title: Serosurveillance to monitor onchocerciasis elimination: the Ugandan experience.
abstract: Uganda is the only African country whose onchocerciasis elimination program uses a two-pronged approach of vector control and mass drug distribution. The Ugandan program relies heavily upon the use of serosurveys of children to monitor progress toward elimination. The program has tested over 39,000 individuals from 11 foci for Onchocerca volvulus exposure, using the Ov16 ELISA test. The data show that the Ov16 ELISA is a useful operational tool to monitor onchocerciasis transmission interruption in Africa at the World Health Organization (WHO) recommended threshold of < 0.1% in children. The Ugandan experience has also resulted in a re-examination of the statistical methods used to estimate the boundary of the upper 95% confidence interval for the WHO prevalence threshold when all samples tested are negative. This has resulted in the development of Bayesian and hypergeometric statistical methods that reduce the number of individuals who must be tested to meet the WHO criterion.
authors.affiliation: Vector Control Division, Ministry of Health, Kampala, Uganda; The Carter Center, Kampala, Uganda; Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama; Department of Global Health, University of South Florida, Tampa, Florida; The Carter Center, Atlanta, Georgia.
authors.forename: David
authors.initials: D
authors.lastname: Oguttu
authors.forename: Edson
authors.initials: E
authors.lastname: Byamukama
authors.forename: Charles R
authors.initials: CR
authors.lastname: Katholi
authors.forename: Peace
authors.initials: P
authors.lastname: Habomugisha
authors.forename: Christine
authors.initials: C
authors.lastname: Nahabwe
authors.forename: Monica
authors.initials: M
authors.lastname: Ngabirano
authors.forename: Hassan K
authors.initials: HK
authors.lastname: Hassan
authors.forename: Thomson
authors.initials: T
authors.lastname: Lakwo
authors.forename: Moses
authors.initials: M
authors.lastname: Katabarwa
authors.forename: Frank O
authors.initials: FO
authors.lastname: Richards
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Unnasch
mesh_terms: D000293:Adolescent; D000818:Animals; D001499:Bayes Theorem; D002648:Child; D002675:Child, Preschool; D060740:Disease Eradication / Q000379:methods*; D004797:Enzyme-Linked Immunosorbent Assay; D062665:Epidemiological Monitoring; D006801:Humans; D007223:Infant; D017181:Onchocerca volvulus / Q000302:isolation & purification; D009855:Onchocerciasis / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology* / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D015995:Prevalence; D062486:Public Health Surveillance; D014454:Uganda / Q000453:epidemiology; D014944:World Health Organization