Longitudinal studies of skin microfilaria and antibody conversion rates in children living in an endemic focus of onchocerciasis in Nigeria.

We monitored skin microfilarial conversion and antibody (serum) conversion rates to Onchocerca volvulus recombinant antigens (OC3.6 and OC9.3) over a 2-year period, in a cohort of 208 children aged 9-11 years and living in a mesoendemic focus of savannah-type onchocerciasis in Nigeria in order to detect prepatent onchocerciasis in children. Between time point A and time point B (9 months apart) the seroconversion rate was 19.4 per cent, and between time points B and C (15 months apart), a further 31.4 per cent of seronegative children had seroconverted. However, only a third of the seroconverted children became microfilaria-positive. From the time-lag between antibody conversion and skin snip conversion, we estimated that a 9-12 month interval was required for the detection of O. volvulus microfilariae following infection with viable third stage larva (L3s). The predictive value of antibody detection as a measure of skin microfilarial conversion was >90 per cent when the optical density (OD) at 490 nm was >0.80. We therefore propose a strategy for monitoring changes in transmission of onchocerciasis following vector control or chemotherapy through an evaluation of annual antibody seroconversion rates in a standardized sentinel population of children.