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Sulik M, Antoszczak M, Huczyński A, Steverding D. Antiparasitic activity of ivermectin: Four decades of research into a "wonder drug". Eur J Med Chem 2023; 261:115838. [PMID: 37793327 DOI: 10.1016/j.ejmech.2023.115838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/17/2023] [Accepted: 09/26/2023] [Indexed: 10/06/2023]
Abstract
Parasitic diseases still pose a serious threat to human and animal health, particularly for millions of people and their livelihoods in low-income countries. Therefore, research into the development of effective antiparasitic drugs remains a priority. Ivermectin, a sixteen-membered macrocyclic lactone, exhibits a broad spectrum of antiparasitic activities, which, combined with its low toxicity, has allowed the drug to be widely used in the treatment of parasitic diseases affecting humans and animals. In addition to its licensed use against river blindness and strongyloidiasis in humans, and against roundworm and arthropod infestations in animals, ivermectin is also used "off-label" to treat many other worm-related parasitic diseases, particularly in domestic animals. In addition, several experimental studies indicate that ivermectin displays also potent activity against viruses, bacteria, protozoans, trematodes, and insects. This review article summarizes the last 40 years of research on the antiparasitic effects of ivermectin, and the use of the drug in the treatment of parasitic diseases in humans and animals.
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Affiliation(s)
- Michał Sulik
- Department of Medical Chemistry, Faculty of Chemistry, Adam Mickiewicz University, Uniwersytetu Poznańskiego 8, 61‒614, Poznań, Poland
| | - Michał Antoszczak
- Department of Medical Chemistry, Faculty of Chemistry, Adam Mickiewicz University, Uniwersytetu Poznańskiego 8, 61‒614, Poznań, Poland
| | - Adam Huczyński
- Department of Medical Chemistry, Faculty of Chemistry, Adam Mickiewicz University, Uniwersytetu Poznańskiego 8, 61‒614, Poznań, Poland.
| | - Dietmar Steverding
- Bob Champion Research & Education Building, Norwich Medical School, University of East Anglia, Norwich, UK
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2
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Walker M, Lambert S, Neves MI, Worsley AD, Traub R, Colella V. Modeling the effectiveness of One Health interventions against the zoonotic hookworm Ancylostoma ceylanicum. Front Med (Lausanne) 2023; 10:1092030. [PMID: 36960338 PMCID: PMC10028197 DOI: 10.3389/fmed.2023.1092030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/14/2023] [Indexed: 03/09/2023] Open
Abstract
Hookworm disease is a major global public health concern, annually affecting 500-700 million of the world's poorest people. The World Health Organization is targeting the elimination of hookworm as a public health problem by 2030 using a strategy of mass drug administration (MDA) to at-risk human populations. However, in Southeast Asia and the Pacific the zoonotic hookworm species, Ancylostoma ceylanicum, is endemic in dogs and commonly infects people. This presents a potential impediment to the effectiveness of MDA that targets only humans. Here, we develop a novel multi-host (dog and human) transmission model of A. ceylanicum and compare the effectiveness of human-only and "One Health" (human plus dog) MDA strategies under a range of eco-epidemiological assumptions. We show that One Health interventions-targeting both dogs and humans-could suppress prevalence in humans to ≤ 1% by the end of 2030, even with only modest coverage (25-50%) of the animal reservoir. With increasing coverage, One Health interventions may even interrupt transmission. We discuss key unresolved questions on the eco-epidemiology of A. ceylanicum, the challenges of delivering MDA to animal reservoirs, and the growing importance of One Health interventions to human public health.
