DOCSLIB.ORG

Projected Number of People with Onchocerciasis–Loiasis Coinfection in Africa, 1995 to 2025 Natalie V.S

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Projected Number of People with Onchocerciasis–Loiasis Coinfection in Africa, 1995 to 2025 Natalie V.S Clinical Infectious Diseases MAJOR ARTICLE Projected Number of People With Onchocerciasis–Loiasis Coinfection in Africa, 1995 to 2025 Natalie V.S. Vinkeles Melchers,1 Luc E. Coffeng,1 Michel Boussinesq,2 Belén Pedrique,3 Sébastien D.S. Pion,2 Afework H. Tekle,4 Honorat G.M. Zouré,5 6 7,a 1,a Samuel Wanji, Jan H. Remme, and Wilma A. Stolk Downloaded from https://academic.oup.com/cid/advance-article-abstract/doi/10.1093/cid/ciz647/5532272 by guest on 29 October 2019 1Department of Public Health, Erasmus MC, University Medical Center Rotterdam, The Netherlands; 2Unité Mixte Internationale 233 TransVIHMI, Institut de Recherche pour le Développement (IRD), INSERM U1175, University of Montpellier, Montpellier, France; 3Research & Development Department, Drugs for Neglected Diseases initiative, and 4Preventive Chemotherapy and Transmission Control Unit, Control of Neglected Tropical Diseases Department, World Health Organization, Geneva, Switzerland; 5Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN), World Health Organization, Regional Office for Africa, Cité du Djoué, Brazzaville, Republic of Congo; 6Parasites and Vectors Research Unit, Department of Microbiology and Parasitology, University of Buea, Cameroon; 7Ornex, France Background. Onchocerciasis elimination through mass drug administration (MDA) is hampered by coendemicity of Loa loa, as people with high L. loa microfilariae (mf) density can develop serious adverse events (SAEs) after ivermectin treatment. We assessed the geographical overlap of onchocerciasis and loiasis prevalence and estimated the number of coinfected individuals at risk of post- ivermectin SAEs in West and Central Africa from 1995 to 2025. Methods. Focusing on regions with suspected loiasis transmission in 14 countries, we overlaid precontrol maps of loiasis and onchocerciasis prevalence to calculate precontrol prevalence of coinfection by 5 km2 × 5 km2 pixel, distinguishing different categories of L. loa mf intensity. Using statistical and mathematical models, we predicted prevalence of both infections and coinfection for 2015 and 2025, accounting for the impact of MDA with ivermectin. Results. The number of people infected with onchocerciasis was predicted to decline from almost 19 million in 1995 to 4 million in 2025. Of these, 137 000 people were estimated to also have L. loa hypermicrofilaremia (≥20 000 L. loa mf/mL) in 1995, declining to 31 000 in 2025. In 2025, 92.8% of coinfected cases with loiasis hypermicrofilaremia are predicted to live in hypoendemic areas currently not targeted for MDA. Conclusions. Loiasis coinfection is a major concern for onchocerciasis elimination in Africa. We predict that under current strategies, at least 31 000 coinfected people still require treatment for onchocerciasis in 2025 while being at risk of SAEs, justifying continued efforts in research and development for safer drugs and control strategies. Keywords. Loa loa; onchocerciasis; ONCHOSIM; mass drug administration; serious adverse events. In 2012 the World Health Organization targeted onchocerci- at risk for O. volvulus infection in Africa were treated with iver- asis, also known as river blindness, for elimination through pre- mectin [1]. ventive chemotherapy interventions. Onchocerciasis is caused The elimination of onchocerciasis is hampered by by the filarial nematode Onchocerca volvulus and is transmitted coendemicity of loiasis (African eye worm), another filarial in- by black flies (genus Simulium). Onchocerciasis has a long fection present in West and Central Africa. People with high history of control. The Onchocerciasis Control Programme Loa loa microfilarial (mf) densities can develop potentially (1974–2002) in West Africa started with regional vector con- fatal serious adverse events (SAEs) after ivermectin treatment. trol, later supplemented by mass drug administration (MDA) The pathogenesis of postivermectin L. loa–related neurolog- with ivermectin. The African Programme for Onchocerciasis ical complications is not fully understood but is most likely a Control (APOC, 1995–2015) subsequently initiated MDA in 19 combination of mechanical blockage of capillaries by large additional African countries. In 2016, about 132 million people numbers of L. loa mf paralyzed by the drug and vascular en- dothelial changes associated with the destruction of mf [2, 3]. Ivermectin can induce marked adverse effects with a functional Received 27 March 2019; editorial decision 5 July 2019; accepted 12 July 2019; published impairment that lasts several days in those harboring >8000 mf/ online July 13, 2019. aJ. H. R. and W. A. S. contributed equally to this work. mL blood and unconsciousness, coma, and death in individuals