National guidelines for onchocerciasis elimination.

The Ministry of Health, Uganda, established UOEEAC in 2008 to guide the nationwide River Blindness Elimination Program and provide recommendations for decision making on when and why to stop interventions and move the concerned foci to PTS phase and subsequent elimination of the disease. The national guidelines were based on the 2001 World Health Organization criteria for certification of elimination of onchocerciasis.²⁴ The national guidelines include three indicators: 1) parasitological assessments: microfilaria (mf) prevalence in skin snips must be less than 5% in all sampled communities and less than 1% in 90% of sampled communities; 2) serological assessments: infection rates in a sample of 3,000 children must be < 0.1% (to exclude 0.1% antibody prevalence with 95% confidence interval [95% CI]); and 3) entomological assessments: in the S. neavei foci, an absence of positive crabs for larvae/pupae of S. neavei species in a series of surveys and an absence of S. neavei or S. damnosum collected in a defined focus over a period of 3 years when the objective is vector elimination.^15,25