Ivermectin treatment response in two rural villages with a high prevalence of onchocerciasis and epilepsy, Mahenge Tanzania

Background: Despite 20 years of ivermectin mass distribution in the Mahenge area, Tanzania, the prevalence of onchocerciasis and epilepsy has remained high in rural villages. Objectives: We investigated the efficacy of ivermectin in reducing Onchocerca volvulus microfilariae and predictors for parasitic load following ivermectin treatment in persons with (PWE) and without epilepsy (PWOE). Methods: Between April and September 2019, 50 PWE and 160 randomly selected PWOE from Msogezi and Mdindo villages participated in a follow-up study. Skin snips were obtained pre (baseline) and three months post-ivermectin treatment. Results: The overall prevalence of O. volvulus positive skin snips at baseline was 49% (103/210), with no significant difference between PWE (58.0%) and PWOE (46.3%); p=0.197. The overall mean micro filarial density was significantly higher at baseline 1.45(95%CI:0.98-2.04)) than three-month post-ivermectin treatment (0.23(95%CI:0.11-0.37), p<0.001. Three months after ivermectin, the micro filarial density had decreased by ≥80% in 54 (81.8%, 95%CI: 72.3-91.4) of the 66 individuals with positive skin snips at baseline. High micro filarial density at baseline was the only significant predictor associated with higher micro filarial density in the post-ivermectin skin snips. Conclusion: Our study reports a decrease in micro filarial density following ivermectin treatment in most individuals. Optimizing ivermectin coverage will address the ongoing onchocerciasis transmission in Mahenge

Infectivity of Simulium damnosum s.l. and therapeutic coverage of ivermectin distribution 10 years post treatment around Owena Dam, Ondo state, Nigeria

ABSTRACT Background: Studies related to infectivity status of insect vectors are seen as necessities in understanding the epidemiology of vector-borne diseases and planning effective control measures. This study assessed the infectivity ofSimulium damnosum s.l. around Owena River as well as evaluated therapeutic coverage of Ivermectin distribution in the area. Method: Human landing sampling method was used to collect adult flies on human attractants from 07:00 to 18:00 for two consecutive days a month for three months (July 2016 - September 2016). Parity assessment was conducted to determine the age of fly populations. Parous flies were further dissected to detect the presence or absence ofOnchocerca larvae. Biting rates and transmission potentials were calculated using standard methods. A quantitative survey was carried out to determine the therapeutic coverage and compliance to ivermectin treatment for the control of Onchocerciasis in the study area using standard household coverage questionnaires. Results: A total of 914 adult female flies were collected during the study period. The daily biting rate (DBR) varied from 146 fly per man day (FMD) in July to 162.5 FMD in August. The monthly biting rate (MBR) was lowest in September (2170 bites per man per month) but highest in August (3358.3 bites per man per month). MBD ranged from 13.23 fly per man hour (FMH) in July to 14.77 FMH in August. The results indicated that the majority of the flies collected at the sampling points were nulliparous [685 (74.95%)] while others were parous [229 (25.05%)]. The biting activity of the flies showed a marked decrease in population in August compared to July which later increased in September. Infection rates varied from 2 (0.7%) in July to 7 (2.2%) in August while the infectivity rate during the study ranged from zero (July and September) to 3 (1.0%) in August. Conclusion: Despite the years of treatment of onchocerciasis in Owena community, there were still some infective flies capable of transmitting O. volvolus. This could be due to the low rate of therapeutic coverage as a result of non-compliance in the community for various reasons earlier stated.

Protocolo del Sistema Nacional de Vigilancia Epidemiológica: enfermedades vectoriales de origen parasitario. No. 04 / Protocol of the National Epidemiological Surveillance System: vector diseases of parasitic origin. No. 04

Estos protocolos están dirigido a personal médico, paramédico y otros profesionales que realizan acciones gerenciales y operativas de vigilancia epidemiológica en los servicios de salud del país, y están divididos en varios tomos para dar a conocer y actualizar la identificación y medidas de control para diversos padecimientos a fin de continuar con el mejoramiento de las capacidades técnicas de los trabajadores de salud, que permita planificar la prestación de servicios con decisiones partiendo de un enfoque epidemiológico comprobado, para responder a los cambios de tendencias epidemiológicas y con ello contribuir al fortalecimiento de prácticas asertivas de la salud pública de nuestro país.