Correspondence: N.V.S. Vinkeles Melchers, Department of Public Health, Erasmus MC, with >30 000 mf/mL levels prior to treatment [2, 4, 5]. The prob- University Medical Center Rotterdam, P.O. box 2040, 3000 CA Rotterdam, The Netherlands (n. ability of SAEs after ivermectin intake increases from approxi- [email protected], [email protected]). mately 0.7% in individuals with 30 000 mf/mL to approximately Clinical Infectious Diseases® 2019;XX(XX):1–9 © The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society 7% in individuals with L. loa counts of 50 000 mf/mL [3]. As of America. This is an Open Access article distributed under the terms of the Creative Commons the benefits of treatment were considered to outweigh the risk Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. of SAEs, coendemic areas with high onchocerciasis prevalence DOI: 10.1093/cid/ciz647 were nevertheless targeted for MDA with ivermectin, although Coinfections of Onchocerciasis–Loiasis • CID 2019:XX (XX XXXX) • 1 fear for SAEs sometimes resulted in low treatment coverage [6]. S3, and section 3.2. Next, we used the prevalence of history of However, coendemic areas with low onchocerciasis prevalence eye worm from the RAPLOA map to estimate the proportion have remained untreated to date and might be in need of alter- of people in each L. loa mf count intensity category (≥8000 to native strategies. <20 000 mf/mL; ≥20 000 to <30 000 mf/mL; ≥30 000 mf/mL) To understand the need for and feasibility of alternative using a statistical model as described in Supplement S1, section strategies for onchocerciasis elimination in loiasis-endemic 3.4, and Figure S4. areas, we assessed the extent of coendemicity and estimated the number of coinfected individuals, including people with Onchocerciasis Maps We used previously published maps based on rapid epidemio- such high L. loa mf intensity levels that ivermectin treatment Downloaded from https://academic.oup.com/cid/advance-article-abstract/doi/10.1093/cid/ciz647/5532272 by guest on 29 October 2019 is considered unsafe. We combined empirical data using mul- logical mapping of onchocerciasis (REMO) [12, 13]. A previous tiple sources with statistical and mathematical models to esti- model-based geostatistical analysis of REMO data [12] resulted mate how the number of onchocerciasis, loiasis, and coinfection in a raster map of the precontrol prevalence of nodules in cases change over time since precontrol levels up to 2025. APOC countries (Figure 1) and some newly added extensions (Figure S2 and Supplement S1, section 3.3 in). We converted the 2 2 METHODS precontrol nodule prevalence map into a 5 km × 5 km map of precontrol O. volvulus mf prevalence in the general population General Approach using methods described elsewhere [14, 15]. To estimate the number of people with onchocerciasis–lo- We linked each raster cell to its APOC project (implemen- iasis coinfection in Africa, we first overlaid 5 km2 × 5 km2 tation unit for MDA, see definitions inSupplement S1, section resolution raster precontrol maps of loiasis and onchocer- 1) and related information on project treatment history and ciasis prevalence with rural population density data from expected future treatment scenario. Briefly, nearly all oncho- 1995. For each raster cell, we then used predictive mod- cerciasis hyper- and mesoendemic areas had started annual or eling approaches to assess likely changes in the prevalence sometimes biannual MDA by 2013 (up to which year we have of both infections thanks to locally implemented MDA with reported treatment history). For the few projects that had not ivermectin. Predictions for 2015 and 2025 were combined yet started MDA by 2013, we followed the assumptions of Kim with raster maps of estimated population density for the et al [16], with some adaptations described in Supplement S1, same years, and results were subsequently aggregated over section 3.5, and Supplement S3. all raster cells within defined target areas. Below, we de- scribe the methods used to estimate the impact of MDA with Impact of MDA on Loiasis ivermectin on the 2 infections. A detailed methodology de- Based on published studies [17–19], we assume that MDA scription, including the definitions applied, is provided in causes a change in the L. loa mf count frequency distribu- Supplement S1, Table S1. tion. In our main analysis, we assumed that MDA causes a Geographical Scope of the Analysis change in the L. loa mf count frequency distribution among The geographical scope of this analysis includes areas that were the population that received a first ivermectin treatment ac- surveyed for L. loa endemicity across
Load more

Recommended publications
  • The Functional Parasitic Worm Secretome: Mapping the Place of Onchocerca Volvulus Excretory Secretory Products
