1
|
Le Rutte EA, Shattock AJ, Zhao C, Jagadesh S, Balać M, Müller SA, Nagel K, Erath AL, Axhausen KW, Van Boeckel TP, Penny MA. A case for ongoing structural support to maximise infectious disease modelling efficiency for future public health emergencies: A modelling perspective. Epidemics 2024; 46:100734. [PMID: 38118273 DOI: 10.1016/j.epidem.2023.100734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 11/20/2023] [Accepted: 12/08/2023] [Indexed: 12/22/2023] Open
Abstract
This short communication reflects upon the challenges and recommendations of multiple COVID-19 modelling and data analytic groups that provided quantitative evidence to support health policy discussions in Switzerland and Germany during the SARS-CoV-2 pandemic. Capacity strengthening outside infectious disease emergencies will be required to enable an environment for a timely, efficient, and data-driven response to support decisions during any future infectious disease emergency. This will require 1) a critical mass of trained experts who continuously advance state-of-the-art methodological tools, 2) the establishment of structural liaisons amongst scientists and decision-makers, and 3) the foundation and management of data-sharing frameworks.
Collapse
Affiliation(s)
- Epke A Le Rutte
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Andrew J Shattock
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Cheng Zhao
- Health Geography and Policy group, ETH Zurich, Switzerland
| | | | - Miloš Balać
- Institute of Transport planning and systems, ETH Zurich, Switzerland
| | - Sebastian A Müller
- Transport Systems Planning and Transport Telematics, TU Berlin, Berlin, Germany
| | - Kai Nagel
- Transport Systems Planning and Transport Telematics, TU Berlin, Berlin, Germany
| | | | - Kay W Axhausen
- Institute of Transport planning and systems, ETH Zurich, Switzerland
| | - Thomas P Van Boeckel
- Health Geography and Policy group, ETH Zurich, Switzerland; Department of Infectious Diseases, Institute for Biomedicine, University of Gothenburg, Gothenburg, Sweden; One Health Trust, Washington, DC, USA
| | - Melissa A Penny
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland.
| |
Collapse
|
2
|
Borlase A, Le Rutte EA, Castaño S, Blok DJ, Toor J, Giardina F, Davis EL. Evaluating and mitigating the potential indirect effect of COVID-19 on control programmes for seven neglected tropical diseases: a modelling study. Lancet Glob Health 2022; 10:e1600-e1611. [PMID: 36240827 PMCID: PMC9579354 DOI: 10.1016/s2214-109x(22)00360-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 07/25/2022] [Accepted: 08/03/2022] [Indexed: 11/06/2022]
Abstract
Background In line with movement restrictions and physical distancing essential for the control of the COVID-19 pandemic, WHO recommended postponement of all neglected tropical disease (NTD) control activities that involve community-based surveys, active case finding, and mass drug administration in April, 2020. Following revised guidance later in 2020, and after interruptions to NTD programmes of varying lengths, NTD programmes gradually restarted in the context of an ongoing pandemic. However, ongoing challenges and service gaps have been reported. This study aimed to evaluate the potential effect of the programmatic interruptions and strategies to mitigate this effect. Methods For seven NTDs, namely soil-transmitted helminths, schistosomiasis, lymphatic filariasis, onchocerciasis, trachoma, visceral leishmaniasis, and human African trypanosomiasis, we used mathematical transmission models to simulate the effect of programme interruptions on the dynamics of each of these diseases in different endemic settings. We also explored the potential benefit of implementing mitigation strategies, primarily in terms of minimising the delays to control targets. Findings We show that the effect of the COVID-19-induced interruption in terms of delay to achieving elimination goals might in some cases be much longer than the duration of the interruption. For schistosomiasis, onchocerciasis, trachoma, and visceral leishmaniasis, a mean delay of 2–3 years for a 1-year interruption is predicted in areas of highest prevalence. We also show that these delays can largely be mitigated by measures such as additional mass drug administration or enhanced case-finding. Interpretation The COVID-19 pandemic has brought infectious disease control to the forefront of global consciousness. It is essential that the NTDs, so long neglected in terms of research and financial support, are not overlooked, and remain a priority in health service planning and funding. Funding Bill & Melinda Gates Foundation, Medical Research Council, and the UK Foreign, Commonwealth & Development Office.