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Affiliation(s)
- Martin Walker
- Department of Pathobiology and Populations Sciences, Royal Veterinary College, Hatfield, United Kingdom
- Department of Infectious Disease Epidemiology, London Centre for Neglected Tropical Disease Research, Imperial College London, London, United Kingdom
- *Correspondence: Martin Walker
| | - Sébastien Lambert
- Department of Pathobiology and Populations Sciences, Royal Veterinary College, Hatfield, United Kingdom
- Department of Infectious Disease Epidemiology, London Centre for Neglected Tropical Disease Research, Imperial College London, London, United Kingdom
- IHAP, INRAE, ENVT, Université de Toulouse, Toulouse, France
| | - M. Inês Neves
- Department of Pathobiology and Populations Sciences, Royal Veterinary College, Hatfield, United Kingdom
- Department of Infectious Disease Epidemiology, London Centre for Neglected Tropical Disease Research, Imperial College London, London, United Kingdom
| | - Andrew D. Worsley
- Department of Veterinary Biosciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Rebecca Traub
- Department of Veterinary Biosciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Vito Colella
- Department of Veterinary Biosciences, The University of Melbourne, Melbourne, VIC, Australia
- Vito Colella
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3
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Grau-Pujol B, Martí-Soler H, Escola V, Demontis M, Jamine JC, Gandasegui J, Muchisse O, Cambra-Pellejà M, Cossa A, Martinez-Valladares M, Sacoor C, Van Lieshout L, Cano J, Giorgi E, Muñoz J. Towards soil-transmitted helminths transmission interruption: The impact of diagnostic tools on infection prediction in a low intensity setting in Southern Mozambique. PLoS Negl Trop Dis 2021; 15:e0009803. [PMID: 34695108 PMCID: PMC8568186 DOI: 10.1371/journal.pntd.0009803] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 11/04/2021] [Accepted: 09/09/2021] [Indexed: 11/19/2022] Open
Abstract
World Health Organization goals against soil-transmitted helminthiases (STH) are pointing towards seeking their elimination as a public health problem: reducing to less than 2% the proportion of moderate and heavy infections. Some regions are reaching WHO goals, but transmission could rebound if strategies are discontinued without an epidemiological evaluation. For that, sensitive diagnostic methods to detect low intensity infections and localization of ongoing transmission are crucial. In this work, we estimated and compared the STH infection as obtained by different diagnostic methods in a low intensity setting. We conducted a cross-sectional study enrolling 792 participants from a district in Mozambique. Two stool samples from two consecutive days were collected from each participant. Samples were analysed by Telemann, Kato-Katz and qPCR for STH detection. We evaluated diagnostic sensitivity using a composite reference standard. By geostatistical methods, we estimated neighbourhood prevalence of at least one STH infection for each diagnostic method. We used environmental, demographical and socioeconomical indicators to account for any existing spatial heterogeneity in infection. qPCR was the most sensitive technique compared to composite reference standard: 92% (CI: 83%- 97%) for A. lumbricoides, 95% (CI: 88%- 98%) for T. trichiura and 95% (CI: 91%- 97%) for hookworm. qPCR also estimated the highest neighbourhood prevalences for at least one STH infection in a low intensity setting. While 10% of the neighbourhoods showed a prevalence above 20% when estimating with single Kato-Katz from one stool and Telemann from one stool, 86% of the neighbourhoods had a prevalence above 20% when estimating with qPCR. In low intensity settings, STH estimated prevalence of infection may be underestimated if based on Kato-Katz. qPCR diagnosis outperformed the microscopy methods. Thus, implementation of qPCR based predictive maps at STH control and elimination programmes would disclose hidden transmission and facilitate targeted interventions for transmission interruption.
