title: Evaluation of Lymphatic Filariasis and Onchocerciasis in Three Senegalese Districts Treated for Onchocerciasis with Ivermectin.
abstract: In Africa, onchocerciasis and lymphatic filariasis (LF) are co-endemic in many areas. Current efforts to eliminate both diseases are through ivermectin-based mass drug administration (MDA). Years of ivermectin distribution for onchocerciasis may have interrupted LF transmission in certain areas. The Kédougou region, Senegal, is co-endemic for LF and onchocerciasis. Though MDA for onchocerciasis started in 1988, in 2014 albendazole had not yet been added for LF. The objective of this study was to assess in an integrated manner the LF and onchocerciasis status in the three districts of the Kédougou region after ≥10 years of ivermectin-based MDA. The study employed an African Programme for Onchocerciasis Control (APOC) onchocerciasis-related methodology. In the three districts, 14 villages close to three rivers that have Simulium damnosum breeding sites were surveyed. Convenience sampling of residents ≥5 years old was performed. Assessment for LF antigenemia by immunochromatographic testing (ICT) was added to skin snip microscopy for onchocerciasis. Participants were also tested for antibodies against Wb123 (LF) and Ov16 (onchocerciasis) antigens. In two districts, no participants were ICT or skin snip positive. In the third district, 3.5% were ICT positive and 0.7% were skin snip positive. In all the three districts, Wb123 prevalence was 0.6%. Overall, Ov16 prevalence was 6.9%. Ov16 prevalence among children 5-9 years old in the study was 2.5%. LF antigenemia prevalence was still above treatment threshold in one district despite ≥10 years of ivermectin-based MDA. The presence of Ov16 positive children suggested recent transmission of Onchocerca volvulus. This study showed the feasibility of integrated evaluation of onchocerciasis and LF but development of integrated robust methods for assessing transmission of both LF and onchocerciasis are needed to determine where MDA can be stopped safely in co-endemic areas.
authors.affiliation: Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America.
authors.forename: Nana O
authors.initials: NO
authors.lastname: Wilson
authors.affiliation: Ministère de la Santé et de l'Action Sociale, Dakar, Senegal.
authors.forename: Alioune
authors.initials: A
authors.lastname: Badara Ly
authors.affiliation: Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America.
authors.forename: Vitaliano A
authors.initials: VA
authors.lastname: Cama
authors.affiliation: Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America.
authors.forename: Paul T
authors.initials: PT
authors.lastname: Cantey
authors.affiliation: RTI International, Washington, DC, United States of America.
authors.forename: Daniel
authors.initials: D
authors.lastname: Cohn
authors.affiliation: World Health Organization, Regional Office for Africa, Senegal.|African Programme for Onchocerciasis Control Representative, Ougadougou, Burkina Faso.
authors.forename: Lamine
authors.initials: L
authors.lastname: Diawara
authors.affiliation: IMA World Health, Port-au-Prince, Haiti.
authors.forename: Abdel
authors.initials: A
authors.lastname: Direny
authors.affiliation: RTI/ENVISION, Dakar, Senegal.
authors.forename: Mawo
authors.initials: M
authors.lastname: Fall
authors.affiliation: Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America.
authors.forename: Karla R
authors.initials: KR
authors.lastname: Feeser
authors.affiliation: Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America.
authors.forename: LeAnne M
authors.initials: LM
authors.lastname: Fox
authors.affiliation: RTI International, Washington, DC, United States of America.
authors.forename: Achille
authors.initials: A
authors.lastname: Kabore
authors.affiliation: Ministère de la Santé et de l'Action Sociale, Dakar, Senegal.
authors.forename: Amadou F
authors.initials: AF
authors.lastname: Seck
authors.affiliation: Service de Lutte Antiparasitaire, Ministère de la Santé et de l'Action Sociale, Thies, Senegal.
authors.forename: Ngayo
authors.initials: N
authors.lastname: Sy
authors.affiliation: University Cheikh Anta Diop, Dakar, Senegal.
authors.forename: Daouda
authors.initials: D
authors.lastname: Ndiaye
authors.affiliation: Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America.
authors.forename: Christine
authors.initials: C
authors.lastname: Dubray
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000909:Antibodies, Helminth / Q000097:blood; D002648:Child; D002675:Child, Preschool; D004605:Elephantiasis, Filarial / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007559:Ivermectin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009855:Onchocerciasis / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D012675:Senegal / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000909:Antibodies, Helminth; D007559:Ivermectin