Genoma mitocondrial de Simulium spp. e Onchocerca volvulus na Amazônia brasileira / Mitochondrial genome of Simulium spp. and Onchocerca volvulus in the Brazilian Amazon

As espécies de simulídeos são vetores de filárias, como as do gênero Onchocerca e Mansonella, que são os agentes etiológicos da oncocercose e mansonellose, respectivamente. Essas duas filárias ocorrem na região Amazônica brasileira e são transmitidas pelas seguintes espécies de vetores: Simulium incrustatum, S. limbatum, S. oyapockense, S. exiguum, S. guianense, e S. roraimense. As espécies de Simulium tem sido designada com base em caracteres morfológicos, os quais, em alguns casos, não são bem discriminativos. Recentemente, o gene mitocondrial Citocromo c-oxidase 1 (CO1) e a região nuclear Internal Transcribed Spacer (ITS) tem sido utilizados para descriminar espécies e definir populações dentro deste gênero. Entretanto, existe um grande gap acerca da informação genética de Simulium, o qual é considerado a linha de base para estudos ecológicos e populacionais. Considerando este cenário, nosso objetivo foi aplicar a metagenômica para recuperar genomas mitocondriais de amostras brasileiras S. incrustatum e S. oyapockense do foco de oncocercose e também a informação genética a respeito de seus microbiomas. O DNA total de dez simulídeos, morfologicamente identificados como S. incrustatum (3) e S. oyapockense (7) foram sequenciados randomicamente na plataforma Illumina HiSeq 2500. Nós recuperamos dez genomas mitocondriais com cobertura média de 15,591 bp e conteúdo médio de GC de 22,94 %, apresentando o mesmo conteúdo gênico e em sintenia. Baseado nestes mitogenomas, no gene mitocondrial CO1, e também na região nuclear (ITS), realizamos análises filogenéticas que mostraram a presença de três espécies conhecidas dentre as amostras: S. incrustatum, S. oyapockense e S. guianense, e também um grupo de amostras pertencentes à Simulium spp. Nós também recuperamos um genoma mitocondrial de Onchocerca volvulus da amostra aqui identificada como S. guianense.

Análises taxonômicas do microbioma dos simulídeos revelaram Proteobacteria e Ascomycota como os filos mais abundantes. A análise funcional revelou que a família de enzimas das Transcriptases Reversas são as mais abundantes. Portanto, nós contribuímos com informação genética original preenchendo parte do viés a respeito das espécies de Simulium associadas ao foco brasileiro de oncocercose. (AU)

Litomosoides silvai (Nematoda: Onchocercidae) parasitizing Akodon montensis (Rodentia: Cricetidae) in the southern region of Brazil / Litomosoides silvai (Nematoda: Onchocercidae) parasitando Akodon montensis (Rodentia: Cricetidae) na região Sul do Brasil

Abstract In the present study, Litomosoides silvai parasitizing Akodon montensis in the southern region of Brazil is reported for the first time. New morphological information is provided for some structures of this nematode species, such as a flattened cephalic extremity, presence of two dorsal cephalic papillae, female tail with a constriction at its tip, "s" shaped vagina, spicules characteristic of the carinii species group and microfilaria tail constricted at the tip. This nematode was found parasitizing the thoracic cavity with a prevalence of 10% (2/20), mean intensity of 4 (6/2), mean abundance of 0.4 (8/20) and range of infection of 2-6 specimens per host, in southern Brazil. This occurrence of L. silvai in A. montensis is a new geographical record for southern Brazil, in the Upper Paraná Atlantic Forest ecoregion of the northwestern region of Rio Grande do Sul, which is part of the Atlantic Forest biome.

Resumo No presente estudo é relatado pela primeira vez Litomosoides silvai parasitando Akodon montensis coletados na região Sul do Brasil. Foram fornecidas novas informações morfológicas para algumas estruturas desta espécie de nematódeo, tais como extremidade cefálica achatada, a presença de duas papilas cefálicas dorsais, cauda das fêmeas com uma constrição na ponta da cauda, vagina em forma de "s", espículas de característica do grupo de espécies de carinii e cauda da microfilária com constrição na ponta. Este nematódeo parasitava a cavidade torácica com uma prevalência de 10% (2/20), intensidade média de 4 (8/2) e abundância média de 0,4 (8/20), e intervalo de infecção de 2-6 espécimes por hospedeiro no Sul do Brasil. A ocorrência de L. silvai em A. montensis é um novo registro geográfico, no sul do Brasil, a noroeste do estado do Rio Grande do Sul, na ecorregião da Mata Atlântica do Alto Paraná, parte do bioma da Mata Atlântica.