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Affiliation(s)
- Berta Grau-Pujol
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic—University of Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- Mundo Sano Foundation, Buenos Aires, Argentina
- * E-mail:
| | - Helena Martí-Soler
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic—University of Barcelona, Barcelona, Spain
| | - Valdemiro Escola
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Maria Demontis
- Department of Parasitology, Centre of Infectious Diseases, Leiden University Medical Center (LUMC), Leiden, The Netherlands
| | | | - Javier Gandasegui
- Instituto de Ganadería de Montaña (CSIC-Universidad de León), Grulleros, León, Spain
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad de León, Campus de Vegazana, León, Spain
| | - Osvaldo Muchisse
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Maria Cambra-Pellejà
- Instituto de Ganadería de Montaña (CSIC-Universidad de León), Grulleros, León, Spain
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad de León, Campus de Vegazana, León, Spain
| | - Anelsio Cossa
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Maria Martinez-Valladares
- Instituto de Ganadería de Montaña (CSIC-Universidad de León), Grulleros, León, Spain
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad de León, Campus de Vegazana, León, Spain
| | - Charfudin Sacoor
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Lisette Van Lieshout
- Department of Parasitology, Centre of Infectious Diseases, Leiden University Medical Center (LUMC), Leiden, The Netherlands
| | - Jorge Cano
- Expanded Special Project for Elimination of NTDs, World Health Organization Regional Office for Africa, Brazzaville, The Republic of the Congo
| | - Emanuele Giorgi
- Centre for Health Informatics, Computing and Statistics, Lancaster Medical School, Faculty of Health and Medicine, Lancaster University, United Kingdom
| | - Jose Muñoz
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic—University of Barcelona, Barcelona, Spain
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4
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Walker M, Hamley JID, Milton P, Monnot F, Kinrade S, Specht S, Pedrique B, Basáñez MG. Supporting drug development for neglected tropical diseases using mathematical modelling. Clin Infect Dis 2021; 73:e1391-e1396. [PMID: 33893482 PMCID: PMC8442785 DOI: 10.1093/cid/ciab350] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Indexed: 11/14/2022] Open
Abstract
Drug-based interventions are at the heart of global efforts to reach elimination as a public health problem (trachoma, soil-transmitted helminthiases, schistosomiasis, lymphatic filariasis) or elimination of transmission (onchocerciasis) for 5 of the most prevalent neglected tropical diseases tackled via the World Health Organization preventive chemotherapy strategy. While for some of these diseases there is optimism that currently available drugs will be sufficient to achieve the proposed elimination goals, for others—particularly onchocerciasis—there is a growing consensus that novel therapeutic options will be needed. Since in this area no high return of investment is possible, minimizing wasted money and resources is essential. Here, we use illustrative results to show how mathematical modeling can guide the drug development pathway, yielding resource-saving and efficiency payoffs, from the refinement of target product profiles and intended context of use to the design of clinical trials.
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Affiliation(s)
- Martin Walker
- Department of Pathobiology and Population Sciences and London Centre for Neglected Tropical Disease Research, Royal Veterinary College, UK.,MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology and London Centre for Neglected Tropical Disease Research, Imperial College London, UK
| | - Jonathan I D Hamley
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology and London Centre for Neglected Tropical Disease Research, Imperial College London, UK
| | - Philip Milton
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology and London Centre for Neglected Tropical Disease Research, Imperial College London, UK
| | - Frédéric Monnot
- Drugs for Neglected Diseases initiative (DNDi), Geneva, Switzerland
| | - Sally Kinrade
- Medicines Development for Global Health, Southbank VIC, Australia
| | - Sabine Specht
- Drugs for Neglected Diseases initiative (DNDi), Geneva, Switzerland
| | - Bélen Pedrique
- Drugs for Neglected Diseases initiative (DNDi), Geneva, Switzerland
| | - Maria-Gloria Basáñez
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology and London Centre for Neglected Tropical Disease Research, Imperial College London, UK
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5
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Vegvari C, Giardina F, Bajaj S, Malizia V, Hardwick RJ, Truscott JE, Montresor A, de Vlas SJ, Coffeng LE, Anderson RM. Deworming women of reproductive age during adolescence and pregnancy: what is the impact on morbidity from soil-transmitted helminths infection? Parasit Vectors 2021; 14:220. [PMID: 33892750 PMCID: PMC8063329 DOI: 10.1186/s13071-021-04620-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 02/01/2021] [Indexed: 11/19/2022] Open
Abstract
