Transmission of Onchocerciasis in Wadelai Focus of Northwestern Uganda Has Been Interrupted and the Disease Eliminated

Wadelai, an isolated focus for onchocerciasis in northwest Uganda, was selected for piloting an onchocerciasis elimination strategy that was ultimately the precursor for countrywide onchocerciasis elimination policy. The Wadelai focus strategy was to increase ivermectin treatments from annual to sem...

Full description

Saved in:
Bibliographic Details
Main Authors: Moses N. Katabarwa, Frank Walsh, Peace Habomugisha, Thomson L. Lakwo, Stella Agunyo, David W. Oguttu, Thomas R. Unnasch, Dickson Unoba, Edson Byamukama, Ephraim Tukesiga, Richard Ndyomugyenyi, Frank O. Richards
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:Journal of Parasitology Research
Online Access:http://dx.doi.org/10.1155/2012/748540
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849685463891181568
author Moses N. Katabarwa
Frank Walsh
Peace Habomugisha
Thomson L. Lakwo
Stella Agunyo
David W. Oguttu
Thomas R. Unnasch
Dickson Unoba
Edson Byamukama
Ephraim Tukesiga
Richard Ndyomugyenyi
Frank O. Richards
author_facet Moses N. Katabarwa
Frank Walsh
Peace Habomugisha
Thomson L. Lakwo
Stella Agunyo
David W. Oguttu
Thomas R. Unnasch
Dickson Unoba
Edson Byamukama
Ephraim Tukesiga
Richard Ndyomugyenyi
Frank O. Richards
author_sort Moses N. Katabarwa
collection DOAJ
description Wadelai, an isolated focus for onchocerciasis in northwest Uganda, was selected for piloting an onchocerciasis elimination strategy that was ultimately the precursor for countrywide onchocerciasis elimination policy. The Wadelai focus strategy was to increase ivermectin treatments from annual to semiannual frequency and expand geographic area in order to include communities with nodule rate of less than 20%. These communities had not been covered by the previous policy that sought to control onchocerciasis only as a public health problem. From 2006 to 2010, Wadelai program successfully attained ultimate treatment goal (UTG), treatment coverage of ≥90%, despite expanding from 19 to 34 communities and from 5,600 annual treatments to over 29,000 semiannual treatments. Evaluations in 2009 showed no microfilaria in skin snips of over 500 persons examined, and only 1 of 3011 children was IgG4 antibody positive to the OV16 recombinant antigen. No Simulium vectors were found, and their disappearance could have sped up interruption of transmission. Although twice-per-year treatment had an unclear role in interruption of transmission, the experience demonstrated that twice-per-year treatment is feasible in the Ugandan setting. The monitoring data support the conclusion that onchocerciasis has been eliminated from the Wadelai focus of Uganda.
format Article
id doaj-art-bb5759ad118c4fcf86940de5058cbfd2
institution DOAJ
issn 2090-0023
2090-0031
language English
publishDate 2012-01-01
publisher Wiley
record_format Article
series Journal of Parasitology Research
spelling doaj-art-bb5759ad118c4fcf86940de5058cbfd22025-08-20T03:23:07ZengWileyJournal of Parasitology Research2090-00232090-00312012-01-01201210.1155/2012/748540748540Transmission of Onchocerciasis in Wadelai Focus of Northwestern Uganda Has Been Interrupted and the Disease EliminatedMoses N. Katabarwa0Frank Walsh1Peace Habomugisha2Thomson L. Lakwo3Stella Agunyo4David W. Oguttu5Thomas R. Unnasch6Dickson Unoba7Edson Byamukama8Ephraim Tukesiga9Richard Ndyomugyenyi10Frank O. Richards11Emory University and The Carter Center, One Copenhill, 453 Freedom Parkway, Atlanta, GA 30307, USA80 Arundel Road, Lythan St. Anne's, Lancashire FY8 1BN, UKThe Carter Center, Uganda, P.O. Box 12027, Kampala, UgandaVector Control Division, Ministry of Health, 15 Bombo Road, P.O. Box 1661, Kampala, UgandaThe Carter Center, Uganda, P.O. Box 12027, Kampala, UgandaVector Control Division, Ministry of Health, 15 Bombo Road, P.O. Box 1661, Kampala, UgandaGlobal Health Infectious Disease Research, College of Public Health, University of South Florida 3720 Spectrum Boulevard, Suite 304, Tampa, FL 33612, USANebbi District Health Services, P.O. Box 1, Nebbi, UgandaThe Carter Center, Uganda, P.O. Box 12027, Kampala, UgandaKabarole District Health Services, P.O. Box 38, Kabarole, UgandaVector