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PubMed2006

[African Program for Onchocerciasis Control (APOC): Onchocerca volvulus transmission by Simulium damnosum s. l. in two regions of the Central African Republic].

Entomological baseline data were collected in the villages of Zinga and Boali-Falls in Central African Republic (CAR) in view of the long term impact assessment of community-directed treatment with ivermectin (CDTI). Morphological determinations revealed that flies caught in both sites belong to the sub-group Sou/Sq. In Boali, the nuisance was relatively high with biting rates averaging 243 bites/man/day, with a parous rate of 61.6% and a crude annual transmission potential (ATP) of 8,259 infective larvae/man/year; and the average number of infective larvae per 1,000 parous flies was 177. In Zinga, the mean biting rate was 191 bites/man/day, with a parous rate of 51.6%, a crude ATP of 3,422, and 86 infective larvae per 1,000 porous flies. In conclusion, the vectorial capacity and the entomological indices recorded are characteristic of high onchocerciasis transmission zones. However, some of the infective larvae found, maybe of animal origin, need identification to better determine the real level of endemicity.

Animals↗
PubMed2002

Detection of Onchocerca volvulus infection in low prevalence areas: a comparison of three diagnostic methods.

The standard assay for onchocerciasis diagnosis is microscopical detection of microfilariae in skin snips. Skin snipping is painful, requires appropriate sterilization of equipment, and may fail to diagnose light infections. Two alternatives are a polymerase chain reaction (PCR) test which detects parasite DNA in pieces or scrapings of skin and a test based on allergic reactions to topical application of diethylcarbamazine (DEC). We compared these 2 diagnostics with standard skin snip microscopy in 313 individuals from 2 villages in Guinea, with low prevalence after over 10 years of control by the Onchocerciasis Control Programme. Lower and upper bounds on sensitivities and specificities of these 3 tests were estimated. In addition, these parameters were estimated using 5 different statistical models. Where prevalence was low, PCR and the DEC patch test appeared to be more sensitive than skin snipping which has low sensitivity. As the DEC test is non-invasive, simple and cheap, it may provide a good alternative to skin snipping alone for surveillance in low prevalence areas.

Adolescent↗
PubMedDate not supplied

[The effect of ivermectin on the transmission of Onchocerca volvulus in southern Mexico].

We assessed the transmission potential and the mean infected and infective biting density of S. ochraceum in an onchocerciasis endemic community in the southern Mexican state of Chiapas. In addition, the impact of first treatment of ivermectin during the peak of natural infection of host-seeking S. ochraceum populations was also evaluated. Monthly entomological sampling was carried out during the year before treatment to assess the seasonal biting behavior of parous host-seeking S. ochraceum females, and either infected (with whatever stage of O. volvulus) or infective females (with only third larval stage of O. volvulus). The mean of infective biting density was unimodal with the peak in February. Higher densities of infective females were detected from January to March. Annual infective biting density estimated was 95.2 and the annual transmission potential of 152.3. After treatment with ivermectin, entomological collections were carried out during the December-April period. In these months, the first ivermectin mass treatment produced a reduction of natural infection rates of 55 per cent in the mean infected females density (p < 0.001) and of 30 per cent in the transmission potential. However, significative differences were found in parity rates of biting females during the evaluation periods. Decrease of infection rates in vector populations was caused by immediate effect of ivermectin over the skin microfilariae. Microfilariae community load available for transmission declined significantly from 14 Dmg/mg to 5.9 Dmf/mg. These means were statistically different (p < 0.001) and were reduced by 58 per cent from the baseline value.

Animals↗
PubMed2000

Analysis of IgG isotype responses against Onchocerca volvulus antigens in children in an onchocerciasis-endemic area in northern Nigeria.

This study evaluated the usefulness of parasite-specific IgG and IgG isotype responses for diagnosing early or pre-patent onchocerciasis in children using sandwich ELISA. The children (n = 199) were aged between 5 and 12 years and living in a meso-endemic area of northern Nigeria. Only five had detectable skin microfilariae. The mean optical density (OD) values of children from the study area were significantly higher than those of normal controls' sera (n = 10, p < 0.01), except for IgG2. There were 145 (73%) children positive for total IgG, 161 (81%) for IgG1, 68 (34%) for IgG3 and 187 (94%) for IgG4 antibodies. The mean OD values of all antibodies tended to increase with age and peaked in the 9-10-year age group, except in the case of IgG3 which peaked at 11-12 years. IgG4 proved most sensitive compared with IgG, IgG1 and IgG3 in all age groups, and was significantly different (p < 0.05). Analysis by sex showed no significant difference between the boys and girls. We conclude that IgG4 serology is a useful diagnostic tool in the assay of early or pre-patent onchocerciasis in children.

