Maintaining low prevalence of Schistosoma mansoni: modelling the effect of less frequent treatment
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Author(s)
Type
Journal Article
Abstract
BACKGROUND: The World Health Organization (WHO) previously set goals of controlling morbidity due to schistosomiasis by 2020 and attaining elimination as a public health problem (EPHP) by 2025 (now adjusted to 2030 in the new neglected tropical diseases roadmap). As these milestones are reached, it is important that programs reassess their treatment strategies to either maintain these goals or progress from morbidity control to EPHP and ultimately to interruption of transmission. In this study, we consider different mass drug administration (MDA) strategies to maintain the goals. METHODS: We use two independently developed individual-based stochastic models of schistosomiasis transmission to assess the optimal treatment strategy of a multi-year program to maintain the morbidity control and the EPHP goals. RESULTS: We find that in moderate prevalence settings, once the morbidity control and EPHP goals are reached, it may be possible to maintain the goals using less frequent MDAs than those that are required to achieve the goals. On the other hand, in some high transmission settings, if control efforts are reduced after achieving the goals, particularly the morbidity control goal, there is a high chance of recrudescence. CONCLUSIONS: To reduce the risk of recrudescence after the goals are achieved, programs have to re-evaluate their strategies and decide to either maintain these goals with reduced efforts where feasible or continue with at least the same efforts required to reach the goals.
Date Issued
2021-06-15
Online Publication Date
2021-05-12T10:30:32Z
Date Acceptance
2021-04-01
ISSN
1058-4838
Publisher
Oxford University Press
Start Page
S140
End Page
S145
Journal / Book Title
Clinical Infectious Diseases
Volume
72
Issue
Suppl. 3
Copyright Statement
© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Sponsor
The Task Force for Global Health
Identifier
https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciab246/6256990
https://www.ncbi.nlm.nih.gov/pubmed/33909064
6256990
Grant Number
1708CR001/VP1 (OPP1184344)
Subjects
EPHP
MDA
modeling
morbidity control
schistosomiasis
EPHP
MDA
modelling
morbidity control
schistosomiasis
Microbiology
06 Biological Sciences
11 Medical and Health Sciences
Publication Status
Published
Country
United States
Date Publish Online
2021-04-28