Control Division, Ministry of Health, 15 Bombo Road, P.O. Box 1661, Kampala, UgandaEmory University and The Carter Center, One Copenhill, 453 Freedom Parkway, Atlanta, GA 30307, USAWadelai, an isolated focus for onchocerciasis in northwest Uganda, was selected for piloting an onchocerciasis elimination strategy that was ultimately the precursor for countrywide onchocerciasis elimination policy. The Wadelai focus strategy was to increase ivermectin treatments from annual to semiannual frequency and expand geographic area in order to include communities with nodule rate of less than 20%. These communities had not been covered by the previous policy that sought to control onchocerciasis only as a public health problem. From 2006 to 2010, Wadelai program successfully attained ultimate treatment goal (UTG), treatment coverage of ≥90%, despite expanding from 19 to 34 communities and from 5,600 annual treatments to over 29,000 semiannual treatments. Evaluations in 2009 showed no microfilaria in skin snips of over 500 persons examined, and only 1 of 3011 children was IgG4 antibody positive to the OV16 recombinant antigen. No Simulium vectors were found, and their disappearance could have sped up interruption of transmission. Although twice-per-year treatment had an unclear role in interruption of transmission, the experience demonstrated that twice-per-year treatment is feasible in the Ugandan setting. The monitoring data support the conclusion that onchocerciasis has been eliminated from the Wadelai focus of Uganda.http://dx.doi.org/10.1155/2012/748540
spellingShingle Moses N. Katabarwa
Frank Walsh
Peace Habomugisha
Thomson L. Lakwo
Stella Agunyo
David W. Oguttu
Thomas R. Unnasch
Dickson Unoba
Edson Byamukama
Ephraim Tukesiga
Richard Ndyomugyenyi
Frank O. Richards
Transmission of Onchocerciasis in Wadelai Focus of Northwestern Uganda Has Been Interrupted and the Disease Eliminated
Journal of Parasitology Research
title Transmission of Onchocerciasis in Wadelai Focus of Northwestern Uganda Has Been Interrupted and the Disease Eliminated
title_full Transmission of Onchocerciasis in Wadelai Focus of Northwestern Uganda Has Been Interrupted and the Disease Eliminated
title_fullStr Transmission of Onchocerciasis in Wadelai Focus of Northwestern Uganda Has Been Interrupted and the Disease Eliminated
title_full_unstemmed Transmission of Onchocerciasis in Wadelai Focus of Northwestern Uganda Has Been Interrupted and the Disease Eliminated
title_short Transmission of Onchocerciasis in Wadelai Focus of Northwestern Uganda Has Been Interrupted and the Disease Eliminated
title_sort transmission of onchocerciasis in wadelai focus of northwestern uganda has been interrupted and the disease eliminated
url http://dx.doi.org/10.1155/2012/748540
work_keys_str_mv AT mosesnkatabarwa transmissionofonchocerciasisinwadelaifocusofnorthwesternugandahasbeeninterruptedandthediseaseeliminated
AT frankwalsh transmissionofonchocerciasisinwadelaifocusofnorthwesternugandahasbeeninterruptedandthediseaseeliminated
AT peacehabomugisha transmissionofonchocerciasisinwadelaifocusofnorthwesternugandahasbeeninterruptedandthediseaseeliminated
AT thomsonllakwo transmissionofonchocerciasisinwadelaifocusofnorthwesternugandahasbeeninterruptedandthediseaseeliminated
AT stellaagunyo transmissionofonchocerciasisinwadelaifocusofnorthwesternugandahasbeeninterruptedandthediseaseeliminated
AT davidwoguttu transmissionofonchocerciasisinwadelaifocusofnorthwesternugandahasbeeninterruptedandthediseaseeliminated
AT thomasrunnasch transmissionofonchocerciasisinwadelaifocusofnorthwesternugandahasbeeninterruptedandthediseaseeliminated
AT dicksonunoba transmissionofonchocerciasisinwadelaifocusofnorthwesternugandahasbeeninterruptedandthediseaseeliminated
AT edsonbyamukama transmissionofonchocerciasisinwadelaifocusofnorthwesternugandahasbeeninterruptedandthediseaseeliminated
AT ephraimtukesiga transmissionofonchocerciasisinwadelaifocusofnorthwesternugandahasbeeninterruptedandthediseaseeliminated
AT richardndyomugyenyi transmissionofonchocerciasisinwadelaifocusofnorthwesternugandahasbeeninterruptedandthediseaseeliminated
AT frankorichards transmissionofonchocerciasisinwadelaifocusofnorthwesternugandahasbeeninterruptedandthediseaseeliminated