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- Title
How Does the Proportion of Never Treatment Influence the Success of Mass Drug Administration Programs for the Elimination of Lymphatic Filariasis?
- Authors
Kura, Klodeta; Stolk, Wilma A; Basáñez, Maria-Gloria; Collyer, Benjamin S; Vlas, Sake J de; Diggle, Peter J; Gass, Katherine; Graham, Matthew; Hollingsworth, T Déirdre; King, Jonathan D; Krentel, Alison; Anderson, Roy M; Coffeng, Luc E
- Abstract
Background Mass drug administration (MDA) is the cornerstone for the elimination of lymphatic filariasis (LF). The proportion of the population that is never treated (NT) is a crucial determinant of whether this goal is achieved within reasonable time frames. Methods Using 2 individual-based stochastic LF transmission models, we assess the maximum permissible level of NT for which the 1% microfilaremia (mf) prevalence threshold can be achieved (with 90% probability) within 10 years under different scenarios of annual MDA coverage, drug combination and transmission setting. Results For Anopheles -transmission settings, we find that treating 80% of the eligible population annually with ivermectin + albendazole (IA) can achieve the 1% mf prevalence threshold within 10 years of annual treatment when baseline mf prevalence is 10%, as long as NT <10%. Higher proportions of NT are acceptable when more efficacious treatment regimens are used. For Culex -transmission settings with a low (5%) baseline mf prevalence and diethylcarbamazine + albendazole (DA) or ivermectin + diethylcarbamazine + albendazole (IDA) treatment, elimination can be reached if treatment coverage among eligibles is 80% or higher. For 10% baseline mf prevalence, the target can be achieved when the annual coverage is 80% and NT ≤15%. Higher infection prevalence or levels of NT would make achieving the target more difficult. Conclusions The proportion of people never treated in MDA programmes for LF can strongly influence the achievement of elimination and the impact of NT is greater in high transmission areas. This study provides a starting point for further development of criteria for the evaluation of NT.
- Subjects
COMBINATION drug therapy; RESEARCH funding; DRUG administration; PROBABILITY theory; MOSQUITOES; DESCRIPTIVE statistics; ELEPHANTIASIS; MATHEMATICAL models; PUBLIC health; THEORY; MACROLIDE antibiotics; ANTHELMINTICS; INFECTIOUS disease transmission
- Publication
Clinical Infectious Diseases, 2024, Vol 78, pS93
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/ciae021