Collapse
Affiliation(s)
- Anna Borlase
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK
| | - Epke A Le Rutte
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands; Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Soledad Castaño
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland; LYO-X, Allschwil, Switzerland
| | - David J Blok
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Jaspreet Toor
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK; MRC 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, Netherlands; Department of Health Evidence, Radboud University Medical Center, Nijmegen, Netherlands
| | - Emma L Davis
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK; Mathematics Institute, University of Warwick, Coventry, UK.
| |
Collapse
|
3
|
Kelly SL, Le Rutte EA, Richter M, Penny MA, Shattock AJ. COVID-19 Vaccine Booster Strategies in Light of Emerging Viral Variants: Frequency, Timing, and Target Groups. Infect Dis Ther 2022; 11:2045-2061. [PMID: 36094720 PMCID: PMC9464609 DOI: 10.1007/s40121-022-00683-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 08/01/2022] [Indexed: 01/06/2023] Open
Abstract
Background Vaccinations have reduced severe burden of COVID-19 and allowed for lifting of non-pharmaceutical interventions. However, with immunity waning alongside emergence of more transmissible variants of concern, vaccination strategies must be examined. Methods Here we apply a SARS-CoV-2 transmission model to identify preferred frequency, timing, and target groups for vaccine boosters to reduce public health burden and health systems risk. We estimated new infections and hospital admissions averted over 2 years through annual or biannual boosting of those eligible (those who received doses one and two) who are (1) most vulnerable (60+ or living with comorbidities) or (2) those 5+, at universal (98% of eligible) or lower coverage (85% of those 50+ or with comorbidities and 50% of 5–49 year olds) representing moderate vaccine fatigue and/or hesitancy. We simulated three emerging variant scenarios: (1) no new variants; (2) 25% more infectious and immune-evading Omicron-level severity variants emerge annually and become dominant; (3) emerge biannually. We further explored the impact of varying seasonality, variant immune-evading capacity, infectivity, severity, timing, and vaccine infection blocking assumptions. Results To reduce COVID-19-related hospitalisations over the next 2 years, boosters should be provided for all those eligible annually 3–4 months ahead of peak winter whether or not new variants of concern emerge. Only boosting those most vulnerable is unlikely to ensure reduced stress on health systems. Moreover, boosting all eligible better protects those most vulnerable than only boosting the vulnerable group. Conversely, while this strategy may not ensure reduced stress on health systems, as an indication of cost-effectiveness, per booster dose more hospitalisations could be averted through annual boosting of those most vulnerable versus all eligible, since those most vulnerable are more likely to seek hospital care once infected, whereas increasing to biannual boosting showed diminishing returns. Results were robust when key model parameters were varied. However, we found that the more frequently variants emerge, the less the effect boosters will have, regardless of whether administered annually or biannually. Conclusions Delivering well-timed annual COVID-19 vaccine boosters to all those eligible, prioritising those most vulnerable, can reduce infections and hospital admissions. Findings provide model-based evidence for decision-makers to plan for administering COVID-19 boosters ahead of winter 2022–2023 to help mitigate the health burden and health system stress. Supplementary Information The online version contains supplementary material available at 10.1007/s40121-022-00683-z.
Collapse
Affiliation(s)
- Sherrie L Kelly
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Epke A Le Rutte
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Maximilian Richter
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Melissa A Penny
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland.
