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Human Onchocerciasis: Modelling the Potential Long-term Consequences of a Vaccination Programme
Hugo C Turner1, Martin Walker1, Sara Lustigman2
1London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine (St. Mary's Campus), Imperial College London, London, United Kingdom; Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine (St. Mary's Campus), Imperial College London, London, United Kingdom.
An onchocerciasis vaccine could significantly reduce disease burden in co-endemic areas and prevent resurgence after mass drug administration. This novel strategy is crucial where ivermectin is contraindicated or resistance emerges.
Area of Science:
- Tropical medicine
- Parasitology
- Vaccinology
Background:
- Current onchocerciasis control relies on ivermectin mass drug administration (MDA), but elimination is unlikely in all African foci.
- Ivermectin use is limited in Loa loa co-endemic regions and where resistance is observed.
- Novel strategies are urgently needed to combat onchocerciasis effectively.
Purpose of the Study:
- To model the impact of an onchocerciasis vaccine in co-endemic and ivermectin-contraindicated areas.
- To assess the vaccine's potential to prevent infection resurgence after successful MDA.
- To evaluate the vaccine's role in overcoming ivermectin resistance.
Main Methods:
- Utilized the EPIONCHO onchocerciasis transmission model for simulations.
- Assessed vaccine impact on microfilarial load in different age groups.
- Modeled a vaccine targeting children aged 1-5 years, aligned with the Expanded Programme on Immunization (EPI).
Main Results:
- Vaccination showed a beneficial impact in onchocerciasis-loiasis co-endemic areas.
- Marked reduction in microfilarial load observed in younger age groups (under 20 years).
- The model explored potential influence on infection resurgence post-elimination.
Conclusions:
- An onchocerciasis vaccine can reduce disease burden where ivermectin is unsafe.
- Vaccination can prevent the re-emergence of Onchocerca volvulus infection.
- A vaccine protects control program investments and combats ivermectin resistance.
