Roberto Proaño

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INTRODUCTION A clinically significant endemic focus of onchocerciasis existing in Esmeraldas Province, coastal Ecuador has been under an ivermectin mass drug administration program since 1991. The main transmitting vector in this area is the voracious blackfly, Simulium exiguum. This paper describes the assessments made that support the decision to cease(More)
Onchocerciasis is a major blinding disease in equatorial Africa and Central and South America. Ivermectin is a safe and effective drug in the treatment of this disease and now forms the basis of disease control in most endemic areas. We report the findings of long-term control of this infection in the Río Santiago focus in Ecuador, between January 1990 and(More)
BACKGROUND Onchocerciasis is a leading cause of blindness worldwide, hence elimination of the infection is an important health priority. Community-based treatment programs with ivermectin form the basis of control programs for the disease in Latin America. The long-term administration of ivermectin could eliminate Onchocerca volvulus infection from endemic(More)
World Health Organization certification criteria for onchocerciasis elimination use anterior segment eye lesion prevalence as an indicator of mass ivermectin treatment program success. Lesions either contain visible microfilaria (noninflammatory punctate keratitis [PK] or microfilariae in anterior chamber [MFAC]), or microfilaria obscured by inflammation(More)
In the province of Esmeraldas in Ecuador, 11 endemic foci of onchocerciasis were identified. The major focus, located on Rio Cayapas, consisted of 65 contiguous positive communities with an average infection rate of 51.1%. A distance-dependent characteristic of the onchocerciasis infection suggested that the transmission was centered principally in the(More)
The epidemiology of infection was studied in all endemic foci of onchocerciasis in the province of Esmeraldas in Ecuador. The incidence of infection and the density of microfilariae in the skin, both greater in males than females, increased with age, reaching highest levels at 40-45 years in males and at 60 years and older in females. In the hyperendemic(More)
The frequency, intensity and clinical features of onchocerciasis in the two ethnic groups (Blacks and Chachilla--an indigenous tribe) in the endemic foci of the disease in Esmeraldas province (Ecuador) were evaluated. The incidence of infection and intensity of the disease seen in both groups were directly related to the frequency of man-vector contact and(More)
Little is known of the epidemiology and clinical picture of ocular onchocerciasis in South America. A survey of onchocercal eye disease was performed in the hyperendemic area of a rain forest focus of onchocerciasis in Esmeraldas Province in Ecuador. A total of 785 skin snip positive individuals from black and Chachi Amerindian communities were examined.(More)
PURPOSE Onchocerciasis is a major cause of blindness in the developing world. An autoimmune pathogenesis for onchocercal chorioretinopathy was proposed after the identification of a recombinant Onchocerca volvulus antigen (designated Ov39) demonstrated immunologic crossreactivity with a component of the retinal pigment epithelium and other ocular tissues.(More)
This study is concerned with the relationship between palpable onchocercal nodules and Onchocerca volvulus microfilarial loads in the skin. The number of microfilariae in clinically normal skin decreases as the distance from the nodule increases. Surgical removal of nodules reduces the microfilarial loads in 40 of 46 patients studied over a period of five(More)