- University of Basel, Basel, Switzerland.
| | - Andrew J Shattock
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| |
Collapse
|
4
|
Shattock AJ, Le Rutte EA, Dünner RP, Sen S, Kelly SL, Chitnis N, Penny MA. Impact of vaccination and non-pharmaceutical interventions on SARS-CoV-2 dynamics in Switzerland. Epidemics 2021; 38:100535. [PMID: 34923396 PMCID: PMC8669952 DOI: 10.1016/j.epidem.2021.100535] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 11/19/2021] [Accepted: 12/13/2021] [Indexed: 11/24/2022] Open
Abstract
Background As vaccination coverage against SARS-CoV-2 increases amidst the emergence and spread of more infectious and potentially more deadly viral variants, decisions on timing and extent of relaxing effective, but unsustainable, non-pharmaceutical interventions (NPIs) need to be made. Methods An individual-based transmission model of SARS-CoV-2 dynamics, OpenCOVID, was developed to compare the impact of various vaccination and NPI strategies on the COVID-19 epidemic in Switzerland. OpenCOVID uses the Oxford Containment Health Index (OCHI) to quantify the stringency of NPIs. Results Even if NPIs in place in March 2021 were to be maintained and the vaccine campaigns rollout rapidly scaled-up, a ‘third wave’ was predicted. However, we find a cautious phased relaxation can substantially reduce population-level morbidity and mortality. We find that a faster vaccination campaign can offset the size of such a wave, allowing more flexibility for NPIs to be relaxed sooner. Model outcomes were most sensitive to the level of infectiousness of variants of concern observed in Switzerland. Conclusion A rapid vaccination rollout can allow the sooner relaxation of NPIs, however ongoing surveillance of - and swift responses to - emerging viral variants is of utmost importance for epidemic control.
Collapse
Affiliation(s)
- Andrew J Shattock
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
| | - Epke A Le Rutte
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
| | - Robert P Dünner
- Swiss Tropical and Public Health Institute, Basel, Switzerland.
| | - Swapnoleena Sen
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
| | - Sherrie L Kelly
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Burnet Institute, Melbourne, Australia.
| | - Nakul Chitnis
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
| | - Melissa A Penny
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
| |
Collapse
|
5
|
Le Rutte EA, van der Wilt LS, Bulstra CA, Nieboer D, Kontoroupis P, de Vlas SJ, Richardus JH. Incidence and geographical distribution of canine leishmaniosis in 2016-2017 in Spain and France. Vet Parasitol Reg Stud Reports 2021; 25:100613. [PMID: 34474806 DOI: 10.1016/j.vprsr.2021.100613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 07/27/2021] [Accepted: 08/02/2021] [Indexed: 11/16/2022]
Abstract
Leishmania infantum is transmitted by sand flies and causes visceral leishmaniasis (VL) in humans, as well as canine leishmaniosis (CanL) in dogs, the main reservoir of infection in Europe. The infection spread northwards in the last two decades, but case data are scarce, hindering monitoring and evaluation of incidence as is required by European WHO guidelines. We aim to identify the current geographical distribution of CanL incidence in Spain, which has been endemic for CanL, and France, where CanL is emerging. An online survey was conducted among veterinarians in Spain and France questioning CanL incidence in the years 2016-2017. These data were interpolated to estimate incidence in both countries using the geographical analysis ordinary kriging. Two hundred and seventy-three (273) veterinarians from 81 out of 148 French and Spanish districts completed the survey. The mean incidence in veterinary practices was 21 CanL cases per 1000 dogs during the past year, which was higher in Spain (31/1000 dogs/year) than in France (6/1000 dogs/year). Incidence rates were highest in south-eastern Spain, but sporadic cases were found up to the most northern regions of France. Our study confirms the northward spread of CanL in Spain and France, as the incidence rates were higher than reported in previous studies and cases were found in areas formerly considered non-endemic for L. infantum. Monitoring the reservoir of infection in dogs is essential for implementing timely and geographically-targeted interventions to prevent further spread of CanL and VL in Europe.