Knowledge, attitudes, and practices toward onchocerciasis among local population in Bioko Island, Equatorial Guinea

Introduction: Since 1998, the African program for onchocerciasis control has been working with ultimate goal of reducing the public health impact associated with onchocerciasis in Equatorial Guinea. Although dedicated community engagement is crucial for the success of this program, there is no information on the levels of community's knowledge, attitude, and practice (KAP) toward onchocerciasis in this country. Methods: A cross-sectional study was carried out in Bioko Island from mid-January to mid-February 2014. Sampling was carried out by multistage cluster survey. Sociodemographic characteristics, KAP, and stigma-related questions were collected through a pretested questionnaire. A bivariate analysis was performed and results were adjusted by sex and age using logistic regression. Results: A total of 140 housekeepers or head of households agreed to participate. Around 54% of the interviewees had heard about the disease, of which more than one-third identified the disease as filariasis (28/68, 41.2%). Overall, 19.3% respondents highlighted the bite of a blackfly as the main mode of transmission. From those who had a familiar affected by onchocerciasis in the past, 21 out of 32 (65.6%) pointed ivermectin as the preferred treatment and 43.8% pointed out the health center as the first choice place to seek for treatment. About 67.1% of individuals believed that having onchocerciasis would not cause any contact avoidance with other members in the community. Conclusions: People's practices toward onchocerciasis tend to be better than disease knowledge in Bioko Island. Increasing awareness through community-based campaigns and educational activities is encouraged in the current onchocerciasis preelimination stage at Bioko Island

Presencia y distribución espacial de Simulium sp. (Díptera: Simuliidae) en dos provincias de Angola / Presence and spatial distribution of Simuliumsp.(Diptera: Simuliidae) in two provinces of Angola

En el oeste de África los miembros del complejo Simulium damnosum son los vectores de la oncocercosis. El objetivo es obtener datos sobre la presencia y distribución de simúlidos en dos provincias de Angola. El trabajo se realizó en las provincias de Huambo y Bié donde se muestrearon 24 cuerpos de agua entre julio y agosto, 2015. Todos los sitios se localizaron por encima de una altitud de 1 000 m y solo tres resultaron negativos a la presencia de simúlidos. Estos resultados constituyen los primeros que se obtienen sobre la presencia y distribución espacial de Simulium sp. en Angola de gran importancia, pues la superposición de los mapas de distribución de la infección humana y los vectores permiten localizar áreas con peligro de transmisión(AU)

In West Africa Simuliumdamnosum complex members are the main vectors of onchocerciasis. The objective of this paper was to collect data on the presence and spatial distribution of black flies in two provinces of Angola. The research work was conducted in Huambo and Bié provinces where 24 water bodies were sampled between July and August 2015. All the studied sites were located above 1 000 m of altitude and only three of them were found to be negative for the presence of black flies. These were the first results obtained on the presence and spatial distribution of Simulium sp. in Angola and are of great importance because overlapping the distribution maps of human infection and of vectors allows finding the areas at risk of transmission(AU)

Oncocercosis: de lo básico a lo clínico / Onchocerciasis: From basics to clinical / Oncocercose: do básico ao clínico

La oncocercosis es una de las enfermedades tropicales desatendidas, producida por el nemátodo filárico Onchocerca volvulus y transmitida por la picadura de la mosca negra del género Simulium. Es considerada la segunda causa mundial de ceguera prevenible y está presente en 35 naciones de tres continentes: África, América y Asia. Existen tres países declarados libres de oncocercosis: Colombia, Ecuador y México. Las principales manifestaciones clínicas son dermatológicas y oculares; sin embargo, también se han descrito alteraciones linfáticas y neurológicas. El diagnóstico se realiza por identificación de microfilarias en biopsia de piel o esclerocorneal, nodulectomía para buscar gusanos adultos o con lámpara de hendidura y observar el parásito en el ojo. Existe tratamiento farmacológico con ivermectina o quirúrgico con extracción directa de los nemátodos adultos de los oncocercomas. Los programas mundiales se basan en control vectorial y farmacoterapia. Con los conocimientos actuales y esfuerzos mundiales, la oncocercosis continúa siendo un grave problema de salud pública y causa de discapacidad. Por estas razones, se hace necesario una actualización en el tema.