    pathogens Review The Functional Parasitic Worm Secretome: Mapping the Place of Onchocerca volvulus Excretory Secretory Products Luc Vanhamme 1,*, Jacob Souopgui 1 , Stephen Ghogomu 2 and Ferdinand Ngale Njume 1,2 1 Department of Molecular Biology, Institute of Biology and Molecular Medicine, IBMM, Université Libre de Bruxelles, Rue des Professeurs Jeener et Brachet 12, 6041 Gosselies, Belgium; [email protected] (J.S.); [email protected] (F.N.N.) 2 Molecular and Cell Biology Laboratory, Biotechnology Unit, University of Buea, Buea P.O Box 63, Cameroon; [email protected] * Correspondence: [email protected] Received: 28 October 2020; Accepted: 18 November 2020; Published: 23 November 2020 Abstract: Nematodes constitute a very successful phylum, especially in terms of parasitism. Inside their mammalian hosts, parasitic nematodes mainly dwell in the digestive tract (geohelminths) or in the vascular system (filariae). One of their main characteristics is their long sojourn inside the body where they are accessible to the immune system. Several strategies are used by parasites in order to counteract the immune attacks. One of them is the expression of molecules interfering with the function of the immune system. Excretory-secretory products (ESPs) pertain to this category. This is, however, not their only biological function, as they seem also involved in other mechanisms such as pathogenicity or parasitic cycle (molting, for example). Wewill mainly focus on filariae ESPs with an emphasis on data available regarding Onchocerca volvulus, but we will also refer to a few relevant/illustrative examples related to other worm categories when necessary (geohelminth nematodes, trematodes or cestodes).
    [Show full text]
  • Co-Infection with Onchocerca Volvulus and Loa Loa Microfilariae in Central Cameroon: Are These Two Species Interacting?
    843 Co-infection with Onchocerca volvulus and Loa loa microfilariae in central Cameroon: are these two species interacting? S. D. S. PION1,2*, P. CLARKE3, J. A. N. FILIPE2,J.KAMGNO1,J.GARDON1,4, M.-G. BASA´ N˜ EZ2 and M. BOUSSINESQ1,5 1 Laboratoire mixte IRD (Institut de Recherche pour le De´veloppement) – CPC (Centre Pasteur du Cameroun) d’Epide´miologie et de Sante´ publique, Centre Pasteur du Cameroun, BP 1274, Yaounde´, Cameroun 2 Department of Infectious Disease Epidemiology, St Mary’s campus, Norfolk Place, London W2 1PG, UK 3 Infectious Disease Epidemiology Unit London School of Hygiene and Tropical Medicine Keppel Street, London WC1E 7HT, UK 4 Institut de Recherche pour le De´veloppement, UR 24 Epide´miologie et Pre´vention, CP 9214 Obrajes, La Paz, Bolivia 5 Institut de Recherche pour le De´veloppement, De´partement Socie´te´s et Sante´, 213 rue La Fayette, 75480 Paris Cedex 10, France (Received 16 August 2005; revised 3 October; revised 9 December 2005; accepted 9 December 2005; first published online 10 February 2006) SUMMARY Ivermectin treatment may induce severe adverse reactions in some individuals heavily infected with Loa loa. This hampers the implementation of mass ivermectin treatment against onchocerciasis in areas where Onchocerca volvulus and L. loa are co-endemic. In order to identify factors, including co-infections, which may explain the presence of high L. loa micro- filaraemia in some individuals, we analysed data collected in 19 villages of central Cameroon. Two standardized skin snips and 30 ml of blood were obtained from each of 3190 participants and the microfilarial (mf) loads of both O.
    [Show full text]
  • Comparative Genomics of the Major Parasitic Worms
    Comparative genomics of the major parasitic worms International Helminth Genomes Consortium Supplementary Information Introduction ............................................................................................................................... 4 Contributions from Consortium members ..................................................................................... 5 Methods .................................................................................................................................... 6 1 Sample collection and preparation ................................................................................................................. 6 2.1 Data production, Wellcome Trust Sanger Institute (WTSI) ........................................................................ 12 DNA template preparation and sequencing................................................................................................. 12 Genome assembly ........................................................................................................................................ 13 Assembly QC ................................................................................................................................................. 14 Gene prediction ............................................................................................................................................ 15 Contamination screening ............................................................................................................................