Collapse
Affiliation(s)
- Epke A Le Rutte
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000, CA, Rotterdam, the Netherlands.
| | - Lotte S van der Wilt
- Department of Epidemiology, University Medical Center, Heidelberglaan 100, 3584, CX, Utrecht, the Netherlands
| | - Caroline A Bulstra
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000, CA, Rotterdam, the Netherlands
| | - Daan Nieboer
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000, CA, Rotterdam, the Netherlands
| | - Periklis Kontoroupis
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000, CA, Rotterdam, the Netherlands
| | - Sake J de Vlas
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000, CA, Rotterdam, the Netherlands
| | - Jan Hendrik Richardus
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000, CA, Rotterdam, the Netherlands
| |
Collapse
|
6
|
Malvolti S, Malhame M, Mantel CF, Le Rutte EA, Kaye PM. Human leishmaniasis vaccines: Use cases, target population and potential global demand. PLoS Negl Trop Dis 2021; 15:e0009742. [PMID: 34547025 PMCID: PMC8486101 DOI: 10.1371/journal.pntd.0009742] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 10/01/2021] [Accepted: 08/18/2021] [Indexed: 11/18/2022] Open
Abstract
The development of vaccines against one or all forms of human leishmaniasis remains hampered by a paucity of investment, at least in part resulting from the lack of well-evidenced and agreed estimates of vaccine demand. Starting from the definition of 4 main use cases (prevention of visceral leishmaniasis, prevention of cutaneous leishmaniasis, prevention of post-kala-azar dermal leishmaniasis and treatment of post-kala-azar dermal leishmaniasis), we have estimated the size of each target population, focusing on those endemic countries where incidence levels are sufficiently high to justify decisions to adopt a vaccine. We assumed a dual vaccine delivery strategy, including a wide age-range catch-up campaign before the start of routine immunisation. Vaccine characteristics and delivery parameters reflective of a target product profile and the likely duration of the clinical development effort were considered in forecasting the demand for each of the four indications. Over a period of 10 years, this demand is forecasted to range from 300-830 million doses for a vaccine preventing visceral leishmaniasis and 557-1400 million doses for a vaccine preventing cutaneous leishmaniasis under the different scenarios we simulated. In a scenario with an effective prophylactic visceral leishmaniasis vaccine, demand for use to prevent or treat post-kala-azar dermal leishmaniasis would be more limited (over the 10 years ~160,000 doses for prevention and ~7,000 doses for treatment). Demand would rise to exceed 330,000 doses, however, in the absence of an effective vaccine for visceral leishmaniasis. Because of the sizeable demand and potential for public health impact, a single-indication prophylactic vaccine for visceral or cutaneous leishmaniasis, and even more so a cross-protective prophylactic vaccine could attract the interest of commercial developers. Continuous refinement of these first-of-their kind estimates and confirmation of country willingness and ability to pay will be paramount to inform the decisions of policy makers and developers in relation to a leishmaniasis vaccine. Positive decisions can provide a much-needed contribution towards the achievement of global leishmaniasis control.
Collapse
Affiliation(s)
| | | | | | - Epke A. Le Rutte
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Paul M. Kaye
- York Biomedical Research Institute, Hull York Medical School, University of York, Heslington, York, United Kingdom
| |
Collapse
|
7
|
Coffeng LE, Le Rutte EA, Munoz J, Adams E, de Vlas SJ. Antibody and Antigen Prevalence as Indicators of Ongoing Transmission or Elimination of Visceral Leishmaniasis: A Modeling Study. Clin Infect Dis 2021; 72:S180-S187. [PMID: 33906229 PMCID: PMC8201595 DOI: 10.1093/cid/ciab210] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background Control of visceral leishmaniasis (VL) on the Indian subcontinent has been highly successful. Control efforts such as indoor residual spraying and active case detection will be scaled down or even halted over the coming years. We explored how after scale-down, potential recurrence of VL cases may be predicted based on population-based surveys of antibody or antigenemia prevalence. Methods Using a stochastic age-structured transmission model of VL, we predicted trends in case incidence and biomarker prevalence over time after scaling down control efforts when the target of 3 successive years without VL cases has been achieved. Next, we correlated biomarker prevalence with the occurrence of new VL cases within 10 years of scale-down. Results Occurrence of at least 1 new VL case in a population of 10 000 was highly correlated with the seroprevalence and antigenemia prevalence at the moment of scale-down, or 1 or 2 years afterward. Receiver operating characteristic curves indicated that biomarker prevalence in adults provided the most predictive information, and seroprevalence was a more informative predictor of new VL cases than antigenemia prevalence. Thresholds for biomarker prevalence to predict occurrence of new VL cases with high certainty were robust to variation in precontrol endemicity. Conclusions The risk of recrudescence of VL after scaling down control efforts can be monitored and mitigated by means of population-based surveys. Our findings highlight that rapid point-of-care diagnostic tools to assess (preferably) seroprevalence or (otherwise) antigenemia in the general population could be a key ingredient of sustainable VL control.
