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      Contribution of migrant coffee labourers infected with Onchocerca volvulus to the maintenance of the microfilarial reservoir in an ivermectin-treated area of Mexico

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          Abstract

          Background

          Since 1991, in Mexico, ivermectin has been administered twice a year to all residents in the onchocerciasis endemic foci which are mainly located in the coffee growing areas. However, the presence of a potentially infected itinerant seasonal labour force which is not treated regularly could jeopardise the attainment of the 85% coverage which is the present target for elimination of the disease.

          Methods

          The prevalence and intensity of Onchocerca volvulus microfilariae (mf), as well as their transmission from humans to vectors, were assessed during the coffee planting-clearing and harvesting seasons of 1997–1998, and 1998–1999 in two localities (I and II) of Southern Chiapas, Mexico, which regularly receive an influx of untreated migrant coffee labourers.

          Results

          Localities I and II had, respectively, an average of 391 (± 32) and 358 (± 14) resident inhabitants, and 70 (± 52) and 498 (± 289) temporary labourers. The ratio of migrants to residents ranged from 0.1:1 in locality I to 2.4:1 in locality II. The proportion of infected Simulium ochraceum s.l. parous flies was significantly lower in locality I than in locality II, and significantly higher during the stay of the migrants than before their arrival or after their departure. Parity and infection were higher in May-July than in November-February (in contrast with the latter being typically considered as the peak onchocerciasis transmission season by S. ochraceum s.l.).

          Conclusion

          The presence of significant numbers of untreated and potentially infected migrants may contribute to ongoing transmission, and their incorporation into ivermectin programmes should be beneficial for the attainment of the elimination goals of the regional initiative. However, the possibility that the results also reflect transmission patterns for the area cannot be excluded and these should be analyzed further.

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          Most cited references44

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          River Blindness: A Success Story under Threat?

          The success of the Onchocerciasis Control Programme is undeniable and exemplary, say the authors, but it is too early to claim victory against river blindness.
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            A force-of-infection model for onchocerciasis and its applications in the epidemiological evaluation of the Onchocerciasis Control Programme in the Volta River basin area.

            A simple force-of-infection model for onchocerciasis has been developed for a study of the age-specific epidemiological trends during a period of vector control in the Onchocerciasis Control Programme in the Volta River basin area (OCP). The most important factors included in the model are the longevity of an infection, the aspect of super-infection, age-specific exposure, and the intensity of transmission during the pre-control period. The aim of the study was to determine the most appropriate statistics for the epidemiological evaluation in the OCP. There was generally good agreement between the epidemiological trends, predicted by the model, and the observed trends in the prevalence and mean load of microfilariae in skin snips taken from a cohort population from 23 villages in an area with 8 years of successful vector control in the OCP. It is concluded that the epidemiological trends during the control period are not uniform but depend on the initial age and the initial endemicity level of the population. The epidemiological indices for cohorts of children, born before the start of control, will not show a decrease during the first 8 years of interruption of transmission. The prevalence is too insensitive to be useful for the evaluation in hyperendemic villages during most of the control period. The most sensitive and meaningful statistic for a comparative analysis and for the assessment of epidemiological changes is the geometric mean microfilarial load in a cohort of adults. This index, which is called the Community Microfilarial Load (CMFL), is now routinely used in the OCP. The new analytical methodology has enabled a much better appreciation of the significant epidemiological impact of 8 years of vector control in the OCP. Several related aspects of the pre- and post-control dynamics of onchocerciasis infection are also discussed and priorities are formulated for further work on applied modelling of onchocerciasis.
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              Transmission intensity and the patterns of Onchocerca volvulus infection in human communities.

              We focus on possible constraints upon Onchocerca volvulus establishment in humans in relation to exposure rates to infective larvae (L3) as measured by the annual transmission potential (ATP). We use mathematical and statistical modeling of pre-control west African (savanna), Mexican, and Guatemalan data to explore two hypotheses relating human infection to transmission intensity: microfilarial (mf) loads either saturate with increasing ATP or become (asymptotically) proportional to the ATP. The estimated proportion of L3 developing into adult worms ranged from 7% to 0.3% (low and high intensity areas, respectively). Relationships between mf prevalence and both mf and transmission intensity were nonlinear and statistically similar between west Africa (Simulium damnosum s.l.) and Meso America (S. ochraceum s.l.). This similarity extended to the relationship between mf intensity and ATP. The critical biting rates for onchocerciasis introduction and persistence (which depended on vector competence and host preference), were approximately 10-fold higher in settings where onchocerciasis is transmitted by S. ochraceum than in those where the vector is S. damnosum. A role for focal vector control in Mexico and Guatemala, in addition to nodulectomy and ivermectin, is suggested.
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                Author and article information

                Journal
                Filaria J
                Filaria Journal
                BioMed Central
                1475-2883
                2007
                18 December 2007
                : 6
                : 16
                Affiliations
                [1 ]Centro de Biotecnología Genómica, Instituto Politécnico Nacional, Blvd. del Maestro esquina Elías Piña, Col. Narciso Mendoza, 88710, Reynosa, Tamaulipas, México
                [2 ]Department of Infectious Disease Epidemiology, Faculty of Medicine (St. Mary's campus), Imperial College London, Norfolk Place, London W2 1PG, UK
                [3 ]Department of Parasite and Vector Biology, Liverpool School of Tropical Medicine, Pembroke Place Liverpool, L3 5QA, UK
                Article
                1475-2883-6-16
                10.1186/1475-2883-6-16
                2238739
                18088423
                ae86c416-391b-4aac-99b9-e726deb4ef3b
                Copyright © 2007 Rodríguez-Pérez et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 22 October 2007
                : 18 December 2007
                Categories
                Research

                Parasitology
                Parasitology

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