Background Soil-transmitted helminths (STHs) are a major cause of poor health in low- and middle-income countries. In particular, hookworm is known to cause anaemia in children and women of reproductive age (WRA). One goal of the World Health Organization’s (WHO) 2030 roadmap for neglected tropical diseases is to reduce STH-related morbidity in WRA. As a minimal intervention, the WHO recommends deworming adolescent girls annually during human papilloma virus vaccination programmes and WRA during pregnancy and lactation. These routine interventions are low cost and can be implemented even by the most basic health services in endemic countries. In this study we use a cohort model to investigate the potential impact on STH-related morbidity in WRA. Results Annual deworming treatment of adolescent girls reduces the prevalence of moderate- and heavy-intensity infections in this age group by up to 60% in moderate transmission settings and by 12–27% in high transmission settings. Treatment of WRA during pregnancy and lactation on its own has a small (< 20%) but significant effect on morbidity although it does not lead to the achievement of the morbidity target (< 2% moderate- to high-intensity infections) in this age group. However, depending on the age-intensity profile of infection, which may vary geographically, and assumptions on the density-dependence of egg production by fertilised female worms, continued school-based treatment may be able to reduce the force of infection acting on WRA, both through an indirect effect on the overall population-based force of infection and via reducing the burden of infection as children age and move into the WRA age classes. As a result, morbidity in WRA may be eliminated. Conclusion While deworming during pregnancy and lactation does not lead to the achievement of the morbidity target in WRA and its efficacy may vary by setting, it is still expected to be beneficial for maternity and child health. Monitoring of any WRA-based intervention is recommended to evaluate its effectiveness.![]()
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Affiliation(s)
- Carolin Vegvari
- Department of Infectious Disease Epidemiology, London Centre for Neglected Tropical Disease Research (LCNTDR), Imperial College London, St Mary's Campus, Praed Street, London, W2 1PG, UK. .,Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1PG, UK. .,Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK.
| | - Federica Giardina
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Sumali Bajaj
- Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1PG, UK.,Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK
| | - Veronica Malizia
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Robert J Hardwick
- Department of Infectious Disease Epidemiology, London Centre for Neglected Tropical Disease Research (LCNTDR), Imperial College London, St Mary's Campus, Praed Street, London, W2 1PG, UK.,Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1PG, UK.,Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK.,The DeWorm3 Project, The Natural History Museum of London, London, SW7 5BD, UK
| | - James E Truscott
- Department of Infectious Disease Epidemiology, London Centre for Neglected Tropical Disease Research (LCNTDR), Imperial College London, St Mary's Campus, Praed Street, London, W2 1PG, UK.,Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1PG, UK.,Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK.,The DeWorm3 Project, The Natural History Museum of London, London, SW7 5BD, UK
| | - Antonio Montresor
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Sake J de Vlas
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Luc E Coffeng
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Roy M Anderson
- Department of Infectious Disease Epidemiology, London Centre for Neglected Tropical Disease Research (LCNTDR), Imperial College London, St Mary's Campus, Praed Street, London, W2 1PG, UK.,Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1PG, UK.,Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK.,The DeWorm3 Project, The Natural History Museum of London, London, SW7 5BD, UK
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6
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Malizia V, Giardina F, Vegvari C, Bajaj S, McRae-McKee K, Anderson RM, de Vlas SJ, Coffeng LE. Modelling the impact of COVID-19-related control programme interruptions on progress towards the WHO 2030 target for soil-transmitted helminths. Trans R Soc Trop Med Hyg 2021; 115:253-260. [PMID: 33313897 PMCID: PMC7798673 DOI: 10.1093/trstmh/traa156] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/21/2020] [Accepted: 11/23/2020] [Indexed: 12/21/2022] Open
Abstract
Background On 1 April 2020, the WHO recommended an interruption of all activities for the control of neglected tropical diseases, including soil-transmitted helminths (STH), in response to the COVID-19 pandemic. This paper investigates the impact of this disruption on the progress towards the WHO 2030 target for STH. Methods We used two stochastic individual-based models to simulate the impact of missing one or more preventive chemotherapy (PC) rounds in different endemicity settings. We also investigated the extent to which this impact can be lessened by mitigation strategies, such as semiannual or community-wide PC. Results Both models show that without a mitigation strategy, control programmes will catch up by 2030, assuming that coverage is maintained. The catch-up time can be up to 4.5 y after the start of the interruption. Mitigation strategies may reduce this time by up to 2 y and increase the probability of achieving the 2030 target. Conclusions Although a PC interruption will only temporarily impact the progress towards the WHO 2030 target, programmes are encouraged to restart as soon as possible to minimise the impact on morbidity. The implementation of suitable mitigation strategies can turn the interruption into an opportunity to accelerate progress towards reaching the target.