Collapse
Affiliation(s)
- Luc E Coffeng
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam,The Netherlands
| | - Epke A Le Rutte
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam,The Netherlands.,Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel,Switzerland.,University of Basel, Basel, Switzerland
| | - Johanna Munoz
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam,The Netherlands
| | - Emily Adams
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Sake J de Vlas
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam,The Netherlands
| |
Collapse
|
8
|
Toor J, Hamley JID, Fronterre C, Castaño MS, Chapman LAC, Coffeng LE, Giardina F, Lietman TM, Michael E, Pinsent A, Le Rutte EA, Hollingsworth TD. Strengthening data collection for neglected tropical diseases: What data are needed for models to better inform tailored intervention programmes? PLoS Negl Trop Dis 2021; 15:e0009351. [PMID: 33983937 PMCID: PMC8118349 DOI: 10.1371/journal.pntd.0009351] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Locally tailored interventions for neglected tropical diseases (NTDs) are becoming increasingly important for ensuring that the World Health Organization (WHO) goals for control and elimination are reached. Mathematical models, such as those developed by the NTD Modelling Consortium, are able to offer recommendations on interventions but remain constrained by the data currently available. Data collection for NTDs needs to be strengthened as better data are required to indirectly inform transmission in an area. Addressing specific data needs will improve our modelling recommendations, enabling more accurate tailoring of interventions and assessment of their progress. In this collection, we discuss the data needs for several NTDs, specifically gambiense human African trypanosomiasis, lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminths (STH), trachoma, and visceral leishmaniasis. Similarities in the data needs for these NTDs highlight the potential for integration across these diseases and where possible, a wider spectrum of diseases.
Collapse
Affiliation(s)
- Jaspreet Toor
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Oxford, United Kingdom
- * E-mail:
| | - Jonathan I. D. Hamley
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
- Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, United Kingdom
| | - Claudio Fronterre
- Centre for Health Informatics, Computing and Statistics, Lancaster University, Lancaster, United Kingdom
| | - María Soledad Castaño
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Lloyd A. C. Chapman
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, United Kingdom
- Department of Medicine, University of California, San Francisco, California, United States of America
| | - Luc E. Coffeng
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Federica Giardina
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Thomas M. Lietman
- Francis I Proctor Foundation, University of California, San Francisco, California, United States of America
- Department of Ophthalmology, University of California, San Francisco, California, United States of America
- Department of Epidemiology & Biostatistics, University of California, San Francisco, California, United States of America
| | - Edwin Michael
- Department of Biological Sciences, University of Notre Dame, Notre Dame, Indiana, United States of America
| | - Amy Pinsent
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Epke A. Le Rutte
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - T. Déirdre Hollingsworth
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Oxford, United Kingdom
| |
Collapse
|
9
|
Le Rutte EA, Coffeng LE, Muñoz J, de Vlas SJ. Modelling the impact of COVID-19-related programme interruptions on visceral leishmaniasis in India. Trans R Soc Trop Med Hyg 2021; 115:229-235. [PMID: 33580952 PMCID: PMC7928630 DOI: 10.1093/trstmh/trab012] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/22/2020] [Accepted: 01/13/2021] [Indexed: 01/05/2023] Open
Abstract
Background In March 2020, India declared a nationwide lockdown to control the spread of coronavirus disease 2019. As a result, control efforts against visceral leishmaniasis (VL) were interrupted. Methods Using an established age-structured deterministic VL transmission model, we predicted the impact of a 6- to 24-month programme interruption on the timeline towards achieving the VL elimination target as well as on the increase of VL cases. We also explored the potential impact of a mitigation strategy after the interruption. Results Delays towards the elimination target are estimated to range between 0 and 9 y. Highly endemic settings where control efforts have been ongoing for 5–8 y are most affected by an interruption, for which we identified a mitigation strategy to be most relevant. However, more importantly, all settings can expect an increase in the number of VL cases. This increase is substantial even for settings with a limited expected delay in achieving the elimination target. Conclusions Besides implementing mitigation strategies, it is of great importance to try and keep the duration of the interruption as short as possible to prevent new individuals from becoming infected with VL and continue the efforts towards VL elimination as a public health problem in India.
