WA Stolk
Scaling-Down Mass Ivermectin Treatment for Onchocerciasis Elimination: Modeling the Impact of the Geographical Unit for Decision Making
Stolk, WA; Blok, DJ; Hamley, JID; Cantey, PT; de Vlas, SJ; Walker, M; Basanez, MG
Authors
DJ Blok
JID Hamley
PT Cantey
SJ de Vlas
M Walker
MG Basanez
Abstract
Background. Due to spatial heterogeneity in onchocerciasis transmission, the duration of ivermectin mass drug administration (MDA) required for eliminating onchocerciasis will vary within endemic areas and the occurrence of transmission "hotspots" is inevitable. The geographical scale at which stop-MDA decisions are made will be a key driver in how rapidly national programs can scale down active intervention upon achieving the epidemiological targets for elimination. Methods. We used 2 onchocerciasis models (EPIONCHO-IBM and ONCHOSIM) to predict the likelihood of achieving elimination by 2030 in Africa, accounting for variation in preintervention endemicity levels and histories of ivermectin treatment. We explore how decision making at contrasting geographical scales (community vs larger scale "project") changes projections on populations still requiring MDA or transitioning to post-treatment surveillance. Results. The total population considered grows from 118 million people in 2020 to 136 million in 2030. If stop-MDA decisions are made at project level, the number of people requiring treatment declines from 69-118 million in 2020 to 59-118 million in 2030. If stop-MDA decisions are made at community level, the numbers decline from 23-81 million in 2020 to 15-63 million in 2030. The lower estimates in these prediction intervals are based on ONCHOSIM, the upper limits on EPIONCHO-IBM. Conclusions. The geographical scale at which stop-MDA decisions are made strongly determines how rapidly national onchocerciasis programs can scale down MDA programs. Stopping in portions of project areas or transmission zones would free up human and economic resources.
Citation
Stolk, W., Blok, D., Hamley, J., Cantey, P., de Vlas, S., Walker, M., & Basanez, M. (2021). Scaling-Down Mass Ivermectin Treatment for Onchocerciasis Elimination: Modeling the Impact of the Geographical Unit for Decision Making. Clinical Infectious Diseases, 72, S165-S171. https://doi.org/10.1093/cid/ciab238
Journal Article Type | Article |
---|---|
Acceptance Date | Jun 14, 2021 |
Publication Date | 2021 |
Deposit Date | Dec 22, 2021 |
Publicly Available Date | Dec 22, 2021 |
Journal | Clinical Infectious Diseases |
Print ISSN | 1058-4838 |
Electronic ISSN | 1537-6591 |
Publisher | Oxford University Press |
Peer Reviewed | Peer Reviewed |
Volume | 72 |
Pages | S165-S171 |
DOI | https://doi.org/10.1093/cid/ciab238 |
Keywords | onchocerciasis; elimination; ivermectin; mass drug administration; mathematical modeling; DYNAMICS; VOLVULUS; PROGRAM |
Public URL | https://rvc-repository.worktribe.com/output/1553913 |
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