How Can Onchocerciasis Elimination in Africa Be Accelerated? Modeling the Impact of Increased Ivermectin Treatment Frequency and Complementary Vector Control.

Autor: Verver S; Department of Public Health, Erasmus MC, University Medical Center Rotterdam, The Netherlands., Walker M; Department of Pathobiology and Population Sciences and London Centre for Neglected Tropical Disease Research, Royal Veterinary College, Hatfield.; Department of Infectious Disease Epidemiology and London Centre for Neglected Tropical Disease Research, Imperial College London, United Kingdom., Kim YE; Department of Public Health, Erasmus MC, University Medical Center Rotterdam, The Netherlands.; Swiss Tropical and Public Health, Basel, Switzerland., Fobi G; Independent Consultant, Yaoundé, Cameroon., Tekle AH; World Health Organization, Geneva, Switzerland., Zouré HGM; World Health Organization, Geneva, Switzerland., Wanji S; Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Cameroon., Boakye DA; Noguchi Memorial Institute of Medical Research, University of Ghana, Legon., Kuesel AC; United Nations Children's Fund/United Nations Development Programme/World Bank/World Health Organization Special Programme for Research and Training in Tropical Diseases, Geneva, Switzerland., de Vlas SJ; Department of Public Health, Erasmus MC, University Medical Center Rotterdam, The Netherlands., Boussinesq M; Institut de Recherche pour le Développement, Montpellier, France., Basáñez MG; Department of Infectious Disease Epidemiology and London Centre for Neglected Tropical Disease Research, Imperial College London, United Kingdom., Stolk WA; Department of Public Health, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
Jazyk: angličtina
Zdroj: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2018 Jun 01; Vol. 66 (suppl_4), pp. S267-S274.
DOI: 10.1093/cid/cix1137
Abstrakt: Background: Great strides have been made toward onchocerciasis elimination by mass drug administration (MDA) of ivermectin. Focusing on MDA-eligible areas, we investigated where the elimination goal can be achieved by 2025 by continuation of current practice (annual MDA with ivermectin) and where intensification or additional vector control is required. We did not consider areas hypoendemic for onchocerciasis with loiasis coendemicity where MDA is contraindicated.
Methods: We used 2 previously published mathematical models, ONCHOSIM and EPIONCHO, to simulate future trends in microfilarial prevalence for 80 different settings (defined by precontrol endemicity and past MDA frequency and coverage) under different future treatment scenarios (annual, biannual, or quarterly MDA with different treatment coverage through 2025, with or without vector control strategies), assessing for each strategy whether it eventually leads to elimination.
Results: Areas with 40%-50% precontrol microfilarial prevalence and ≥10 years of annual MDA may achieve elimination with a further 7 years of annual MDA, if not achieved already, according to both models. For most areas with 70%-80% precontrol prevalence, ONCHOSIM predicts that either annual or biannual MDA is sufficient to achieve elimination by 2025, whereas EPIONCHO predicts that elimination will not be achieved even with complementary vector control.
Conclusions: Whether elimination will be reached by 2025 depends on precontrol endemicity, control history, and strategies chosen from now until 2025. Biannual or quarterly MDA will accelerate progress toward elimination but cannot guarantee it by 2025 in high-endemicity areas. Long-term concomitant MDA and vector control for high-endemicity areas might be useful.
Databáze: MEDLINE