Collapse
Affiliation(s)
- Epke A Le Rutte
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands.,Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Luc E Coffeng
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
| | - Johanna Muñoz
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
| | - Sake J de Vlas
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
| |
Collapse
|
10
|
Coffeng LE, Le Rutte EA, Muñoz J, Adams ER, Prada JM, de Vlas SJ, Medley GF. Impact of Changes in Detection Effort on Control of Visceral Leishmaniasis in the Indian Subcontinent. J Infect Dis 2021; 221:S546-S553. [PMID: 31841593 PMCID: PMC7289545 DOI: 10.1093/infdis/jiz644] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background Control of visceral leishmaniasis (VL) on the Indian subcontinent relies on prompt detection and treatment of symptomatic cases. Detection efforts influence the observed VL incidence and how well it reflects the underlying true incidence. As control targets are defined in terms of observed cases, there is an urgent need to understand how changes in detection delay and population coverage of improved detection affect VL control. Methods Using a mathematical model for transmission and control of VL, we predict the impact of reduced detection delays and/or increased population coverage of the detection programs on observed and true VL incidence and mortality. Results Improved case detection, either by higher coverage or reduced detection delay, causes an initial rise in observed VL incidence before a reduction. Relaxation of improved detection may lead to an apparent temporary (1 year) reduction in VL incidence, but comes with a high risk of resurging infection levels. Duration of symptoms in detected cases shows an unequivocal association with detection effort. Conclusions VL incidence on its own is not a reliable indicator of the performance of case detection programs. Duration of symptoms in detected cases can be used as an additional marker of the performance of case detection programs.
Collapse
Affiliation(s)
- Luc E Coffeng
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Epke A Le Rutte
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Johanna Muñoz
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Emily R Adams
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Joaquin M Prada
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Sake J de Vlas
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Graham F Medley
- Centre for Mathematical Modelling of Infectious Disease and Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| |
Collapse
|
11
|
Toor J, Adams ER, Aliee M, Amoah B, Anderson RM, Ayabina D, Bailey R, Basáñez MG, Blok DJ, Blumberg S, Borlase A, Rivera RC, Castaño MS, Chitnis N, Coffeng LE, Crump RE, Das A, Davis CN, Davis EL, Deiner MS, Diggle PJ, Fronterre C, Giardina F, Giorgi E, Graham M, Hamley JID, Huang CI, Kura K, Lietman TM, Lucas TCD, Malizia V, Medley GF, Meeyai A, Michael E, Porco TC, Prada JM, Rock KS, Le Rutte EA, Smith ME, Spencer SEF, Stolk WA, Touloupou P, Vasconcelos A, Vegvari C, de Vlas SJ, Walker M, Hollingsworth TD. Predicted Impact of COVID-19 on Neglected Tropical Disease Programs and the Opportunity for Innovation. Clin Infect Dis 2020; 72:1463-1466. [PMID: 32984870 PMCID: PMC7543306 DOI: 10.1093/cid/ciaa933] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 07/10/2020] [Indexed: 11/12/2022] Open
Abstract
Due to the COVID-19 pandemic, many key neglected tropical disease (NTD) activities have been postponed. This hindrance comes at a time when the NTDs are progressing towards their ambitious goals for 2030. Mathematical modelling on several NTDs, namely gambiense sleeping sickness, lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminthiases (STH), trachoma, and visceral leishmaniasis, shows that the impact of this disruption will vary across the diseases. Programs face a risk of resurgence, which will be fastest in high-transmission areas. Furthermore, of the mass drug administration diseases, schistosomiasis, STH, and trachoma are likely to encounter faster resurgence. The case-finding diseases (gambiense sleeping sickness and visceral leishmaniasis) are likely to have fewer cases being detected but may face an increasing underlying rate of new infections. However, once programs are able to resume, there are ways to mitigate the impact and accelerate progress towards the 2030 goals.
