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@article{Stolk:2021:cid/ciab238,
author = {Stolk, WA and Blok, DJ and Hamley, JID and Cantey, PT and de, Vlas SJ and Walker, M and Basáñez, M-G},
doi = {cid/ciab238},
journal = {Clinical Infectious Diseases},
pages = {S165--S171},
title = {Scaling-down mass ivermectin treatment for onchocerciasis elimination: modelling the impact of the geographical unit for decision making},
url = {http://dx.doi.org/10.1093/cid/ciab238},
volume = {72},
year = {2021}
}

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TY  - JOUR
AB  - 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 programmes can scale down active intervention upon achieving the epidemiological targets for elimination. METHODS: We use two onchocerciasis models (EPIONCHO-IBM and ONCHOSIM) to predict the likelihood of achieving elimination by 2030 in Africa, accounting for variation in pre-intervention 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 predictions intervals are based on ONCHOSIM, the upper limits on EPIONCHO-IBM. DISCUSSION/CONCLUSIONS: The geographical scale at which stop-MDA decisions are made strongly determines how rapidly national onchocerciasis programmes can scale down MDA programmes. Stopping in portions of project areas or transmission zones would free up human and economic resources.
AU  - Stolk,WA
AU  - Blok,DJ
AU  - Hamley,JID
AU  - Cantey,PT
AU  - de,Vlas SJ
AU  - Walker,M
AU  - Basáñez,M-G
DO  - cid/ciab238
EP  - 171
PY  - 2021///
SN  - 1058-4838
SP  - 165
TI  - Scaling-down mass ivermectin treatment for onchocerciasis elimination: modelling the impact of the geographical unit for decision making
T2  - Clinical Infectious Diseases
UR  - http://dx.doi.org/10.1093/cid/ciab238
UR  - https://www.ncbi.nlm.nih.gov/pubmed/33909070
UR  - https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciab238/6256998
UR  - http://hdl.handle.net/10044/1/88419
VL  - 72
ER  -

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