Onchocerciasis is one of the neglected tropical diseases; it is produced by the filarial nematode Onchocerca volvulus and is transmitted through the bites of infected black flies of the Simulium genus. It is considered the second leading cause of preventable blindness and is present in 35 countries on three continents: Africa, America, and Asia. The following three countries have been declared free from onchocerciasis: Colombia, Ecuador, and Mexico. The main clinical manifestations are dermatological and ocular; however, lymphatic and neurological alterations have also been described. Diagnosis is made by identification of microfilariae in skin or sclerocorneal biopsy, by nodulectomy in search of adult worms, or by using a slit lamp to observe the parasite in the eye. There is pharmacological treatment through the use of ivermectin or surgical treatment by direct removal of adult nematodes from the onchocercomas. World programs are based on vector control and drug therapy. Despite current knowledge and global efforts, onchocerciasis remains a serious public health issue and an important cause of disability. Thus, an update on the topic is warranted.

A oncocercose é uma das doenças tropicais desatendidas, produzida pelo nemátodo filárico Onchocerca volvulus e transmitida pela picada da mosca negra do gênero Simulium. É considerada a segunda causa mundial de cegueira evitáveis e está presente em 35 nações de três continentes: África, América e Ásia. Existem três países declarados livres de oncocercose: Colômbia, Equador e México. As principais manifestações clínicas são dermatológicas e oculares; apesar disso, também se há descrito alterações linfáticas e neurológicas. O diagnóstico se realiza por identificação de microfilárias em biopsia da pele ou esclerocorneano, nodulectomia para buscar larva adultas ou com lâmpada de fenda e observar o parasita no olho. Existe tratamento farmacológico com ivermectina ou cirúrgico com extração direta dos nemátodos adultos dos oncocercomas. Os programas mundiais se baseiam no controle vectorial e farmacoterapia. Com os conhecimentos atuais e esforços mundiais, a oncocercose continua sendo um grave problema de saúde pública e causa de deficiência. Por estas razões, se faz necessário uma atualização no assunto.

Parasitosis intestinales en Altragracia de la Montaña, Estado Miranda, Venezuela: Influencia del programa para la eliminación de oncocercosis / Intestinal parasites in Altragracia de la Montaña, Miranda State, Venezuela: Influence of the program for onchocerciasis elimination

El objetivo general de este trabajo fue determinar la prevalencia de parasitosis intestinales y sus características epidemiológicas en cuatro comunidades de la parroquia Altagracia de la Montaña, Estado Miranda (Venezuela). Se desarrolló un estudio de corte transversal con una muestra constituida por 492 en su mayoría niños, en febrero de 2011. Previo consentimiento informado, se realizó una encuesta clínico-epidemiológica, extracción de sangre y exámenes coproparasitológicos con los métodos directo, Kato y cultivo en agar. El 60% de la población tenía al menos un parásito de transmisión hídrica y/o alimentos contaminados por heces de humanos y/o animales. La elevada frecuencia de protozoarios intestinales, especialmente Blastocystis sp., con predominio entre quienes viven con fallas en la disposición de excretas y baja calidad del agua para consumo humano, demuestran la persistencia de parasitosis intestinales como problema de salud pública; sin embargo, la influencia indirecta de la administración semestral de ivermectina y educación sanitaria con visión etnográfica impartida por el Programa para la Eliminación de Oncocercosis en Bucarito, una de las comunidades evaluadas, tuvo como efecto colateral no sólo disminuir la prevalencia de helmintos intestinales, sino de los protozoarios, a pesar de estar sometida a los mismos factores de riesgo que las comunidades restantes.

The aim of this study was to determine the prevalence of intestinal parasites and their epidemiological characteristics in four rural communities from Altagracia de la Montaña, Miranda State (Venezuela). A cross sectional study was conducted in February 2011 where 492 subjects were evaluated, mostly children. Informed consent was previously obtained. A clinical and epidemiological survey was done. Patients voluntarily brought a fresh stool sample for analysis with direct smear, Kato and agar culture; blood was extracted for eosinophil count. 60% of the evaluated people had at least one parasite transmitted by water or food contaminated by human or animal feces. The high prevalence of protozoa, specially Blastocystis sp., among those who live under poor living conditions such as inadequate feces disposal and low quality of drinking water, shows the persistence of intestinal parasites as a public health problem; nevertheless, indirect influence of ivermectin treatment every six months and health education with an ethnographic orientation given by the Onchocerciasis Elimination Programme in Bucarito, one of the evaluated communities, had an unexpected outcome not only diminishing the prevalence of helminthes but also the prevalence of intestinal protozoa, being this community under the same risk factors as the rest of the evaluated communities.