Collapse
Affiliation(s)
- Jaspreet Toor
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Oxford, United Kingdom
| | - Emily R Adams
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Maryam Aliee
- Mathematics Institute, University of Warwick, Coventry, United Kingdom,Zeeman Institute for Systems Biology and Infectious Disease Epidemiology Research, University of Warwick, Coventry, United Kingdom
| | - Benjamin Amoah
- Centre for Health Informatics, Computing and Statistics, Lancaster University, Lancaster, United Kingdom
| | - Roy M Anderson
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom,Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, United Kingdom,The DeWorm3 Project, Natural History Museum, London, United Kingdom
| | - Diepreye Ayabina
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Oxford, United Kingdom
| | - Robin Bailey
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Maria-Gloria Basáñez
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom,Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, United Kingdom
| | - David J Blok
- Department of Public Health, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Seth Blumberg
- Francis I Proctor Foundation, University of California, San Francisco, California, United States of America
| | - Anna Borlase
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Oxford, United Kingdom
| | - Rocio Caja Rivera
- Department of Biological Sciences, University of Notre Dame, Notre Dame, Indiana, United States of America
| | - María Soledad Castaño
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland,University of Basel, Basel, Switzerland
| | - Nakul Chitnis
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland,University of Basel, Basel, Switzerland
| | - Luc E Coffeng
- Department of Public Health, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Ronald E Crump
- Mathematics Institute, University of Warwick, Coventry, United Kingdom,Zeeman Institute for Systems Biology and Infectious Disease Epidemiology Research, University of Warwick, Coventry, United Kingdom,The School of Life Sciences, University of Warwick, Coventry, United Kingdom
| | - Aatreyee Das
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland,University of Basel, Basel, Switzerland
| | - Christopher N Davis
- Mathematics Institute, University of Warwick, Coventry, United Kingdom,Zeeman Institute for Systems Biology and Infectious Disease Epidemiology Research, University of Warwick, Coventry, United Kingdom
| | - Emma L Davis
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Oxford, United Kingdom
| | - Michael S Deiner
- Francis I Proctor Foundation, University of California, San Francisco, California, United States of America,Department of Ophthalmology, University of California, San Francisco, California, United States of America
| | - Peter J Diggle
- Centre for Health Informatics, Computing and Statistics, Lancaster University, Lancaster, United Kingdom
| | - Claudio Fronterre
- Centre for Health Informatics, Computing and Statistics, Lancaster University, Lancaster, United Kingdom
| | - Federica Giardina
- Department of Public Health, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Emanuele Giorgi
- Centre for Health Informatics, Computing and Statistics, Lancaster University, Lancaster, United Kingdom
| | - Matthew Graham
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Oxford, United Kingdom,Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jonathan I D Hamley
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom,Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, United Kingdom
| | - Ching-I Huang
- Mathematics Institute, University of Warwick, Coventry, United Kingdom,Zeeman Institute for Systems Biology and Infectious Disease Epidemiology Research, University of Warwick, Coventry, United Kingdom
| | - Klodeta Kura
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom,Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, United Kingdom
| | - Thomas M Lietman
- Francis I Proctor Foundation, University of California, San Francisco, California, United States of America,Department of Ophthalmology, University of California, San Francisco, California, United States of America,Department of Epidemiology & Biostatistics, University of California, San Francisco, California, United States of America
| | - Tim C D Lucas
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Oxford, United Kingdom
| | - Veronica Malizia
- Department of Public Health, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Graham F Medley
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Aronrag Meeyai
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Edwin Michael
- Department of Biological Sciences, University of Notre Dame, Notre Dame, Indiana, United States of America
| | - Travis C Porco