    [Show full text]
  • Public Health Service Centers for Disease Control and Prevention (CDC) Memorandum Date: January 7, 2011 From: WHO Collaborat
    Public Health Service Centers for Disease Control DEPARTMENT OF HEALTH & HUMAN SERVICES and Prevention (CDC) Memorandum Date: January 7, 2011 From: WHO Collaborating Center for Research, Training and Eradication of Dracunculiasis Subject: GUINEA WORM WRAP-UP #202 To: Addressees “Perseverance and spirit have done wonders in all ages.” George Washington GHANA IS DONE Sometimes the sight and sound of bat against ball or gloved fist against an opponent’s head lets seasoned observers sense a homerun or knockout has occurred even before the ball leaves the park or the boxer hits the floor. We feel that way now about Guinea worm eradication in Ghana. With seven consecutive months of zero cases reported since May 2010 and fourteen months after reporting its last known uncontained case in October 2009, Ghana has finally conquered Guinea worm disease. (Figure 1) This early conclusion is unprecedented. Up to now the editors of Guinea Worm Wrap-Up have, with good reason, warned Ghana repeatedly about the perils of over-confidence or premature declarations of success. We have never before felt as assured about a national milestone of elimination before at least twelve consecutive months of indigenous cases have passed as we do now. And that this should occur in Ghana is especially wondrous, given that country’s exceptionally tortuous and delayed arrival at this point in its campaign. The long hoped-for portents were there with the record-breaking 85% reduction in cases between 2007 (3,358 cases) and 2008 (501 cases), the 97% reduction in cases between 2009 (242 cases) and 2010 (8 cases), and the obsessive attention to detecting every case, containing every worm, and tracing every source that Ghana’s Guinea Worm Eradication Program has manifest recently.
    [Show full text]
  • STUDIES on CHANDLERELLA Hawkincf, a FILARIAL PARASITE of CROW
    STUDIES ON CHANDLERELLA HAWKiNCf, A FILARIAL PARASITE OF CROW ABSTRACT Mthesis SUBMITtED' ' IN FULM.LMENT:OF THE:RHQUIREMENTS FOR THE DEGREE OF DOCTOR .OF PHlLOSdPHY IN . /nomRY SHAHNAZ BANO SECTION OF PARASITOLOGY DEPARTMENT OF ZOOLOGY ALIGARH MUSLIM UNIVERSITY ALIGARH January, 1981 ABSTRACT The thesis embodies the results of the studies on Chandlerella haukingi, a filarial parasite of Indian jungle crou, Corvus macrorhynchos (Uagler). Only four aspects, morphology, histology, histochemistry and in ^itro culture have been taken up. The morphological studies include a re description of adult worm uith an addition of a feu minor details in the adult. The structures described in microfilaria are the nuclear structures, cephalic structures, pharyngeal thread, Innenkorper and also occurrence of tuo forms of microfilariae in blood of crou. The nuclear structures naue been studied uith special reference to nuclear landmarks which are of great taxonomic vyalu^. Sometimes the nuclear structures do not suffice for identification of genera and soecies, the cephalic structures, pharyngeal thread and Innenkorper have also been studied. It has also been proved that the tuo forms of microfilariae, the long and the short, present in the blood of crou belono to the same species, C. haukingi. The stereoscan studies of the cuticular structures of the adult and the microfilaria have heen done as these are of great taxonomic importance in classification of uorms. The histological studies include the study of histological features of the body uall, musculature, alimentary canal and reproductiue organs as some of these structures provide a taxonomic tool at various levels. Among histochemical •^^tudies, four enzymes, viz; acid phosphatase, alkaline phosphatase, adenosine triphosphatase and carboxylesterase have been localized as these enzymes are attributed to different functions and their distribution is very specific.
