title: Mass Administration of Ivermectin for the Elimination of Onchocerciasis Significantly Reduced and Maintained Low the Prevalence of Strongyloides stercoralis in Esmeraldas, Ecuador.
abstract: OBJECTIVE
  To evaluate the effect of ivermectin mass drug administration on strongyloidiasis and other soil transmitted helminthiases.
  
  
  METHODS
  We conducted a retrospective analysis of data collected in Esmeraldas (Ecuador) during surveys conducted in areas where ivermectin was annually administered to the entire population for the control of onchocerciasis. Data from 5 surveys, conducted between 1990 (before the start of the distribution of ivermectin) and 2013 (six years after the interruption of the intervention) were analyzed. The surveys also comprised areas where ivermectin was not distributed because onchocerciasis was not endemic. Different laboratory techniques were used in the different surveys (direct fecal smear, formol-ether concentration, IFAT and IVD ELISA for Strongyloides stercoralis).
  
  
  RESULTS
  In the areas where ivermectin was distributed the strongyloidiasis prevalence fell from 6.8% in 1990 to zero in 1996 and 1999. In 2013 prevalence in children was zero with stool examination and 1.3% with serology, in adult 0.7% and 2.7%. In areas not covered by ivermectin distribution the prevalence was 23.5% and 16.1% in 1996 and 1999, respectively. In 2013 the prevalence was 0.6% with fecal exam and 9.3% with serology in children and 2.3% and 17.9% in adults. Regarding other soil transmitted helminthiases: in areas where ivermectin was distributed the prevalence of T. trichiura was significantly reduced, while A. lumbricoides and hookworms were seemingly unaffected.
  
  
  CONCLUSIONS
  Periodic mass distribution of ivermectin had a significant impact on the prevalence of strongyloidiasis, less on trichuriasis and apparently no effect on ascariasis and hookworm infections.
authors.affiliation: Centro de Epidemiología Comunitaria y Medicina Tropical (CECOMET), Esmeraldas, Ecuador.
authors.forename: Mariella
authors.initials: M
authors.lastname: Anselmi
authors.affiliation: Centro per le Malattie tropicali, Negrar (Verona), Italy.
authors.forename: Dora
authors.initials: D
authors.lastname: Buonfrate
authors.affiliation: Facultad de Ciencias Medicas, Universidad Central del Ecuador, Quito, Ecuador.
authors.forename: Angel
authors.initials: A
authors.lastname: Guevara Espinoza
authors.affiliation: Centro de Epidemiología Comunitaria y Medicina Tropical (CECOMET), Esmeraldas, Ecuador.
authors.forename: Rosanna
authors.initials: R
authors.lastname: Prandi
authors.affiliation: Centro de Epidemiología Comunitaria y Medicina Tropical (CECOMET), Esmeraldas, Ecuador.
authors.forename: Monica
authors.initials: M
authors.lastname: Marquez
authors.affiliation: Centro per le Malattie tropicali, Negrar (Verona), Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Gobbo
authors.affiliation: Department of Control of Neglected Tropical Diseases (NTD), World Health Organization (WHO), Geneva, Switzerland.
authors.forename: Antonio
authors.initials: A
authors.lastname: Montresor
authors.affiliation: Fondazione Ivo de Carneri, Milano, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Albonico
authors.affiliation: Facultad de Ciencias Medicas, Universidad Central del Ecuador, Quito, Ecuador.
authors.forename: Marcia
authors.initials: M
authors.lastname: Racines Orbe
authors.affiliation: Centro de Epidemiología Comunitaria y Medicina Tropical (CECOMET), Esmeraldas, Ecuador.
authors.forename: Juan
authors.initials: J
authors.lastname: Martin Moreira
authors.affiliation: Centro per le Malattie tropicali, Ospedale Sacro Cuore, Negrar (Verona), Italy.
authors.forename: Zeno
authors.initials: Z
authors.lastname: Bisoffi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use*; D001196:Ascariasis / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004358:Drug Therapy / Q000379:methods; D004484:Ecuador / Q000453:epidemiology; D005260:Female; D006725:Hookworm Infections / Q000453:epidemiology; D006801:Humans; D007559:Ivermectin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009855:Onchocerciasis / Q000188:drug therapy*; D015995:Prevalence; D012189:Retrospective Studies; D017171:Strongyloides stercoralis / Q000187:drug effects*; D013322:Strongyloidiasis / Q000453:epidemiology*; D014257:Trichuriasis / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000871:Anthelmintics; D007559:Ivermectin