Animals↗
PubMed2004

Preliminary studies on the biting activity and transmission of Onchocerca volvulus by Simulium neavei (diptera: simuliidae) in Kashoya-Kitomi focus, Western Uganda.

OBJECTIVE: To determine the biting activity and onchocerciasis transmission in Kashoya-Kitomi focus, Western Uganda. DESIGN: Cross-sectional survey in randomly selected sites. SETTING: Three districts in Western Uganda. METHOD: Crab trapping and examination for immature stages of Simulium neavei and full day human bait catches and dissections were conducted at three sites. RESULTS: A total of 338 crabs were caught and out of this 372 (95.9%) were positive with immature stages of S. neavei with mean S. neavei/crab of 6.9. High biting density of S. neavei was observed in the two sites in Kabarole and Mbarara districts whereas an extremely low density was observed at a site in Bushenyi. Diurnal biting pattern revealed two peaks in the morning (09:00-10:00 hours.) and in the late afternoon (14:00-15:00 hours.) with a mid-day lull. The infection/infective rates were 53.3/11.0%, 30.7% to 7.8% and 20.0/0% for sites in Mbarara, Kabarole and Bushenyi districts, respectively. Monthly biting rates/ Transmission potentials for Mbarara, Kabarole and Bushenyi districts were 6231/5437, 9244/2916 and 247/0. CONCLUSION: There was high transmission of onchocerciasis observed in Kashoya-Kitomi focus despite the ongoing ivermectin treatment. The need for improved chemotherapeutic coverage and instituting other control measures may be necessary.

Animals↗
PubMed1995

Onchocerciasis in Ecuador: ocular findings in Onchocerca volvulus infected individuals.

Little is known of the epidemiology and clinical picture of ocular onchocerciasis in South America. A survey of onchocercal eye disease was performed in the hyperendemic area of a rain forest focus of onchocerciasis in Esmeraldas Province in Ecuador. A total of 785 skin snip positive individuals from black and Chachi Amerindian communities were examined. The blindness rate attributable to onchocerciasis was 0.4%, and 8.2% were visually impaired. Onchocercal ocular lesions were seen in a high proportion of the study group: 33.6% had punctate keratitis, microfilariae in the anterior chamber and cornea were seen in 28.9% and 33.5% respectively, iridocyclitis was seen in 1.5%, optic atrophy in 5.1%, and chorioretinopathy in 28.0%. Sclerosing keratitis was not seen. The prevalence of all ocular lesions increased with age. Punctate keratitis was strongly associated with microfilarial counts in the cornea and chorioretinopathy was correlated with infection intensities in the cornea and anterior chamber. Chachi Amerindians had higher anterior chamber microfilarial counts and a greater prevalence of punctate keratitis than blacks though blacks had a greater prevalence of iridocyclitis and optic nerve disease. The pattern of ocular disease resembled rain forest onchocerciasis in west Africa with few severe ocular lesions in the anterior segment and all blinding lesions attributable to posterior segment disease.

Adolescent↗
PubMedDate not supplied

[Entomology of onchocercosis in Soconusco, Chiapas. 6. Quantitative studies of the transmission of Onchocerca volvulus by 3 species of Simuliidae in a community with high endemicity].

In Guatemala, there is no doubt about the participation of Simulium ochraceum as vector of Onchocerciasis. However, in Mexico practically there are not studies focussed to determine the role of this species in the transmission. The objective of the present investigation was to determine which of the 3 species of Simulium founded in the Soconusco region of Chiapas, is the main, and which were secondary in the transmission of Onchocerciasis in that area. The locality of Morelos, in the Huixtla "municipio" of Chiapas, localized a 1200 meters over the sea level (mosl) were selected to carried out the present study. According to own parasitological studies, this locality is considered as highly endemic (more than 66% prevalence). From March 1979 to March, 1981, we performed captures of Simulium sp caught on human bait. Quantitative studies and of transmission potentials were also performed. The following results were obtained: a) Absolute black flies densities (nulliparous and pariparous) and infected black flies (with L1 and L2 larvae): S. ochraceum, S. metallicum and S. callidum, in that order was the distribution of densities. Infected black flies were obtained in the 3 species. However, in despite of an irregular distribution in all the year, it was possible to identify 2 peaks of maximum infection of S. ochraceum in March, 1979 and March 1981. b) Monthly bite densities and infective bites.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

Onchocerca volvulus: in vitro cytotoxic effects of human neutrophils and serum on third-stage larvae.