    [Show full text]
  • Classification and Nomenclature of Human Parasites Lynne S
    C H A P T E R 2 0 8 Classification and Nomenclature of Human Parasites Lynne S. Garcia Although common names frequently are used to describe morphologic forms according to age, host, or nutrition, parasitic organisms, these names may represent different which often results in several names being given to the parasites in different parts of the world. To eliminate same organism. An additional problem involves alterna- these problems, a binomial system of nomenclature in tion of parasitic and free-living phases in the life cycle. which the scientific name consists of the genus and These organisms may be very different and difficult to species is used.1-3,8,12,14,17 These names generally are of recognize as belonging to the same species. Despite these Greek or Latin origin. In certain publications, the scien- difficulties, newer, more sophisticated molecular methods tific name often is followed by the name of the individual of grouping organisms often have confirmed taxonomic who originally named the parasite. The date of naming conclusions reached hundreds of years earlier by experi- also may be provided. If the name of the individual is in enced taxonomists. parentheses, it means that the person used a generic name As investigations continue in parasitic genetics, immu- no longer considered to be correct. nology, and biochemistry, the species designation will be On the basis of life histories and morphologic charac- defined more clearly. Originally, these species designa- teristics, systems of classification have been developed to tions were determined primarily by morphologic dif- indicate the relationship among the various parasite ferences, resulting in a phenotypic approach.
    [Show full text]
  • Nematode Infections of the Eye: Toxocariasis, Onchocerciasis, Diffuse Unilateral Subacute Neuroretinitis, and Cysticercosis
    Ophthalmol Clin N Am 15 (2002) 351–356 Nematode infections of the eye: toxocariasis, onchocerciasis, diffuse unilateral subacute neuroretinitis, and cysticercosis Nelson Alexandre Sabrosa, MD a,b,*, Moyse´s Zajdenweber, MD c,d aDepartment of Ophthalmology, University of Sa˜o Paulo, FMUSP, Sa˜o Paulo, Brazil bOphthalmology Department, Clı´nica Sa˜o Vicente, Rua Joao Borges, 204-Gavea, CEP 22451-100, Rio de Janeiro, Brazil cDepartment of Ophthalmology, Federal University of Sa˜o Paulo, Paulista School of Medicine, Sa˜o Paulo, Brazil dOphthalmology Department, Instituto Brasileiro de Oftalmologia, Praia de Botafogo 206, Botafogo, Rio de Janeiro, Brazil Ocular toxocariasis may cause a large spectrum of illitis, each of which can lead to loss of vision in the manifestations in the eye, from an asymptomatic affected eye [7]. posterior granuloma, to total retinal detachment [1]. It represents one of the most common parasitic causes Epidemiology of visual loss throughout the world [2], and it usually affects young children. Other nematodes can cause Human toxocariasis is probably one of the most ocular disease, most of them related to adult large widespread zoonotic nematode infections, occurring worms. Diffuse unilateral subacute neuroretinitis mainly in areas where the relationship between man, (DUSN) is a more recently described disorder soil, and dog is particularly close [8]. T canis is an believed to be caused by smaller nematodes [3,4]. often encountered canine parasite, affecting dogs, Onchocerciasis and cysticercosis are seen mainly in wolves, foxes, and other canidis, whereas T catis the developing world. may be found in domestic cats [9–11]. Human beings are contaminated through ingestion of the ova by geophagia, by eating contaminated foods, or by close Toxocariasis contact with puppies.
    [Show full text]
  • Zoonotic Helminths Affecting the Human Eye Domenico Otranto1* and Mark L Eberhard2
    Otranto and Eberhard Parasites & Vectors 2011, 4:41 http://www.parasitesandvectors.com/content/4/1/41 REVIEW Open Access Zoonotic helminths affecting the human eye Domenico Otranto1* and Mark L Eberhard2 Abstract Nowaday, zoonoses are an important cause of human parasitic diseases worldwide and a major threat to the socio-economic development, mainly in developing countries. Importantly, zoonotic helminths that affect human eyes (HIE) may cause blindness with severe socio-economic consequences to human communities. These infections include nematodes, cestodes and trematodes, which may be transmitted by vectors (dirofilariasis, onchocerciasis, thelaziasis), food consumption (sparganosis, trichinellosis) and those acquired indirectly from the environment (ascariasis, echinococcosis, fascioliasis). Adult and/or larval stages of HIE may localize into human ocular tissues externally (i.e., lachrymal glands, eyelids, conjunctival sacs) or into the ocular globe (i.e., intravitreous retina, anterior and or posterior chamber) causing symptoms due to the parasitic localization in the eyes or to the immune reaction they elicit in the host. Unfortunately, data on HIE are scant and mostly limited to case reports from different countries. The biology and epidemiology of the most frequently reported HIE are discussed as well as clinical description of the diseases, diagnostic considerations and video clips on their presentation and surgical treatment. Homines amplius oculis, quam auribus credunt Seneca Ep 6,5 Men believe their eyes more than their ears Background and developing countries. For example, eye disease Blindness and ocular diseases represent one of the most caused by river blindness (Onchocerca volvulus), affects traumatic events for human patients as they have the more than 17.7 million people inducing visual impair- potential to severely impair both their quality of life and ment and blindness elicited by microfilariae that migrate their psychological equilibrium.
