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Onchocerciasis Elimination Program for the Americas — OEPA – October 2005. Lymphatic Filariasis Elimination in the Americas 5 th Regional Program Review Group (RPRG) Meeting (San José, Costa Rica) . Onchocerciasis Elimination Program for the Americas (OEPA).

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onchocerciasis elimination program for the americas oepa october 2005

Onchocerciasis Elimination Program for the Americas— OEPA –October 2005

Lymphatic Filariasis Elimination in the Americas

5th Regional Program Review Group (RPRG) Meeting(San José, Costa Rica)

onchocerciasis elimination program for the americas oepa
Onchocerciasis Elimination Program for the Americas (OEPA)

Headquartered in Guatemala, OEPA is the technical and coordinating body of a multi-national, multi-agency coalition that acts under the 1991 Resolution XIV of XXXV Directing Council of the Pan American Health Organization calling for the elimination of all onchocerciasis morbidity from the Americas by the year 2007.

partnership organizational chart
Partnership Organizational Chart

57th WHA, May 19, 2004

IACO 2003, Cartagena, Colombia

MDP/

Merck & Co.

CDC

Lions

Club

Carter

Center

Gates

Foundation

PAHO/

WHO

NGDO

& OTHERS

PCC

Programmatic

Directorship

OEPA

Executor

Country Programs

Brazil

Colombia

Ecuador

Guatemala

Mexico

Venezuela

geographic distribution of onchocerciasis in the americas
Geographic Distribution of Onchocerciasis in the Americas

VENEZUELA:

1

9. North-eastern Focus

2

MEXICO

8. North-central Focus

3

4

10. Southern Focus (Amazonas/Bolivar)

GUATEMALA

5

7

6

BRAZIL:

MEXICO:

11. Amazonas-Roraima Focus

1. Oaxaca Focus

2. Northern Chiapas Focus

(YANOMAMI Area)

3. Southern Chiapas Focus

8

9

GUATEMALA:

4. Cuilco Focus (Huehuetenango)

VENEZUELA

5. Central Focus:

- Sololá,

- Suchitepéquez

- Chimaltenango

COLOMBIA:

COLOMBIA

6. Escuintla , Guatemala Focus

10

12. López de Micay Focus

12

7. Santa Rosa Focus

11

ECUADOR:

13

13. Esmeraldas/ Pichincha Focus

- Cayapas River

BRAZIL

ECUADOR

- Santiago River

- Onzole River

- Satellite Foci:

(Canandé and others)

oepa strategy wording from who certification document
OEPA Strategy (wording from WHO Certification Document)

6-monthly mass distributions of Mectizan® in all endemic areas, covering at least 85% of the eligible population.

Two primary goals:

  • First, to eliminate morbidity due to infection with O. volvulus in the six-country programme by the year 2007. This is also stated as elimination of onchocerciasis as a public health problem by the year 2007.
  • Second, to eliminate parasite transmission in those countries or foci where feasible. No time limit is specified.
slide7
Criteria for Certification of Elimination(wording from WHO Certification Document)4. 1. Elimination of Morbidity
  • Absence of reversible lesions in the anterior segment of the eye (punctate keratitis, microfilariae in the anterior chamber). A 5-year cumulative incidence rate of less than 1 new case per 1000 is acceptable
  • It must be remembered that permanent eye lesions, as well as some severe skin or lymphatic lesions, are irreversible. Such “old morbidity” cannot be eliminated except bydeath.
4 2 elimination of transmission and infection
4 .2. Elimination of Transmission and Infection

4. 2. 1. Entomology

The absence, or near absence, of infective-stage larvae in the vector population as determined by PCR in a minimum sample size of 10,000 flies for each endemic community tested.

4 2 2 human epidemiology children
4. 2. 2. Human Epidemiology(Children)

The absence of detectable infection (as evidenced by microfilariae, nodules, immunological or other proven tests) in untreated children reaching the age of 5. A 5-year cumulative incidence rate of less than 1 new case per 1000 susceptible children is acceptable.

4 2 3 human epidemiology migrants
4. 2. 3. Human Epidemiology (Migrants)

The absence of detectable infection in untreated, new residents who have migrated into an endemic area where transmission has been interrupted (1 new case per 1000 susceptible individuals).

slide12

SIMON: A simulation of numbers of infected persons in the population of Corriente Grande following continual six-monthly distribution of ivermectin. Proportion of non- receivers 2.0%. Each line represents one of 100 model replicates.

Adult Worm Negative

slide13

SIMON: A generated probability of eliminating all living female O. volvulus from the human population of Corriente Grande, expressed as the proportion of uninfected persons remaining in the population each year

Source: Davies, 2005, unpublished