The cytotoxic effects of neutrophils co-cultured with infective third-stage larvae (L3) and autologous serum from three groups of individuals: infected (INF), non-patent endemic normals (EN) and non-endemic controls (NEC), were compared using a MTT (3-(4,5 dimethylthiazol-2yl)-2,5 diphenyl tetrazolium bromide) reduction assay as a biochemical parameter of larval viability. The MTT assay permitted the detection of L3 which had suffered varying levels of necrosis. The observations from this study indicate that infected individuals and endemic normals are capable of mounting a specific immune response against the infective L3. This is based on our findings of i) significantly greater numbers of L3 showed necrosis in neutrophil cultures of the INF and EN compared to those from the NEC, ii) a superior ability of cultures from these individuals to inhibit the molting of L3 to fourth-stage larvae, iii) IgG antibodies reactive with the surface of L3, detected by immunofluorescence in the serum of the INF and the EN and iv) recognition of specific antigens in extracts of L3 detected by Western blot analysis. The specific immune response directed against L3 is probably a significant immunological defense mechanism used to limit infection in endemic areas.

Adolescent↗
PubMed1998

Prevalence of Onchocerca volvulus nodules in the Sankuru River Valley, Democratic Republic of the Congo, and reliability of verbal assessment as a method for determining prevalence.

The epidemiology of onchocerciasis in much of the Democratic Republic of the Congo (formerly Zaire) is not well established. We report the results of an onchocerciasis rapid assessment survey carried out in 18 villages of the Sankuru River Valley in the central part of this country in preparation for mass distribution of ivermectin. Thirty men from each village were randomly selected and examined for subcutaneous nodules. The prevalence of nodules among these men in each village ranged from 82.5% to 100% with a mean prevalence of 95.0%. This study also assessed the validity of using verbal assessment instead of physical examination to determine prevalence of nodules. This verbal method had a sensitivity of 93.5% and a specificity of 83.3%. High sensitivity and specificity for this method suggest that it might be a cost-effective approach to determine the prevalence of onchocerciasis over large areas without using physical examinations requiring medical personal. This approach could be particularly useful where the coverage of health services is poor. The use of the Global Positioning System made it possible to send coordinates and survey data electronically to World Health Organization personnel in Geneva for computer generation of prevalence maps. The use of river boats to conduct surveys and support ivermectin distribution in the Congo is discussed.

Adult↗
PubMed1999

Comparison of serological and parasitological assessments of Onchocerca volvulus transmission after 7 years of mass ivermectin treatment in Mexico.

OBJECTIVE AND METHOD: To compare the utility of an ELISA using 3 recombinant antigens with that of the skin biopsy to estimate incidence of infections in a sentinel cohort of individuals living in an endemic community in southern Mexico during a set of 11 subsequent ivermectin treatments. RESULTS: The apparent community prevalence of infection and microfilarial skin infection before and after 11 treatments with ivermectin plus nodulectomy were 78% and 13%, and 0.68 mf/mg and 0.04 mf/mg, respectively, as measured by skin biopsy. Of a group of 286 individuals participating in all surveys, a sentinel cohort of 42 mf and serologically negative individuals had been followed since 1994. The annual percentage of individuals becoming positive in this cohort was 24% (10/42), 28% (9/33), 0%, and 4.3% (1/23) in 1995, 1996, 1997 and 1998, respectively. Likewise, the incidence in children 5 years and under (n = 13) within this sentinel cohort was 15% (2/13), 18% (2/11), 0% and 11% (1/9), respectively. All individuals became positive to both tests simultaneously, indicating that seroconversion assessed infection incidence as accurately as skin biopsy in the sentinel group. CONCLUSION: Incidence monitoring of a sentinel cohort provides an estimation of the parasite transmission in the community; it is less costly than massive sampling, and a finger prick blood test might be more acceptable in some communities.

Adolescent↗
PubMed2002

Co-infection of Onchocerca volvulus and intestinal helminths in indigenous and migrant farmers in southwest Ethiopia.