Distribution and utilisation of Ivermectin [MECTIZAN]: a chemotherapeutic approach to the control of onchocer-ciasis in old Ohaozara Lga, Ebonyi State, Eastern Nigeria

Onchocerciasis [river blindness] is a devastating, debilitating Stigmatising and incapacitating parasitic disease that is endemic in tropical and sub-tropical regions of the world, including Nigeria. Mass distribution of ivermectin [Mectizan] to the endemic parts of the world was initiated by the Onchocerciasis Control Programmes [OCPs]. Absolute compliance to the regimen for up to 15 years has been reported to be effective in the control of the disease. The study was carried out in Ohaozara LGA, Onicha LGA and Ivo LGA. The three [3] LGAs made up the defunct Old Ohaozara LGA. A structured questionnaire was used to generate information on knowledge of Onchocerciasis and on the use of ivermectin by the inhabitants of the communities of the study areas. The distribution coverage of ivermectin in the study areas dating from 2010 to 2014 was ascertained with drug distribution charts obtained from Ebonyi State Health Management Board [ESHMB], Abakaliki [the point source of distribution in the state], and from the health centres in communities of old Ohaozara LGA [the service delivery points [SDPs] to inhabitants of the communities. Data was analysed using descriptive statistics. Utilization of the regimen was ascertained by determining the actual number of tablets of mectizan that was administered to the patients at the various health cenrtes [service delivery points [SDPs] in the communities. The percentage utilization of the regimen was determined by dividing the number of mectizan tablets administered to the patients at SDPs with the number of mectizan tablets supplied from state point source of distribution and multiplying by 100. A total of 347, 299 out of 1, 919135 tablets of mectizan supplied to the study areas from 2010 to 2014 were actually utilized, forming an overall percentage utilization of 18.10%. There was adequate supply but very poor utilization of the regimen. The poor utilization resulted from factors including locating of health centres very far from homes of some of the rural villagers, non-yearly compliance with regimen administration, poor health sensitization and education and lack of incentives or poor incentives to the village-based health workers [VBHWs]. Intensification of efforts to cover the lapses in the utilization of the regimen is advocated for a more effective control of the disease

Outstanding insecurities concerning the use of an Ov16-based ELISA in the Amazonia onchocerciasis focus

In a recent issue of Memórias do Instituto Oswaldo Cruz, published in Rio de Janeiro in February 2014 (109: 87-92), Adami et al. have published a survey reporting Mansonella parasite prevalence in the Amazon Region. This report makes a useful contribution to the existing knowledge of filarial parasite distribution within the Amazon area, parasite prevalence rates in relation to age and occupation and provides observations on the possible clinical impact of Mansonella ozzardi. Their publication also provides an account of what appears to be a novel ELISA that has recently been used in the Simuliidae and Onchocerciasis Laboratory of the Oswaldo Cruz Institute, Rio de Janeiro, Brazil. We are concerned that the publication of this ELISA may have created an excessively positive impression of the effectiveness of the onchocerciasis recrudescence serological surveillance tools that are presently available for use in the Amazonia onchocerciasis focus. In this letter we have, thus, sought to highlight some of the limitations of this ELISA and suggest how continuing insecurities concerning the detection of antibodies to Onchocerca volvulus within the Amazonia onchocerciasis focus might be minimised.

