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Determining Soil-transmitted Helminth Infection Status and Physical Fitness of School-aged Children
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Geographic and ecologic heterogeneity in elimination thresholds for the major vector-borne helminthic disease,

Manoj Gambhir1, Moses Bockarie, Daniel Tisch

  • 1Department of Infectious Disease Epidemiology, Imperial College London, UK. m.gambhir@imperial.ac.uk

BMC Biology
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PubMed
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Ecological factors create varying elimination thresholds for lymphatic filariasis, impacting global disease control. Understanding local transmission dynamics is crucial for effective intervention strategies.

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Area of Science:

  • Epidemiology
  • Mathematical modeling
  • Parasitology

Background:

  • Large-scale infectious disease control programs face challenges in determining appropriate stopping points.
  • Ecological complexity and heterogeneity can lead to variable elimination thresholds in macroparasite transmission.
  • Lymphatic filariasis is a major macroparasitic disease targeted for global elimination.

Purpose of the Study:

  • To empirically investigate the hypothesis that ecological factors cause varying elimination thresholds for macroparasites.
  • To assess the implications of local variations in elimination thresholds for the global elimination of lymphatic filariasis.
  • To identify ecological factors contributing to heterogeneity in lymphatic filariasis transmission.

Main Methods:

  • A novel Bayesian computer simulation procedure was used to fit a dynamic transmission model.
  • The model was calibrated using baseline microfilarial age-prevalence data from nine villages across three distinct endemic regions.
  • Vector-specific filariasis transmission models were employed, considering differences in major vector populations.

Main Results:

  • Significant variations in density-dependent immunity, parasite establishment, and parasite aggregation parameters were observed across settings.
  • Elimination thresholds were higher in settings with anopheline mosquito vectors compared to those with culicine vectors.
  • The probability of parasite elimination after Mass Drug Administration decreased non-linearly with increasing annual biting rate and parasite reproduction number.

Conclusions:

  • Specific ecological conditions significantly influence local population dynamics and lymphatic filariasis elimination thresholds.
  • Challenges in measuring key local parameters (infection aggregation, acquired immunity) necessitate a re-evaluation of current elimination strategies.
  • Rethinking anticipatory approaches is essential for achieving local and global elimination of lymphatic filariasis.