Amazonian onchocerciasis: parasitological profiles by host-age, sex, and endemicity in southern Venezuela.
This paper describes, for the human onchocerciasis focus of southern Venezuela, the age profiles of Onchocerca volvulus microfilarial (mf) and nodule prevalence, mf intensity, and mf aggregation for the whole examined population (836 Yanomami people) living in 20 villages, and for these communities classified according to endemicity levels (hypoendemic: < or = 20 %; mesoendemic: 21-59 %; hyperendemic: < or = 60 % infected). Mf prevalence and intensity increased with age, particularly in the hyperendemic areas, and there were no marked differences between the sexes. The prevalence of nodules followed the same age pattern. Fifty percent mf prevalence was reached in the 15-19 year age-class when the population was taken as a whole; nearly in the 10 to 14-year-olds for the hyperendemic level, in those aged 20-29 years in mesoendemic areas, and not reached at all in hypoendemic villages. The degree of mf aggregation was measured by the k value of the negative binomial distribution and by the variance to mean ratio (VMR). The relationship between the standard deviation (S.D.) of mf counts and the mean mf density was also explored. These 3 indices (k, VMR, and S.D.) showed a tendency to increase with both mean mf load and host age. Since infection intensity and host age were themselves positively related, it was not possible to draw definite conclusions about age-specific changes of parasite aggregation. There was not a significant decrease of mf intensity after an earlier peak neither was there a shift towards younger ages of the maximum no. of mf/mg reached as the endemicity level increased. These results are discussed in relation to detection of density dependence in the human host, selection of an indicator age-group for rapid epidemiological assessment (REA) methods, and strategies of ivermectin distribution in the Amazonian focus. It is recommended that, for the Amazonian onchocerciasis focus, the indicator group for REA consists of all those aged 15 years and over.
Vivas-Martínez
S
S
London School of Hygiene and Tropical Medicine.
Basáñez
M G
MG
Botto
C
C
Rojas
S
S
García
M
M
Pacheco
M
M
Curtis
C F
CF
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000818:Animals; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008842:Microfilariae / Q000302:isolation & purification; D017181:Onchocerca volvulus / Q000254:growth & development*; D009855:Onchocerciasis / Q000453:epidemiology / Q000469:parasitology* / Q000635:transmission; D015995:Prevalence; D000091402:Prohibitins; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data; D012737:Sex Factors; D012867:Skin / Q000469:parasitology; D014687:Venezuela / Q000453:epidemiology