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Affiliation(s)
- Veronica Malizia
- Departmen t of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Federica Giardina
- Departmen t of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Carolin Vegvari
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Imperial College London, London, UK.,Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK
| | - Sumali Bajaj
- Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK.,Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK
| | - Kevin McRae-McKee
- Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK.,Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK
| | - Roy M Anderson
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Imperial College London, London, UK.,Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK.,The DeWorm3 Project, Natural History Museum, London, UK
| | - Sake J de Vlas
- Departmen t of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Luc E Coffeng
- Departmen t of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
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7
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Truscott JE, Hardwick RJ, Werkman M, Saravanakumar PK, Manuel M, Ajjampur SSR, Ásbjörnsdóttir KH, Khumbo K, Witek-McManus S, Simwanza J, Cottrell G, Houngbégnon P, Ibikounlé M, Walson JL, Anderson RM. Forecasting the effectiveness of the DeWorm3 trial in interrupting the transmission of soil-transmitted helminths in three study sites in Benin, India and Malawi. Parasit Vectors 2021; 14:67. [PMID: 33472677 PMCID: PMC7818558 DOI: 10.1186/s13071-020-04572-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 12/29/2020] [Indexed: 11/17/2022] Open
Abstract
Background The DeWorm3 project is an ongoing cluster-randomised trial assessing the feasibility of interrupting the transmission of soil-transmitted helminths (STH) through mass drug administration (MDA) using study sites in India, Malawi and Benin. In this article, we describe an approach which uses a combination of statistical and mathematical methods to forecast the outcome of the trial with respect to its stated goal of reducing the prevalence of infection to below 2%. Methods Our approach is first to define the local patterns of transmission within each study site, which is achieved by statistical inference of key epidemiological parameters using the baseline epidemiological measures of age-related prevalence and intensity of STH infection which have been collected by the DeWorm3 trials team. We use these inferred parameters to calibrate an individual-based stochastic simulation of the trial at the cluster and study site level, which is subsequently run to forecast the future prevalence of STH infections. The simulator takes into account both the uncertainties in parameter estimation and the variability inherent in epidemiological and demographic processes in the simulator. We interpret the forecast results from our simulation with reference to the stated goal of the DeWorm3 trial, to achieve a target of \documentclass[12pt]{minimal}
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\begin{document}$$\le 2\%$$\end{document}≤2% prevalence at a point 24 months post-cessation of MDA. Results Simulated output predicts that the two arms will be distinguishable from each other in all three country sites at the study end point. In India and Malawi, measured prevalence in the intervention arm is below the threshold with a high probability (90% and 95%, respectively), but in Benin the heterogeneity between clusters prevents the arm prevalence from being reduced below the threshold value. At the level of individual study arms within each site, heterogeneity among clusters leads to a very low probability of achieving complete elimination in an intervention arm, yielding a post-study scenario with widespread elimination but a few ‘hot spot’ areas of persisting STH transmission. Conclusions Our results suggest that geographical heterogeneities in transmission intensity and worm aggregation have a large impact on the effect of MDA. It is important to accurately assess cluster-level, or even smaller scale, heterogeneities in factors which influence transmission and aggregation for a clearer perspective on projecting the outcomes of MDA control of STH and other neglected tropical diseases. ![]()
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Affiliation(s)
- James E Truscott
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Imperial College London, St Mary's Campus, London, W2 1PG, UK. .,MRC Centre for Global Infectious Disease Analysis, Imperial College London, St Mary's Campus, London, W2 1PG, UK. .,The DeWorm3 Project, The Natural History Museum, London, SW7 5BD, UK.
