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Delays in lymphatic filariasis elimination programmes due to COVID-19, and possible mitigation strategies
Joaquín M Prada1, Wilma A Stolk2, Emma L Davis3
1School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK.
Background:
In view of the current global coronavirus disease 2019 pandemic, mass drug administration interventions for neglected tropical diseases, including lymphatic filariasis (LF), have been halted. We used mathematical modelling to estimate the impact of delaying or cancelling treatment rounds and explore possible mitigation strategies.
Methods:
We used three established LF transmission models to simulate infection trends in settings with annual treatment rounds and programme delays in 2020 of 6, 12, 18 or 24 months. We then evaluated the impact of various mitigation strategies upon resuming activities.
Results:
The delay in achieving the elimination goals is on average similar to the number of years the treatment rounds are missed. Enhanced interventions implemented for as little as 1 y can allow catch-up on the progress lost and, if maintained throughout the programme, can lead to acceleration of up to 3 y.
Conclusions:
In general, a short delay in the programme does not cause a major delay in achieving the goals. Impact is strongest in high-endemicity areas. Mitigation strategies such as biannual treatment or increased coverage are key to minimizing the impact of the disruption once the programme resumes and lead to potential acceleration should these enhanced strategies be maintained.
Insights
Mass drug administration for lymphatic filariasis (LF) was halted due to COVID-19. Mathematical modeling shows delays impact elimination goals, but enhanced interventions can accelerate progress.
Area of Science:
- Epidemiology
- Mathematical Modeling
- Public Health
Background:
- COVID-19 pandemic disrupted mass drug administration (MDA) for neglected tropical diseases, including lymphatic filariasis (LF).
- This halt impacts disease elimination efforts and requires strategic planning for resumption.
Purpose of the Study:
- To estimate the impact of delayed or canceled LF treatment rounds on elimination goals.
- To explore potential mitigation strategies for program resumption.
Main Methods:
- Utilized three established LF transmission mathematical models.
- Simulated infection trends under various treatment delay scenarios (6-24 months).
- Evaluated the effectiveness of different mitigation strategies upon program restart.
Main Results:
- Program delays generally result in a setback in elimination timelines equivalent to the duration of the missed rounds.
- Enhanced interventions, even for one year, can recover lost progress.
- High-endemicity areas experience the most significant impact from delays.
Conclusions:
- Short program delays may not critically impede long-term elimination goals.
- Mitigation strategies like biannual treatment or increased coverage are crucial for minimizing disruption.
- Sustained enhanced interventions can accelerate LF elimination by up to three years.
