Abstract
BackgroundSince 1991, in Mexico, ivermectin has been administered twice a year to all residents in the onchocerciasis endemic foci which are mainly located in the coffee growing areas. However, the presence of a potentially infected itinerant seasonal labour force which is not treated regularly could jeopardise the attainment of the 85% coverage which is the present target for elimination of the disease.MethodsThe prevalence and intensity of Onchocerca volvulus microfilariae (mf), as well as their transmission from humans to vectors, were assessed during the coffee planting-clearing and harvesting seasons of 1997–1998, and 1998–1999 in two localities (I and II) of Southern Chiapas, Mexico, which regularly receive an influx of untreated migrant coffee labourers.ResultsLocalities I and II had, respectively, an average of 391 (± 32) and 358 (± 14) resident inhabitants, and 70 (± 52) and 498 (± 289) temporary labourers. The ratio of migrants to residents ranged from 0.1:1 in locality I to 2.4:1 in locality II. The proportion of infected Simulium ochraceum s.l. parous flies was significantly lower in locality I than in locality II, and significantly higher during the stay of the migrants than before their arrival or after their departure. Parity and infection were higher in May-July than in November-February (in contrast with the latter being typically considered as the peak onchocerciasis transmission season by S. ochraceum s.l.).ConclusionThe presence of significant numbers of untreated and potentially infected migrants may contribute to ongoing transmission, and their incorporation into ivermectin programmes should be beneficial for the attainment of the elimination goals of the regional initiative. However, the possibility that the results also reflect transmission patterns for the area cannot be excluded and these should be analyzed further.
Highlights
Since 1991, in Mexico, ivermectin has been administered twice a year to all residents in the onchocerciasis endemic foci which are mainly located in the coffee growing areas
In the Americas, the presence of infected migrant labourers who fail to receive regular ivermectin treatments may play a significant role in maintaining the infection reservoir, jeopardizing the goal of eventual parasite elimination from the region
From 1991 to 1994, bi-annual treatment with ivermectin was extended to all eligible residents of mesoendemic villages, and to 25% of those residing in hypoendemic villages
Summary
Since 1991, in Mexico, ivermectin has been administered twice a year to all residents in the onchocerciasis endemic foci which are mainly located in the coffee growing areas. In the Americas, the presence of infected migrant labourers who fail to receive regular ivermectin treatments may play a significant role in maintaining the infection reservoir, jeopardizing the goal of eventual parasite elimination from the region. As OEPA has made progress towards its ultimate goal of eliminating the infection in several foci of the region [8,9,10,11,12,13], there is hope that if the human microfilarial load can be kept below its breakpoint density (a level not yet determined), transmission may be interrupted and the parasite reservoir eventually eliminated [14]. When this study was completed the prospects of transmission interruption in Mexico had been less successful than expected (given the low competence of the main vector at low microfilaridermia levels [15]) despite high levels of coverage and compliance to multiple biannual ivermectin treatments [10,16]
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