| | - Robert J Hardwick
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Imperial College London, St Mary's Campus, London, W2 1PG, UK.,MRC Centre for Global Infectious Disease Analysis, Imperial College London, St Mary's Campus, London, W2 1PG, UK.,The DeWorm3 Project, The Natural History Museum, London, SW7 5BD, UK
| | - Marleen Werkman
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Imperial College London, St Mary's Campus, London, W2 1PG, UK.,MRC Centre for Global Infectious Disease Analysis, Imperial College London, St Mary's Campus, London, W2 1PG, UK.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | | | - Malathi Manuel
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Sitara S R Ajjampur
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Kristjana H Ásbjörnsdóttir
- The DeWorm3 Project, The Natural History Museum, London, SW7 5BD, UK.,Departments of Global Health, Medicine (Infectious Disease), Pediatrics and Epidemiology, University of Washington, Seattle, WA, USA
| | - Kalua Khumbo
- Blantyre Institute for Community Outreach, University of Malawi, College of Medicine, Blantyre, Malawi
| | - Stefan Witek-McManus
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - James Simwanza
- Blantyre Institute for Community Outreach, University of Malawi, College of Medicine, Blantyre, Malawi
| | - Gilles Cottrell
- Institut de Recherche pour le Développement, MERIT, Université de Paris, Paris, France
| | - Parfait Houngbégnon
- Institut de Recherche Clinique du Benin, Université d'Abomey-Calavi, Cotonou, Benin
| | - Moudachirou Ibikounlé
- Institut de Recherche Clinique du Benin, Université d'Abomey-Calavi, Cotonou, Benin.,Département de Zoologie, Faculté des Sciences et Techniques, Université d'Abomey-Calavi, Cotonou, Benin
| | - Judd L Walson
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Imperial College London, St Mary's Campus, London, W2 1PG, UK.,The DeWorm3 Project, The Natural History Museum, London, SW7 5BD, UK.,Departments of Global Health, Medicine (Infectious Disease), Pediatrics and Epidemiology, University of Washington, Seattle, WA, USA
| | - Roy M Anderson
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Imperial College London, St Mary's Campus, London, W2 1PG, UK.,MRC Centre for Global Infectious Disease Analysis, Imperial College London, St Mary's Campus, London, W2 1PG, UK.,The DeWorm3 Project, The Natural History Museum, London, SW7 5BD, UK
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8
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Clark J, Stolk WA, Basáñez MG, Coffeng LE, Cucunubá ZM, Dixon MA, Dyson L, Hampson K, Marks M, Medley GF, Pollington TM, Prada JM, Rock KS, Salje H, Toor J, Hollingsworth TD. How modelling can help steer the course set by the World Health Organization 2021-2030 roadmap on neglected tropical diseases. Gates Open Res 2021; 5:112. [PMID: 35169682 PMCID: PMC8816801 DOI: 10.12688/gatesopenres.13327.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2022] [Indexed: 01/12/2023] Open
Abstract
The World Health Organization recently launched its 2021-2030 roadmap, Ending the Neglect to Attain the Sustainable Development Goals , an updated call to arms to end the suffering caused by neglected tropical diseases. Modelling and quantitative analyses played a significant role in forming these latest goals. In this collection, we discuss the insights, the resulting recommendations and identified challenges of public health modelling for 13 of the target diseases: Chagas disease, dengue, gambiense human African trypanosomiasis (gHAT), lymphatic filariasis (LF), onchocerciasis, rabies, scabies, schistosomiasis, soil-transmitted helminthiases (STH), Taenia solium taeniasis/ cysticercosis, trachoma, visceral leishmaniasis (VL) and yaws. This piece reflects the three cross-cutting themes identified across the collection, regarding the contribution that modelling can make to timelines, programme design, drug development and clinical trials.
