The use of an Onchocerca volvulus microfilarial antigen skin test in an epidemiological survey of onchocerciasis in Guatemala.

Onchocerca volvulus microfilariae obtained from onchocercal nodules were used as antigenic material for a skin test. This antigen is as specific as those previously employed in skin tests, detecting 85.2% of the persons with positive diagnostic signs of onchocerciasis in endemic areas. A low rate of false positives was found in the control group in nonendemic areas. The positive rate of reactions in the persons without positive signs in the endemic areas might be due to the presences of cases not detected as a result of palpation for nodules and two skin biopsies. In the examination of the residents of several populations, a close correlation was found between the positive rates of skin tests and the presence of infection. From these findings, we conclude that the skin test using the microfilarial antigen is a suitable procedure for the diagnosis of onchocerciasis. The skin test could also be useful as an epidemiological tool in assessing the effectiveness of control programmes.