We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Structural Uncertainty in Onchocerciasis Transmission Models Influences the Estimation of Elimination Thresholds and Selection of Age Groups for Seromonitoring.
- Authors
Hamley, Jonathan I D; Walker, Martin; Coffeng, Luc E; Milton, Philip; Vlas, Sake J de; Stolk, Wilma A; Basáñez, Maria-Gloria
- Abstract
Background The World Health Organization recommends monitoring Onchocerca volvulus Ov16 serology in children aged <10 years for stopping mass ivermectin administration. Transmission models can help to identify the most informative age groups for serological monitoring and investigate the discriminatory power of serology-based elimination thresholds. Model predictions depend on assumed age-exposure patterns and transmission efficiency at low infection levels. Methods The individual-based transmission model, EPIONCHO-IBM, was used to assess (1) the most informative age groups for serological monitoring using receiver operating characteristic curves for different elimination thresholds under various age-dependent exposure assumptions, including those of ONCHOSIM (another widely used model), and (2) the influence of within-human density-dependent parasite establishment (included in EPIONCHO-IBM but not ONCHOSIM) on positive predictive values for different serological thresholds. Results When assuming EPIONCHO-IBM exposure patterns, children aged <10 years are the most informative for seromonitoring; when assuming ONCHOSIM exposure patterns, 5–14 year olds are the most informative (as published elsewhere). Omitting density-dependent parasite establishment results in more lenient seroprevalence thresholds, even for higher baseline infection prevalence and shorter treatment durations. Conclusions Selecting appropriate seromonitoring age groups depends critically on age-dependent exposure patterns. The role of density dependence on elimination thresholds largely explains differing EPIONCHO-IBM and ONCHOSIM elimination predictions.
- Subjects
WORLD Health Organization; AGE groups; RECEIVER operating characteristic curves; ONCHOCERCIASIS; ONCHOCERCA volvulus
- Publication
Journal of Infectious Diseases, 2020, Vol 221, pS510
- ISSN
0022-1899
- Publication type
Article
- DOI
10.1093/infdis/jiz674