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Affiliation(s)
- Jessica Clark
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, UK
- Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Wilma A. Stolk
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, 3000 CA, The Netherlands
| | - María-Gloria Basáñez
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, UK
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, UK
| | - Luc E. Coffeng
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, 3000 CA, The Netherlands
| | - Zulma M. Cucunubá
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, UK
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, UK
| | - Matthew A. Dixon
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, UK
- Schistosomiasis Control Initiative Foundation, London, SE11 5DP, UK
| | - Louise Dyson
- Mathematics Institute, University of Warwick, Coventry, CV4 7AL, UK
- School of Life Sciences, University of Warwick, Coventry, CV4 7AL, UK
| | - Katie Hampson
- Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Michael Marks
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Graham F. Medley
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Timothy M. Pollington
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, UK
- Mathematics Institute, University of Warwick, Coventry, CV4 7AL, UK
| | - Joaquin M. Prada
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, GU2 7AL, UK
| | - Kat S. Rock
- Mathematics Institute, University of Warwick, Coventry, CV4 7AL, UK
| | - Henrik Salje
- Department of Genetics, University of Cambridge, Cambridge, CB2 3EH, UK
| | - Jaspreet Toor
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, UK
| | - T. Déirdre Hollingsworth
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, UK
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Clark J, Stolk WA, Basáñez MG, Coffeng LE, Cucunubá ZM, Dixon MA, Dyson L, Hampson K, Marks M, Medley GF, Pollington TM, Prada JM, Rock KS, Salje H, Toor J, Hollingsworth TD. How modelling can help steer the course set by the World Health Organization 2021-2030 roadmap on neglected tropical diseases. Gates Open Res 2021; 5:112. [PMID: 35169682 PMCID: PMC8816801 DOI: 10.12688/gatesopenres.13327.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2021] [Indexed: 01/12/2023] Open
Abstract
The World Health Organization recently launched its 2021-2030 roadmap, Ending the Neglect to Attain the Sustainable Development Goals , an updated call to arms to end the suffering caused by neglected tropical diseases. Modelling and quantitative analyses played a significant role in forming these latest goals. In this collection, we discuss the insights, the resulting recommendations and identified challenges of public health modelling for 13 of the target diseases: Chagas disease, dengue, gambiense human African trypanosomiasis (gHAT), lymphatic filariasis (LF), onchocerciasis, rabies, scabies, schistosomiasis, soil-transmitted helminthiases (STH), Taenia solium taeniasis/ cysticercosis, trachoma, visceral leishmaniasis (VL) and yaws. This piece reflects the three cross-cutting themes identified across the collection, regarding the contribution that modelling can make to timelines, programme design, drug development and clinical trials.