A cross-sectional survey on onchocerciasis and intestinal helminthic infections was conducted in two villages around the town of Teppi, south-west of Ethiopia on a total of 308 subjects of which 180 indigenous and 128 migrant settlers aged 10 years and above who lived in the area for at least 5 years. Of the total study subjects, 65% were males. The majority (64%) of the study subjects were in the age range of 21-40 years. The results of stool and skin snip examinations for ova/parasite and microfilaria revealed that, 62% (190) and 81% (248) of the study subjects were positive for intestinal parasites and microfilariderma respectively. Fifty percent (154) of the total subjects in the two villages had both onchocerciasis and intestinal helminthic infections. However, 80% (94/118) of the stool negative subjects also had onchocerciasis indicating that onchocercal skin infection has no significant influence on the acquisition of intestinal helminthic infections or vice versa [(relative risk 1.04, 95% CI 0.91, 1.18) P > 0.05]. Sixty-five percent (161/248) of the total skin snip positive individuals had microfilarial load of > 10 mf/mg of skin snip. The proportion of multiple infections with 2 or more intestinal helminthes was recorded in 51% (96/190) of individuals positive for intestinal parasitosis. There was a significant (x2 = 8.41, P < 0.005) difference in the onchocerciasis infection rate among indigenous (88%) and migrant (75%). No direct association was observed between onchocerciasis and intestinal parasitosis in the two study groups (indigenous and migrant settlers). The public health significance of coexistence of the two diseases, and the need for intensive control measures are discussed.

Adolescent↗
PubMed1988

An evaluation of implanted male Onchocerca gibsoni in mice as a screen for macrofilaricides against Onchocerca volvulus.

An in vivo drug screen for identifying new compounds with activity against Onchocerca macrofilariae was developed using male Onchocerca gibsoni implanted subcutaneously in outbred mice. There were several similarities (Mel W, CGP 20376, CGP 6140, levamisole) and two differences (suramin, furapyrimidone) between levels of drug efficacy in this model and activity against natural infections of O. gibsoni and O. volvulus. There was considerable variation in the mouse reaction. This mouse model is a potentially useful primary screen for macrofilaricidal drugs against Onchocerca.

Animals↗
PubMed1987

Cell adherence to microfilariae of Onchocerca volvulus: a comparative study.

The conditions were examined for in vitro antibody-mediated adherence of granulocytes to microfilariae of Onchocera volvulus and Dirofilaria immitis. Reactivity in human sera from patients in endemic foci in Sudan was specific for O. volvulus and no reactions were observed with heterologous Onchocerca species or with Mansonella perstans. Microfilariae from skin, nodules or adult female worms were satisfactory targets for cell adherence, and the cells involved were almost exclusively eosinophils. The reaction was inhibited by indomethacin but not by nordihydroguaiaretic acid, an inhibitor of leukotriene production. Agents that slowed or stopped microfilarial motility (e.g. nifedipine, lidocaine, chloroquine) inhibited the reaction, probably by reducing target/cell contact. Ivermectin did not enhance the reaction, and in the absence of cells exerted only slight effects on the movement of microfilariae at higher concentrations (greater than 10 micrograms/ml). Antibody activity was labile, and did not persist well through freeze-thaw cycles. Some differences between homologous and heterologous mixtures (microfilariae/cells/serum) were seen but they could not be resolved satisfactorily. There were no apparent geographical differences between microfilariae from different foci in Sudan. In the D. immitis system neutrophils were the dominant cell type adhering to microfilariae, and the activity was stable to storage and freeze-thaw. No enhancement was detectable with diethylcarbamazine. Antibody activity was absorbable with microfilarial antigens and was reduced by agents that inhibited microfilarial motility. In dogs, adherence-mediating antibody was seen only in amicrofilaraemic animals with occult infection, and in only a minority of these sera. In humans the relationship to clinical findings was less clear, but patients with punctate keratitis were the most likely to have positive serum and were the most reactive in the assay. This system may therefore offer some insights into disease mechanisms in vivo, and its molecular mechanisms deserve further characterization.

Animals↗
PubMed2001

Onchocerca volvulus: genetic diversity of parasite isolates from Sudan.

Onchocerciasis in Sudan exists in three distinct foci which exhibit differing clinical presentations. Previous studies have demonstrated that a tandemly repeated Onchocerca sequence family with a unit repeat length of 150 bp (the O-150 family) is a useful marker for deducing relationships among different O. volvulus populations. In the current study, the O-150 repeat families of O. volvulus from Sudan were analyzed and compared to each other and to those of parasites from West Africa. Similar to West African and American O. volvulus, the O-150 families of the Sudanese parasites could be divided into clusters within which little or no intracluster variation was evident, suggesting that the O-150 family in these parasites was subject to the forces of concerted evolution. Statistical analysis of the O-150 families from the different Sudanese parasite isolates, employing a nested algorithm based on an analysis of variance, revealed that O. volvulus endemic to the northern focus at Abu Hamed were significantly different from all other O. volvulus populations examined to date. In contrast, parasites from the southern and eastern foci of Sudan were indistinguishable from those endemic to the West African savanna. The significance of these data are discussed in light of knowledge of the biogeography and biology of transmission of O. volvulus in Africa.

Africa, Western↗