Contribution of migrant coffee labourers infected with Onchocerca volvulus to the maintenance of the microfilarial reservoir in an ivermectin-treated area of Mexico

Abstract

Background: 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. 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.

Methods: The 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.

Results: Localities 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.).

Conclusion: The 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.

Figure 1

Map of the Mexican-Guatemalan border area showing the geographical location of the three villages and four coffee fincas studied within the southern Chiapas focus endemic for human onchocerciasis, Mexico (indicated by A in the inset).

Figure 2

The prevalence of infection (with any Onchocerca volvulus larval stage) in Simulium ochraceum s.l. parous flies in localities I and II: A, before the arrival (April and October), B, during the stay (May through July and November through February), C, after departure (August and February) of temporary migrant workers in the coffee seasons of 1997–1998 and 1998–1999 in the Southern Chiapas onchocerciasis focus, Mexico. D compares localities I and II for all three periods combined; E and F compare, respectively within localities I and II, fly infection levels between the before, during, and after periods, and G compares the periods for both localities combined. Error bars denote 95% confidence intervals; ovals indicate statistical differences with associated p-values.