7: e2508.
    [Google Scholar]
  16. WHO, 2001. Certification of Elimination of Human Onchocerciasis: Criteria and Procedures. Geneva, Switzerland: World Health Organization.
    [Google Scholar]
  17. WHO, 2016. Guidelines for Stopping Mass Drug Administration and Verifying Elimination of Human Onchocerciasis: Criteria and Procedures. Geneva, Switzerland: World Health Organization.
    [Google Scholar]
  18. APOC, 2013. The World Health Organization Year 2013 progress report, 1st September 2012 – 31st August 2013. Ouagadougou, Burkina Faso: JAF, 62.
    [Google Scholar]
  19. APOC, WHO, 2010. Conceptual and operational framework of onchocerciasis elimination with ivermectin treatment. Joint Action Forum. Ouagadougou, Burkina Faso: African Programme for Onchocerciasis Control. Geneva, Switzerland: World Health Organization.
    [Google Scholar]
  20. Griswold E et al., 2018. The role of national committees in eliminating onchocerciasis. Int Health 10: i60i70.
    [Google Scholar]
  21. Rodriguez-Perez MA, Garza-Hernandez JA, Salinas-Carmona MC, Fernandez-Salas I, Reyes-Villanueva F, Real-Najarro O, Cupp EW, Unnasch TR, 2017. The Esperanza window trap reduces the human biting rate of Simulium ochraceum s.l. in formerly onchocerciasis endemic foci in southern Mexico. PLoS Negl Trop Dis 11: e0005686.
    [Google Scholar]
  22. Richards FO et al., 2018. Operational performance of the Onchocerca volvulus “OEPA” Ov16 ELISA serological assay in mapping, stop mass drug administration, and posttreatment surveillance surveys. Am J Trop Med Hyg 99: 749752.
    [Google Scholar]
  23. Loum D, Katholi CR, Lakwo T, Habomugisha P, Tukahebwa EM, Unnasch TR, 2017. Evaluation of community-directed operation of black fly traps for entomological surveillance of Onchocerca volvulus transmission in the madi-mid north focus of onchocerciasis in northern Uganda. Am J Trop Med Hyg 97: 12351242.
    [Google Scholar]
  24. Gopal H, Hassan HK, Rodriguez-Perez MA, Toe LD, Lustigman S, Unnasch TR, 2012. Oligonucleotide based magnetic bead capture of Onchocerca volvulus DNA for PCR pool screening of vector black flies. PLoS Negl Trop Dis 6: e1712.
    [Google Scholar]
  25. Rodriguez-Perez MA, Lilley BG, Dominguez-Vazquez A, Segura-Arenas R, Lizarazo-Ortega C, Mendoza-Herrera A, Reyes-Villanueva F, Unnasch TR, 2004. Polymerase chain reaction monitoring of transmission of Onchocerca volvulus in two endemic states in Mexico. Am J Trop Med Hyg 70: 3845.
    [Google Scholar]
  26. Oguttu D et al., 2014. Serosurveillance to monitor onchocerciasis elimination: the Ugandan experience. Am J Trop Med Hyg 90: 339345.
    [Google Scholar]
  27. 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.
    [Google Scholar]
  28. Kelly-Hope LA, Unnasch TR, Stanton MC, Molyneux DH, 2015. Hypo-endemic onchocerciasis hotspots: defining areas of high risk through micro-mapping and environmental delineation. Infect Dis Poverty 4: 36.
    [Google Scholar]
  29. Coffeng LE et al., 2013. African Programme for Onchocerciasis Control 1995–2015: model-estimated health impact and cost. PLoS Negl Trop Dis 7: e2032.
    [Google Scholar]
  30. 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.
    [Google Scholar]
  31. Boakye D et al., 2018. Refocusing vector assessment towards the elimination of onchocerciasis from Africa: a review of the current status in selected countries. Int Health 10: i27i32.
    [Google Scholar]
  32. Program Coordinating Committee and OEPA staff, 2012. Guide to detecting a potential recrudescence of onchocerciasis during the posttreatment surveillance period: the American paradigm. Res Rep Trop Med 3: 2133.
    [Google Scholar]
  33. Winnen M, Plaisier AP, Alley ES, Nagelkerke NJ, van Oortmarssen G, Boatin BA, Habbema JD, 2002. Can ivermectin mass treatments eliminate onchocerciasis in Africa? Bull World Health Organ 80: 384391.
    [Google Scholar]
  34. 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.
    [Google Scholar]
  35. Stolk WA, Walker M, Coffeng LE, Basanez MG, de Vlas SJ, 2015. Required duration of mass ivermectin treatment for onchocerciasis elimination in Africa: a comparative modelling analysis. Parasit Vectors 8: 552.
    [Google Scholar]
  36. WHO, 2017. 681 Progress report on the elimination of human onchocerciasis, 2016–2017. Wkly Epidemiol Rec 92: 681694.
    [Google Scholar]
  37. Gass KM, 2018. Rethinking the serological threshold for onchocerciasis elimination. PLoS Negl Trop Dis 12: e0006249.
    [Google Scholar]
  38. 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.
    [Google Scholar]
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  • Received : 02 Aug 2019
  • Accepted : 30 Sep 2019
  • Published online : 10 Feb 2020

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