AJTMH ASTMH Job Mart
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Am. J. Trop. Med. Hyg., 75(6), 2006, pp. 1058-1062
Copyright © 2006 by The American Society of Tropical Medicine and Hygiene

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via ISI Web of Science (1)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by WINTHROP, K. L.
Right arrow Articles by RICHARDS, F.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by WINTHROP, K. L.
Right arrow Articles by RICHARDS, F.
Related Collections
Right arrow Onchocerciasis

THE RELIABILITY OF ANTERIOR SEGMENT LESIONS AS INDICATORS OF ONCHOCERCAL EYE DISEASE IN GUATEMALA

KEVIN L. WINTHROP*, ROBERTO PROAÑO, ORLANDO OLIVA, BYRON ARANA, CARLOS MENDOZA, ALFREDO DOMINGUEZ, JOSEF AMANN, GEORGE PUNKOSDY, CARLOS BLANCO, ROBERT KLEIN, MAURICIO SAUERBREY, AND FRANK RICHARDS
Division of Parasitic Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia; Casey Eye Institute, Oregon Health Sciences University, Portland, Oregon; Medical Entomology Research Unit, US Centers for Disease Control and Prevention and Universidad del Valle, Guatemala City, Guatemala; Program for the Elimination of Onchocerciasis in the Americas, Guatemala City, Guatemala

World Health Organization certification criteria for onchocerciasis elimination use anterior segment eye lesion prevalence as an indicator of mass ivermectin treatment program success. Lesions either contain visible microfilaria (noninflammatory punctate keratitis [PK] or microfilariae in anterior chamber [MFAC]), or microfilaria obscured by inflammation (inflammatory PK). To assess the utility of these disease indicators, two experienced ophthalmologists independently examined persons from endemic (N = 325) and nonendemic (N = 348) Guatemalan communities. Thirty-six (11.1%) and nine (2.6%) persons from endemic and nonendemic areas respectively had lesions found by either ophthalmologist (prevalence ratio = 4.3, 95% CI 2.1–8.8, P < 0.001). All lesions in nonendemic areas were inflammatory PK in whom no persons were seropositive for onchocerciasis. Overall, observer agreement was moderate (Kappa = 0.49), and most (61%) discordance occurred with inflammatory PK lesions. Our findings suggest that inflammatory punctate keratitis is neither a specific nor a reliable indicator of onchocercal eye disease. Future prevalence surveys should rely upon noninflammatory lesions as disease indicators.

Received February 17, 2006. Accepted for publication August 10, 2006.

* Address correspondence to Kevin L. Winthrop, Casey Eye Institute, Oregon Health Sciences University, 3375 S.W. Terwilliger Boulevard, Portland, OR 97239-4197. E-mail: winthrop{at}ohsu.edu

Authors’ addresses: Kevin L. Winthrop, Casey Eye Institute, Oregon Health Sciences University, 3375 Terwilliger Blvd., Portland, Oregon. Roberto Proaño, Orlando Oliva, Alfredo Dominguez, and Mauricio Sauerbrey, Programa para la Eliminación de la Oncocercosis en las Américas (OEPA), 14 Calle 3-51, Zona 10, Edificio Murano Center, Oficina 1401, Cuidad de Guatemala 01010, Guatemala. Byron Arana, Carlos Mendoza, and Robert Klein, Medical Entomology Research Unit (MERTU), AMEMB/HHS/MERTU/G, Unit 3321, APO AA 34024-3321, Miami, FL. Josef Amann, George Punkosdy, and Frank Richards, US Centers for Disease Control and Prevention, Centers for Infectious Disease, Division of Parasitic Diseases, 4770 Buford Hwy., MS F-22, Atlanta, GA 30341. Carlos Blanco, Ministro de Salud Pública y Asistencia Social, 6a Calle 3-45, Zona 11, Guatemala City, Guatemala.

Reprint requests: Kevin L. Winthrop, Casey Eye Institute, Oregon Health Sciences University, 3375 S.W. Terwilliger Boulevard, Portland, OR 97239-4197, E-mail: winthrop{at}ohsu.edu




This article has been cited by other articles:


Home page
 Am J Trop Med HygHome page
M. A. Rodriguez-Perez, M. A. Lutzow-Steiner, A. Segura-Cabrera, C. Lizarazo-Ortega, A. Dominguez-Vazquez, M. Sauerbrey, F. Richards Jr, T. R. Unnasch, H. K. Hassan, and R. Hernandez-Hernandez
Rapid Suppression of Onchocerca volvulus Transmission in Two Communities of the Southern Chiapas Focus, Mexico, Achieved by Quarterly Treatments with Mectizan
Am J Trop Med Hyg, August 1, 2008; 79(2): 239 - 244.
[Abstract] [Full Text] [PDF]

Home page
 Am J Trop Med HygHome page
K. A. Lindblade, B. Arana, G. Zea-Flores, N. Rizzo, C. H. Porter, A. Dominguez, N. Cruz-Ortiz, T. R. Unnasch, G. A. Punkosdy, J. Richards, et al.
Elimination of Onchocercia volvulus Transmission in the Santa Rosa Focus of Guatemala
Am J Trop Med Hyg, August 1, 2007; 77(2): 334 - 341.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2006 by the American Society of Tropical Medicine and Hygiene.