Fighting Disease: Guatemala

Eliminating Onchocerciasis From the Americas

River blindness is a parasitic disease transmitted by the bite of small black flies that breed in rapidly flowing streams and rivers. The disease causes severe itching, eye damage, and often blindness but is preventable through health education and distribution of the medicine Mectizan® (ivermectin, donated by Merck). Learn more about the Carter Center's campaign to eliminate river blindness from the Americas and to control it in Africa >

Bordered by the ocean on two sides, Guatemala's hot and humid coastal plains are among the areas most severely affected by a painful and debilitating disease known as river blindness, or onchocerciasis.

In coffee-producing areas of the country, contracting onchocerciasis may be considered an occupational hazard. The fast-flowing streams providing irrigation to nearby coffee farms also can be breeding grounds for the black flies that spread the disease.

The River Blindness Program began in Guatemala in 1996 after The Carter Center absorbed the River Blindness Foundation. Once the most endemic nation for onchocerciasis in the Americas, Guatemala accounted for more than 40 percent of people at risk for the disease in the Americas. The disease threatened more than 500 communities in four focus areas in some of the poorest areas of Guatemala including: Central, Escuintla-Guatemala, Huehuetenango, and Santa Rosa.

In Guatemala, as well as other nations in the region, suffering has been reduced and overall quality of life has improved through semiannual treatment with Mectizan® (ivermectin, donated by Merck) and health education.

In 2002, Guatemala first achieved the goal of reaching 85 percent of the eligible population with Mectizan treatments — it continues to reach this threshold each year.

In 2006, the Guatemala Ministry of Health concluded that onchocerciasis no longer exists in the Santa Rosa region of the country. The conclusion was based on a 2004-2005 study of entomological, ophthalmologic, and serological field studies completed by the Ministry of Health, the U.S. Centers for Disease Control and Prevention (CDC), and the Onchocerciasis Elimination Program of the Americas. In 2007, the Ministry of Health decided to halt Mectizan treatments in that focus and maintain a post-treatment surveillance program there for at least three years. This was the first of the 13 foci in the Americas where such a decision was made and paved the way for other areas in the Americas preparing for similar withdrawal.

To date, Escuintla-Guatemala and Santa Rosa have eliminated onchocerciasis. In 2009, Huehuetenango stopped mass drug administration and entered the surveillance phase to ensure that infection does not reoccur in the absence of Mectizan distribution.

The Central focus is the only focus remaining under treatment, and treatments there have surpassed the 85 percent coverage goal for 19 consecutive, semiannual treatment rounds in program areas. In 2010, 204,971 treatments were administered. Transmission currently is classified as being suppressed in the Central focus. Additional assessments are in progress to determine if transmission has been halted.

Press Release: A Milestone Toward Ending River Blindness in the Western Hemisphere by 2012: Escuintla, Guatemala, Largest Endemic Area Yet To Stop Transmission (English and Spanish versions) >

Read the Feature: Volunteer Plays Key Role as River Blindness Health Promoter: Making Time To Protect a Community and Fight Disease >

Vigilancia Epidemiológica Postratamiento (VEPT) con Mectizan en el Área de Salud de Huehuetenango (PDF) >

Learn more about the Carter Center's work against river blindness in Guatemala (in search result format) >