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Affiliation(s)
- Jessica Clark
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, UK
- Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Wilma A. Stolk
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, 3000 CA, The Netherlands
| | - María-Gloria Basáñez
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, UK
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, UK
| | - Luc E. Coffeng
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, 3000 CA, The Netherlands
| | - Zulma M. Cucunubá
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, UK
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, UK
| | - Matthew A. Dixon
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, UK
- Schistosomiasis Control Initiative Foundation, London, SE11 5DP, UK
| | - Louise Dyson
- Mathematics Institute, University of Warwick, Coventry, CV4 7AL, UK
- School of Life Sciences, University of Warwick, Coventry, CV4 7AL, UK
| | - Katie Hampson
- Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Michael Marks
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Graham F. Medley
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Timothy M. Pollington
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, UK
- Mathematics Institute, University of Warwick, Coventry, CV4 7AL, UK
| | - Joaquin M. Prada
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, GU2 7AL, UK
| | - Kat S. Rock
- Mathematics Institute, University of Warwick, Coventry, CV4 7AL, UK
| | - Henrik Salje
- Department of Genetics, University of Cambridge, Cambridge, CB2 3EH, UK
| | - Jaspreet Toor
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, UK
| | - T. Déirdre Hollingsworth
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, UK
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Inocencio da Luz R, Linsuke S, Roucher C, Mpanya A, Nyandele J, Mubwa Mungwele N, Mboma BN, Polman K, Hasker E, Boelaert M. Community-based survey on helminth infections in Kwilu province, the Democratic Republic of the Congo, and implications for local control strategies. PLoS Negl Trop Dis 2020; 14:e0008745. [PMID: 33112859 PMCID: PMC7592847 DOI: 10.1371/journal.pntd.0008745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 08/25/2020] [Indexed: 11/19/2022] Open
Abstract
To adequately plan mass drug administration campaigns, the Democratic Republic of the Congo (DRC) needs further support for the mapping and monitoring of schistosomiasis (SCH) and soil-transmitted helminths (STH). We conducted a community-based survey in the health districts of Mosango and Yasa Bonga of the Kwilu province, DRC. A stratified two-stage cluster random sampling method was used to include participants into three different strata: Preschool-aged children (PSAC), school-aged children (SAC), and adults who were further subdivided into women of reproductive age (WRA) and other adults. In total, surveyors visited 30 villages, and 1 206 individuals participated in the study. Stool samples were collected to perform duplicate Kato-Katz smears for the detection of SCH and STH infection. Hookworm was the most prevalent infection in both districts, 34.1% (95%CI: 32.0–38.4), followed by A. lumbricoides (2.7%; 95%CI: 1.3–2.9) and T. trichiura (1.9%; 95%CI: 1.1–2.7). We did not find any SCH infection. The prevalence of each STH infection was similar across all risk groups, and the majority of the infected individuals was carrying light intensity infection. Compared to SAC, other adults were equally infected with hookworm. The prevalence of STH infection in SAC guides the MDA implementation because schoolchildren are most at risk and easily accessible program targets if school attendance is high. The current treatment strategy targets PSAC, SAC and WRA. However, this study shows that adults in general could also benefit from deworming. Therefore, community-wide preventive chemotherapy would be the most appropriate choice to control the hookworm burden rapidly. Helminths are a group of intestinal worms that cause abdominal discomfort, diarrhea, and anemia due to blood loss in the stool. Regular mass drug administration (MDA) is one strategy to fight these worm infections. The appropriate MDA treatment scheme is chosen based on a population survey estimating the burden of infection. This survey is usually done in schoolchildren because they suffer the most from these infections and they are easy to reach through school infrastructures. However, one particular worm, the hookworm, is also highly present and clinically relevant in adults. We conducted a community-based survey in two districts of the Kwilu Province of the DRC. We found that hookworm was the predominant infection in the area and that adults were as often infected as the schoolchildren. Therefore, to effectively reduce hookworm infection, we advise extending treatment schemes to the entire community.
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Affiliation(s)
| | - Sylvie Linsuke
- Epidemiology Unit, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
| | - Clémentine Roucher
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Alain Mpanya
- Ministry of Health, PNLTHA, Kinshasa, Democratic Republic of the Congo
| | - Jane Nyandele
- Hubert Kairuki Memorial University, Dar es Salaam, Tanzania
| | | | | | - Katja Polman
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Epco Hasker
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Marleen Boelaert
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
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