    [Show full text]
  • Detection of the Filarial Parasite Mansonella Streptocerca in Skin Biopsies by a Nested Polymerase Chain Reaction-Based Assay Peter U
    Smith ScholarWorks Biological Sciences: Faculty Publications Biological Sciences 1998 Detection of the Filarial Parasite Mansonella streptocerca in Skin Biopsies by a Nested Polymerase Chain Reaction-Based Assay Peter U. Fischer Dietrich W. Büttner Jotham Bamuhiiga Steven A. Williams Smith College, [email protected] Follow this and additional works at: https://scholarworks.smith.edu/bio_facpubs Part of the Biology Commons Recommended Citation Fischer, Peter U.; Büttner, Dietrich W.; Bamuhiiga, Jotham; and Williams, Steven A., "Detection of the Filarial Parasite Mansonella streptocerca in Skin Biopsies by a Nested Polymerase Chain Reaction-Based Assay" (1998). Biological Sciences: Faculty Publications, Smith College, Northampton, MA. https://scholarworks.smith.edu/bio_facpubs/41 This Article has been accepted for inclusion in Biological Sciences: Faculty Publications by an authorized administrator of Smith ScholarWorks. For more information, please contact [email protected] Am. J. Trop. Med. Hyg., 58(6), 1998, pp. 816±820 Copyright q 1998 by The American Society of Tropical Medicine and Hygiene DETECTION OF THE FILARIAL PARASITE MANSONELLA STREPTOCERCA IN SKIN BIOPSIES BY A NESTED POLYMERASE CHAIN REACTION±BASED ASSAY PETER FISCHER, DIETRICH W. BUÈ TTNER, JOTHAM BAMUHIIGA, AND STEVEN A. WILLIAMS Clark Science Center, Department of Biological Sciences, Smith College, Northampton, Massachusetts; Department of Helminthology and Entomology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany; German Agency for Technical Cooperation and Basic Health Services, Fort Portal, Uganda Abstract. To differentiate the skin-dwelling ®lariae Mansonella streptocerca and Onchocerca volvulus, a nested polymerase chain reaction (PCR) assay was developed from small amounts of parasite material present in skin biopsies. One nonspeci®c and one speci®c pair of primers were used to amplify the 5S rDNA spacer region of M.
    [Show full text]
  • Emergence of Onchocerca Volvulus from Skin Mimicking Dracunculiasis Medinensis
    Am. J. Trop. Med. Hyg., 83(6), 2010, pp. 1348–1351 doi:10.4269/ajtmh.2010.10-0475 Copyright © 2010 by The American Society of Tropical Medicine and Hygiene Case Report: Emergence of Onchocerca volvulus from Skin Mimicking Dracunculiasis medinensis Mark L. Eberhard ,* Ernesto Ruiz-Tiben , Andrew S. Korkor , Sharon L. Roy , and Philip Downs Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; The Carter Center, Atlanta, Georgia; Ghana Guinea Worm Eradication Programme, Ministry of Health/Ghana Health Services, Tamale, Ghana Abstract. We describe 11 cases of suspected Dracunculus medinensis infection in which the worm recovered was iden- tified as Onchocerca volvulus . Identification was based on morphology of the examined specimen. A global campaign to eradicate Guinea worm disease (dra- blemish, pimple, or open lesion was present from which the cunculiasis) began in 1980 1 and, in the ensuing 30 years, tre- worm was removed. Several of these lesions resembled the mendous progress has been achieved. 2, 3 Fewer than 4,000 emergence of a true Guinea worm, except that the worm was cases of Guinea worm disease were reported in 2009, and only smaller or thinner than normal ( Figures 1 and 2 ). In others 764 cases were reported during January–June 2010; more than lesions ( Figure 3 ), the appearance was not typical of Guinea 97% of the cases reported in 2010 have been from only one worm, but because the worm was removed through the skin, it country, (Sudan). 2, 3 Part of the rigorous monitoring and sur- was classified initially by program staff in country as Guinea veillance inherent in the eradication programs within countries worm.