Anatomopatologia de bursite cervical (oncocercose) encontrada em bovinos abatidos sob inspeção estadual no estado do Rio de Janeiro / Anatomopathology of onchocerciases (cervical bursitis) in slaughtered bovine in the north of Rio de Janeiro state

A patologia descritiva das lesões em animais domésticos de açougue permite enriquecer a literatura médica veterinária especializada em inspeção sanitária de carnes, assim como subsidiar tecnicamente os profissionais inspetores. A oncocercose é uma parasitose causada pelo nematódeo Onchocerca sp,, sendo que a espécie O. gutturosa é a que mais acomete bovinos na América do Sul. Foram avaliados, pelo exame anatomopatológico, dois casos de lesões localizadas no ligamento nucal de bovinos abatidos para o consumo. A macroscopia de um caso revelou bursite crônica, representada por grande quantidade de líquido citrino e viscoso e, ainda, muitos corpúsculos livres, elípticos e achatados desprovidos de raiz (arrizo). A microscopia dessas estruturas evidenciou moldes de fibrinas amorfos e eosinofílicos. O segundo caso foi caracterizado por bursite aguda, e a microscopia das lesões ligamentar e periligamentar revelou granulomas epitelioides com reação gigantocitária, centralizados por formações semelhantes ao Onchocerca sp...

The descriptive pathology of lesions in butcher's domestic animals contribute to enrich literature specialized in veterinary sanitary inspection of meat as well as to guide professional meat inspectors. Oncorcecose is a parasitic disease caused by the nematode Onchocerca sp, and the O. gutturosa species affects cattle in South America. Two cases of lesions located in the nuchal ligament of cattle slaughtered for consumption were evaluated by pathological examination. Macroscopic analysis revealed a case of chronic bursitis represented by a large amount of clear and viscous liquid, and also many free, elliptical and flat corpuscles. Microscopy showed arrizoides molds fibrin, amorphous, and eosinophilic structures. The second case was characterized by acute bursitis and microscopic lesions and ligament periligamentous revealed multiple epithelioid granulomas and giant cells centered on formations similar to Onchocerca sp...

Lesions oculaires de l'onchocercose et observance au Traitement a L'ivermectine Sous Directives Communautaires (TIDC)

BUT: Determiner si les complications oculaires de l'onchocercose influencaient l'observance des patients au TIDC. MATeRIELS ET MeTHODES: Nous avons mene une etude transversale descriptive dans la region du Littoral au Cameroun. Etaient inclus dans cette etude tous les sujets ages d'au moins 10 ans. Les variables etudiees etaient l'acuite visuelle; le type de deficience visuelle; le sexe; les lesions oculaires d'onchocercose; le nombre de prises d'Ivermectine au cours des 5 dernieres annees. ReSULTATS : Nous avons collige 764 patients soit 1528 yeux. Le nombre d'yeux presentant des lesions d'onchocercose etait de 56 et ceux n'en presentant pas etaient au nombre de 1472. Nous avons releve une prevalence de 48 de bonne observance au TIDC au sein de la population generale. Mais nous avons retrouve une prevalence de 57 de bonne observance chez les cas contre une prevalence de 48 chez les controles (P = 0;28). Une similarite dans la regularite de la prise de l'Ivermectine entre les femmes et les hommes a ete retrouvee. CONCLUSION :Les patients presentant des lesions oculaires de l'onchocercose ont majoritairement une bonne observance au TIDC dans la region du Littoral contrairement a ceux ne presentant pas de lesions oculaires de l'onchocercose. Le genre n'est pas un facteur influencant l'observance au TIDC dans notre etude contrairement a certaines donnees de la litterature. Le nombre de prises d'Ivermectine n'est pas un facteur predisposant les hommes aux atteintes oculaires de l'onchocercose. En cas d'absence de deficience Visuelle les patients avec des lesions oculaires de l'onchocercose ont une meilleure observance au TIDC. La presence de lesions oculaires de l'onchocercose semble etre un facteur motivant les patients atteints a une meilleure observance au TIDC

Impacto de la ivermectina sobre las geohelmintiasis en el foco de oncocercosis en Colombia / The effect of ivermectin on geohelminth frequency (i.e. as used in the onchocerciasis control program in Colombia)

