Mass Administration of Ivermectin for the Elimination of Onchocerciasis Significantly Reduced and Maintained Low the Prevalence of Strongyloides stercoralis in Esmeraldas, Ecuador

Abstract

ObjectivesTo evaluate the effect of ivermectin mass drug administration on strongyloidiasis and other soil transmitted helminthiases.MethodsWe conducted a retrospective analysis of data collected in Esmeraldas (Ecuador) during surveys conducted in areas where ivermectin was annually administered to the entire population for the control of onchocerciasis.Data from 5 surveys, conducted between 1990 (before the start of the distribution of ivermectin) and 2013 (six years after the interruption of the intervention) were analyzed. The surveys also comprised areas where ivermectin was not distributed because onchocerciasis was not endemic.Different laboratory techniques were used in the different surveys (direct fecal smear, formol-ether concentration, IFAT and IVD ELISA for Strongyloides stercoralis).ResultsIn the areas where ivermectin was distributed the strongyloidiasis prevalence fell from 6.8% in 1990 to zero in 1996 and 1999. In 2013 prevalence in children was zero with stool examination and 1.3% with serology, in adult 0.7% and 2.7%.In areas not covered by ivermectin distribution the prevalence was 23.5% and 16.1% in 1996 and 1999, respectively. In 2013 the prevalence was 0.6% with fecal exam and 9.3% with serology in children and 2.3% and 17.9% in adults.Regarding other soil transmitted helminthiases: in areas where ivermectin was distributed the prevalence of T. trichiura was significantly reduced, while A. lumbricoides and hookworms were seemingly unaffected.ConclusionsPeriodic mass distribution of ivermectin had a significant impact on the prevalence of strongyloidiasis, less on trichuriasis and apparently no effect on ascariasis and hookworm infections.

Side Benefits of Mass Drug Administration for Lymphatic Filariasis on Strongyloides stercoralis Prevalence on Pemba Island, Tanzania

“…The potential benefit of PC with ivermectin in patients infected with S. stercoralis has been observed previously by a few studies that were reporting the results of control programs aiming at the elimination of either lymphatic filariasis (LF) or onchocercosis. 8,9 Pemba is together with Unguja one of the two main islands of the Zanzibar archipelago, where campaigns of PC including ivermectin in combination with albendazole for the elimination of LF have been periodically conducted since 2001. Several surveys assessing the prevalence and intensity of infections with STH were carried out in parallel.…”

Prevalence of Strongyloides stercoralis and Other Intestinal Parasite Infections in School Children in a Rural Area of Angola: A Cross-Sectional Study

“…Regular ivermectin MDA for this purpose has showed an important impact on the prevalence of S. stercoralis. 46 In Cubal, MDA campaigns for the control of lymphatic filariasis, onchocerciasis, soil-transmitted helminthiasis control, or schistosomiasis have not been performed. Findings derived from our study suggest that strategies to control intestinal parasites should be implemented in some areas of Cubal and should include ivermectin in combination with other drugs.…”

High prevalence of Strongyloides stercoralis in school-aged children in a rural highland of north-western Ethiopia: the role of intensive diagnostic work-up

“…Ivermectin is the treatment of choice [29, 30]. In countries where this has been introduced for control/elimination of onchocerciasis and lymphatic filariasis, prevalence of S. stercoralis has declined over time [31, 32]. …”