    [Show full text]
  • 210867Orig1s000
    CENTER FOR DRUG EVALUATION AND RESEARCH APPLICATION NUMBER: 210867Orig1s000 CLINICAL MICROBIOLOGY/VIROLOGY REVIEW(S) Division of Anti-Infective Products Clinical Microbiology Review NDA: 210867 (SDN-001, 003); Original NDA Date Submitted: 10/13/2017; 12/04/2017 Date received by CDER: 10/13/2017; 12/04/2017 Date Assigned: 10/19/2017; 12/05/2017 Date Completed: 03/14/2018 Reviewer: Shukal Bala, PhD APPLICANT: Medicines Development for Global Health 18 Kavanagh Street, Level 1 Southbank Melbourne, VIC 3006 C/O Target Health Inc 261 Madison Ave, 24th Fl New York, New York 10016 DRUG PRODUCT NAMES: Proprietary name: None Non-proprietary name: Moxidectin Chemical name: (2aE,4E,5'R,6R,6'S, 8E,11 R, 13S, 15S, 17aR,20R,20aR,20bS)-6'-[(E)-1,3-dimethyl-1-butenyl] 5',6,6',7,10,11,14,15,17a,20,20a,20b-dodecahydro-20,20b-dihydroxy-5',6,8,19- tetramethylspiro [11,15-methano-2H, 13H, 17 H-furo[ 4,3,2-pq][2,6] benzodioxacyclooctadecin-13,2'-2H]pyran] -4', 17(3'H)-dione 4'-(E)-(0-methyloxime) STRUCTURAL FORMULA: Molecular weight: 639.82 Molecular formula: C37H53NO8 DRUG CATEGORY: Antiparasitic/antheminthic PROPOSED INDICATION: Treatment of onchocerciasis due to (b) (4) Onchocerca volvulus PROPOSED DOSAGE FORM, ROUTE OF ADMINISTRATION AND DURATION OF TREATMENT: Dosage form: Tablets (contains 2 mg of active ingredient) Route of administration: Oral Dosage and Duration: 8 mg/day – single dose Reference ID: 4233984 Division of Anti-Infective Products Clinical Microbiology Review NDA 210867 (Moxidectin) Page 2 of 50 DISPENSED: Rx RELATED DOCUMENTS: IND 126876 REMARKS The nonclinical studies in vitro, in animals infected with Onchocerca or other filarial species as well as the two clinical studies in subjects with onchocerciasis support the activity of moxidectin against Onchocerca parasites.
    [Show full text]
  • Molecular Verification of New World Mansonella Perstans Parasitemias
    RESEARCH LETTERS This evaluation was subject to limitations. We were not 7. Lee D, Philen R, Wang Z, McSpadden P, Posey DL, Ortega LS, able to control for all risk factors for TB (e.g., HIV), which et al.; Centers for Disease Control and Prevention. Disease surveillance among newly arriving refugees and immigrants— could have affected our odds calculations. Also, because dia- Electronic Disease Notification System, United States, 2009. betes screening is not a required part of the overseas medi- MMWR Surveill Summ. 2013;62:1–20. cal examination, some persons with diabetes were probably 8. Benoit SR, Gregg EW, Zhou W, Painter JA. Diabetes among missed, leading to an underestimation of the true prevalence United States–Bound Adult Refugees, 2009–2014. [Epub 2016 Mar 14]. J Immigr Minor Health. 2016;18:1357–64. of diabetes in this population. In the United States, ≈28% http://dx.doi.org/10.1007/s10903-016-0381-7 of persons have undiagnosed diabetes (9); this number may 9. Centers for Disease Control and Prevention. 2014 National diabetes be greater among refugees with limited access to healthcare statistics report. [cited 2016 Oct 3]. http://www.cdc.gov/diabetes/ services (10). Because diabetes was significantly associated data/statistics/2014StatisticsReport.html 10. Beagley J, Guariguata L, Weil C, Motala AA. Global estimates with TB, a differential misclassification may have occurred of undiagnosed diabetes in adults. Diabetes Res Clin Pract. where there was more undiagnosed diabetes among refugees 2014;103:150–60. http://dx.doi.org/10.1016/j.diabres.2013.11.001 with a history of TB disease.
    [Show full text]