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To eliminate transmission of Onchocerca volvulus, semiannual mass treatment with ivermectin (Mectizan; donated by Merck & Co) has been underway in Guatemala since 2000. We applied the 2001 World Health Organization (WHO) elimination criteria in the Santa Rosa focus of onchocerciasis transmission in Guatemala (10,923 persons at risk). No evidence of parasite DNA was found in 2,221 Simulium ochraceum vectors (one-sided 95% confidence interval [CI], 0–0.086%), and no IgG4 antibody positives to recombinant antigen OV16 were found in a sample of 3,232 school children (95% CI, 0–0.009%). We also found no evidence of microfilariae in the anterior segment of the eye in 363 area residents (95% CI, 0–0.08%). Our interpretation of these data, together with historical information, suggest that transmission of O. volvulus is permanently interrupted in Santa Rosa and that ivermectin treatments there can be halted.
Received January 22, 2007. Accepted for publication March 19, 2007.
Acknowledgments: This work would not have been possible without the guidance and assistance of Dr. Robert Klein, retired director of the CDC Regional Office for Central America and Panama. We are grateful to Estuardo Barrios for assistance with mapping, Mayari Hengstermann for support on the ophthalmological survey, Carlos Mendoza for support on the serological survey, and Adria Prosser for her initial attempts in organizing the serology survey. We are grateful to Mynor Lopez, Jorge Sincal, Jose Humberto Miguel, and Rodrigo Gramajo for assisting with the field and laboratory work. We thank the Director of the Santa Rosa Health Area and her team, and in particular Gérman Rosales, for their support and assistance with this project. We are grateful for the willing participation of the residents of Santa Rosa. Without the administrative support of the Centro de Estudios en Salud of the Universidad del Valle de Guatemala this project would not have been possible. This work was presented in part at the 15th Annual Interamerican Conference on Onchocerciasis (IACO), Caracas, Venezuela, November 13–18, 2005, at the 54th Annual Meeting of the American Society of Tropical Medicine and Hygiene, Washington, DC, December 11–15, 2005 (abstract 533), and to the Mectizan Expert Committee, London, January 2006. The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.
Financial support: These studies were funded by the Centers for Disease Control and Prevention (Atlanta, GA) and the Onchocerciasis Elimination Program of the Americas (Guatemala City, Guatemala). The OEPA funds were provided through a grant by the Bill and Melinda Gates Foundation (Seattle, WA) to The Carter Center (Atlanta, GA).
* Address correspondence to Kim A. Lindblade, Regional Office for Central America and Panama, Centers for Disease Control and Prevention, Universidad del Valle de Guatemala, 18 Avenida 11-95, Zona 15 VH III, Apartado Postal No. 82, Guatemala City, Guatemala. E-mail: kil2{at}cdc.gov
Authors’ addresses: Kim A. Lindblade, Regional Office for Central America and Panama, Centers for Disease Control and Prevention, Universidad del Valle de Guatemala, 18 Avenida 11-95, Zona 15 VH III, Apartado Postal No. 82, Guatemala City, Guatemala, Telephone: 502-2364-0336, extension 513, Fax: 502-2369-7539, E-mail: kil2{at}cdc.gov. Byron Arana, Nidia Rizzo, Nancy Cruz-Ortiz, and Jane Richards, Centro de Estudios en Salud, Universidad del Valle de Guatemala, 18 Avenida 11-95, Zona 15 VH III, Apartado Postal No. 82, Guatemala City, Guatemala, Telephone: 502-2364-0336, extension 513, Fax: 502-2369-7539, E-mails: baaz{at}cdc.gov, nrrz{at}cdc.gov, ncoz{at}cdc.gov, and jane.e.richards{at}uth.tmc.edu. Guillermo Zea-Flores, Alfredo Dominguez, Mauricio Sauerbrey, and Orlando Oliva, Onchocerciasis Elimination Program of the Americas, 14 Calle 3-51, Oficina 14-01 Zona 10, Guatemala City 01010 Guatemala, Telephone: 502-2366-6109, Fax: 502-2366-6127, E-mails: gzea{at}oepa.net, adominguez{at}oepa.net, oepa{at}oepa.net, and centrovisual{at}intelnett.com. Charles H. Porter, Division of Parasitic Diseases, National Center for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention, 4770 Buford Highway, MS F-22, Atlanta, GA 30341-3724, Telephone: 770-488-4838, Fax: 770-488-7761, E-mail: chp1{at}cdc.gov. Thomas R. Unnasch, Gorgas Center of Geographic Medicine, Division of Infectious Diseases, BBRB 538, 1530 3rd Ave. South, Birmingham, AL 35294-2170, Telephone: 205-975-7601, Fax: 205-934-5600, E-mail: tunnasch{at}uab.edu. George A. Punkosdy, National Institute of Allergies and Infectious Diseases, National Institutes of Health, Building 10 - Magnuson, CC Room 11N315, 10 Center Dr., Bethesda, MD, Telephone: 301-496-5046, E-mail: punkosdyg{at}mail.nih.gov. Julio Castro and Eduard Catú, Programa de Enfermedades Transmitidas por Vectores, Ministerio de Salud y Asistencia Publica, 5a Avenida 11-40, Zona 11, Guatemala, Guatemala, Telephone/Fax: 502-2472-0128, E-mail: pvectores{at}intelnett.com. Frank O. Richards, Jr., The Carter Center, One Copenhill, 453 Freedom Parkway, Atlanta, GA 30307, Telephone: 404-420-5100, E-mail: fxr1{at}cdc.gov.
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