02775nas a2200397   4500000000100000008004100001260003400042653005700076653002100133653002800154100001400182700001100196700001300207700001400220700001400234700001400248700001100262700001500273700001500288700001100303700001400314700001300328700001100341700001200352700001600364700001300380700001200393700001500405700001400420245013100434856009300565300001400658490000700672520167300679022002502352       2022                            d  bOxford University Press (OUP)10aPublic Health, Environmental and Occupational Health10aGeneral Medicine10aHealth (social science)1 aIsiyaku S1 aIgbe M1 aMadaki S1 aHamill LC1 aNdongmo P1 aAdamani W1 aBush S1 aShu'aibu J1 aElhassan E1 aSaka Y1 aAnyaike C1 aAkpan NM1 aJoel A1 aNyior A1 aAbdullahi A1 aAleiro A1 aLabbo A1 aMafuyai HB1 aNwoke BEB00aThe interruption of transmission of onchocerciasis in Kaduna, Kebbi and Zamfara states, Nigeria: another milestone achievement  uhttps://academic.oup.com/inthealth/article-pdf/14/Supplement_2/ii43/45751591/ihac036.pdf  aii43-ii540 v143 a<p>Background: More than 40 million people live in onchocerciasis-endemic areas in Nigeria. For at least 19&nbsp;y, mass drug administration (MDA) with ivermectin was implemented with at least 65% total population coverage in Kaduna, Kebbi and Zamfara states. Impact surveys done using skin biopsies yielded no infections. Serological and entomological assessments were undertaken to determine if onchocerciasis transmission had been interrupted and MDA could be stopped.</p>

<p>Methods: The presence of onchocerciasis-specific immunoglobulin G4 antibody was measured by enzyme=linked immunosorbent assay conducted on dried blood spots collected from 5- to 9-year-old children resident in each state. O-150 polymerase chain reaction testing of Simulium damnosum s.l. heads for Onchocerca volvulus DNA was done on black flies collected by human landing capture and Esperanza window traps.</p>

<p>Results: A total of 9078 children were surveyed across the three states. A total of 6139 vectors were collected from Kaduna state, 129 from Kebbi state and 2 from Zamfara state; all were negative. Kebbi and Zamfara states did thousands of hours of black fly catching and intensive river prospecting. The resulting low fly catch was due to a low fly population incapable of sustaining transmission.</p>

<p>Conclusion: Onchocerciasis transmission has been interrupted and the three states meet World Health Organization thresholds: seropositivity in children &amp;lt;0.1% and &amp;lt;1/2000 infective black flies with 95% confidence. The 2.2 million people in Kaduna state and 4 million in Kebbi and Zamfara states no longer need ivermectin for onchocerciasis.</p>
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