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Onchocerciasis: changes in transmission in Mexico
Annals of Tropical Medicine and Parasitology
|December 23, 1998
Summary
Onchocerciasis control in Mexico has seen success with Mectizan (ivermectin) treatment, reducing disease incidence and prevalence. However, challenges remain in the Chiapas foci, impacting elimination efforts.
Area of Science:
- Public Health
- Infectious Diseases
- Tropical Medicine
Background:
- Onchocerciasis, or river blindness, endemic in three foci in southeastern Mexico (Chiapas and Oaxaca).
- These foci impact 286,000 people across 947 localities, with coffee farming as the primary economic activity.
- Previous control efforts were limited by logistical challenges and population migration.
Purpose of the Study:
- To evaluate the impact of Mectizan (ivermectin) introduction on onchocerciasis control in Mexico.
- To assess the progress towards onchocerciasis elimination in the endemic foci.
- To identify factors influencing control program success in different regions.
Main Methods:
- Introduction of Mectizan (ivermectin) in 1989 marked a shift in control strategies.
- Concerted control efforts between 1989 and 1997, supported by international organizations.
- Monitoring of disease indicators including new case incidence, nodule prevalence, and skin-snip positivity.
Main Results:
- Significant decreases in onchocerciasis incidence, nodule prevalence, and skin-snip positivity observed nationwide.
- The Oaxaca focus shows marked improvement, with potential interruption of transmission.
- Chiapas foci, despite efforts, face persistent challenges limiting control program success.
Conclusions:
- Mectizan (ivermectin) has revolutionized onchocerciasis control in Mexico, making elimination a feasible goal.
- Progress has been substantial, particularly in Oaxaca, but challenges persist in Chiapas.
- Sustained efforts and addressing logistical/migration issues are crucial for achieving nationwide onchocerciasis elimination.