Objetivo: Evaluar el efecto de la ivermectina sobre la frecuencia de infección por geohelmintos en una población colombiana incluida en el Programa para la Eliminación de la Oncocercosis en las Américas. Métodos: Estudio de evaluación de impacto con enfoque longitudinal como punto referente inicial, la población de Naicioná (1996) y como control, sujetos de la misma población (2008). Para el enfoque transversal se usó como referente la población de Naicioná en 2008 y como control, sujetos de Dos Quebradas en 2008. El procesamiento de las muestras de materia fecal se hizo por Ritchie-Frick modificado. Resultados: Ascaris lumbricoides fue el parásito más frecuente 49,6 % (60/121; IC 95 %:37,8-63,8) en Naicioná y 47,4 % (36/76; IC 95 %: 33,2-65,6) en Dos Quebradas. El mayor efecto de la ivermectina en mayores de 5 años fue la disminución del riesgo de infección, para Trichiuris trichiura, de 86 % (IC95 %:74-93) en la evaluación longitudinal y 63 % (IC 95 %:24-82) en la evaluación transversal. La disminución en la frecuencia de Strongyloides stercoralis fue 93 % (IC 95 %: 45-99), en la evaluación longitudinal y 85 % (IC95 %:-031 - 99) en la evaluación transversal. Conclusiones: El uso de la ivermectina en el contexto del Programa para la Eliminación de la Oncocercosis en las Américas no es suficiente para el control de la morbilidad de todas las geohelmintiasis, se requiere de programas integrales que incluyan los componentes de educación y saneamiento básico.

Objective: Evaluating the effect of ivermectin on soil-transmitted helminthes (STH) infection frequency in a Colombian population included in the Onchocerciasis Elimination Program for the Americas (OEPA). Methods: This was an impact evaluation study which adopted a longitudinal approach using the population of Naicioná (1996) as baseline for comparison to people from the same population as controls (2008). The cross-sectional approach involved comparing the reference population of Naicioná (2008) to the population of Dos Quebradas (2008) used as controls. Fecal samples were processed by a modified Ritchie-Frick method. Results: Ascaris lumbricoides was the most frequently found parasite in Naicioná (60/121; 49.6 %: 37.8-63.895%CI) and in Dos Quebradas (36/76; 47.4 %: 33.2-65.6 95 % CI). Ivermectin’s main effect on the population aged over 5 years was a decreased risk of Trichiuris trichiura infection in both longitudinal assessment (86 % reduction: 74-93 95 % CI) and cross-sectional assessment (63 %:24-82 95 % CI). A 93 % reduction (45-99 95 % CI) in Strongyloides stercoralis frequency was found in longitudinal assessment, compared to 85 % in cross-sectional assessment (-031-99 95 % CI). Conclusions: Ivermectin use in the OEPA is not sufficient for STH morbidity control. Integrated programs including education and basic sanitation are required.

Transmission de l'onchocercose par Simulium squamosum (Diptera : Simuliidae) dans le foyer urbain de Kinsuka a Kinshasa/Republique democratique du Congo

Contexte. Les etudes realisees dans le foyer de Kinsuka entre 1985 et 2001 ont montre une tendance a la reemergence de la transmission de l'onchocercose dans ce foyer. Le but de la presente etude exploratoire etait de determiner le niveau actuel de la transmission de cette parasitose; en vue d'apprehender des facteurs explicatifs du niveau d'endemicite constate. Methodes. Les simulies ont ete capturees dans deux points de capture (P1 et P2); pour une periode de 12 mois (mars 2008-fevrier 2009); par le procede classique de capture sur appats humains. Dans l'ensemble; 82;1des simulies capturees ont ete dissequees pour la determination de la parite; et toutes les simulies pares ont ete dissequees pour denombrer les larves d'O. volvulus. Les autres especes de simulies ont ete inventoriees; et les supports larvaires ont ete prospectes. Resultats. Au total; 12282 simulies ont ete capturees dont 5018 au S1; et 7264 au S2. Le cycle d'agressivite journaliere a presente une courbe concave avec deux pics; dont un mineur entre 8 et 9 heures; et un majeur entre 17h et 18h. Dans l'ensemble de simulies dissequees; 42;4etaient pares. Seules 25 simulies pares etaient infectees par les larves d'O. volvulus; dont 14 au S1; et 11 au S2. Une seule simulie etait infectante. Les taux annuels de piqures (TAP) etaient de 564453; et 78111 piqures par personne par an respectivement. Le potentiel de transmission est pratiquement nul : 0 au S1; et 28 larves infectantes par personne par an au S2. Conclusion. Le taux d'agressivite est environ 12 fois plus eleve que celui observe il y a 27 ans; dans le meme site. Le taux observe est en partie du a l'influence des activites realisees par la nouvelle entreprise d'exploitation de moellons dans la carriere de Kinsuka. Ces activites ont provoque entre autres; le retrecissement du lit du fleuve pendant la saison seche; qui entraine une augmentation du niveau du fleuve; creant une grande disponibilite des supports larvaires. La transmission de l'onchocercose est presque nulle. Des etudes ulterieures permettront d'en identifier les determinants