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

Clin Infect Dis 2018 06;66(suppl_4):S267-S274

Department of Public Health, Erasmus MC, University Medical Center Rotterdam, The Netherlands.

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.

Download full-text PDF

Source
http://dx.doi.org/10.1093/cid/cix1137DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5982715PMC
June 2018
17 Reads

Publication Analysis

Top Keywords

vector control
16
annual mda
12
mda
10
precontrol endemicity
8
onchocerciasis elimination
8
complementary vector
8
achieve elimination
8
elimination will
8
microfilarial prevalence
8
biannual quarterly
8
annual biannual
8
mda ivermectin
8
quarterly mda
8
high-endemicity areas
8
years annual
8
elimination
7
areas
6
0
6
control
5
vector
5

References

(Supplied by CrossRef)
Nodding syndrome: preventable and treatable
Colebunders et al.
Sci Transl Med 2017

World Health Organization/African Programme for Onchocerciasis Control et al.
2010

Similar Publications