- Francis I Proctor Foundation, University of California, San Francisco, California, United States of America,Department of Ophthalmology, University of California, San Francisco, California, United States of America,Department of Epidemiology & Biostatistics, University of California, San Francisco, California, United States of America
| | - Joaquin M Prada
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Kat S Rock
- Mathematics Institute, University of Warwick, Coventry, United Kingdom,Zeeman Institute for Systems Biology and Infectious Disease Epidemiology Research, University of Warwick, Coventry, United Kingdom
| | - Epke A Le Rutte
- Department of Public Health, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands,Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland,University of Basel, Basel, Switzerland
| | - Morgan E Smith
- Department of Biological Sciences, University of Notre Dame, Notre Dame, Indiana, United States of America
| | - Simon E F Spencer
- Zeeman Institute for Systems Biology and Infectious Disease Epidemiology Research, University of Warwick, Coventry, United Kingdom,Department of Statistics, University of Warwick, Coventry, United Kingdom
| | - Wilma A Stolk
- Department of Public Health, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Andreia Vasconcelos
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Oxford, United Kingdom
| | - Carolin Vegvari
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom,Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, United Kingdom
| | - Sake J de Vlas
- Department of Public Health, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Martin Walker
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom,London Centre for Neglected Tropical Disease Research, Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, Hatfield, Hertfordshire, United Kingdom
| | - T Déirdre Hollingsworth
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Oxford, United Kingdom,Correspondence: T. D. Hollingsworth, Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Old Road Campus, Oxford OX3 7LF, UK ()
| |
Collapse
|
12
|
Le Rutte EA, Coffeng LE, Malvolti S, Kaye PM, de Vlas SJ. The potential impact of human visceral leishmaniasis vaccines on population incidence. PLoS Negl Trop Dis 2020; 14:e0008468. [PMID: 32614857 PMCID: PMC7363103 DOI: 10.1371/journal.pntd.0008468] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 07/15/2020] [Accepted: 06/10/2020] [Indexed: 11/18/2022] Open
Abstract
Human visceral leishmaniasis (VL) vaccines are currently under development and there is a need to understand their potential impact on population wide VL incidence. We implement four characteristics from different human VL vaccine candidates into two published VL transmission model variants to estimate the potential impact of these vaccine characteristics on population-wide anthroponotic VL incidence on the Indian subcontinent (ISC). The vaccines that are simulated in this study 1) reduce the infectiousness of infected individuals towards sand flies, 2) reduce risk of developing symptoms after infection, 3) reduce the risk of developing post-kala-azar dermal leishmaniasis (PKDL), or 4) lead to the development of transient immunity. We also compare and combine a vaccine strategy with current interventions to identify their potential role in elimination of VL as a public health problem. We show that the first two simulated vaccine characteristics can greatly reduce VL incidence. For these vaccines, an approximate 60% vaccine efficacy would lead to achieving the ISC elimination target (<1 VL case per 10,000 population per year) within 10 years’ time in a moderately endemic setting when vaccinating 100% of the population. Vaccinating VL cases to prevent the development of PKDL is a promising tool to sustain the low incidence elimination target after regular interventions are halted. Vaccines triggering the development of transient immunity protecting against infection lead to the biggest reduction in VL incidence, but booster doses are required to achieve perduring impact. Even though vaccines are not yet available for implementation, their development should be pursued as their potential impact on transmission can be substantial, both in decreasing incidence at the population level as well as in sustaining the ISC elimination target when other interventions are halted. Vaccines for human visceral leishmaniasis (VL) are currently under development. In this study, we simulate VL transmission dynamics using mathematical models to explore the potential impact of vaccines on population-wide incidence. We show that some vaccines have high potential to reduce VL incidence, namely those that reduce the infectiousness of infected individuals to sand flies and those that reduce the chance of developing symptoms once infected. The effect of vaccines that lead to protection from infection is potentially the greatest, but depending on the duration of immunity, individuals would require booster doses to guarantee lifelong impact. Vaccines that prevent the development of post-kala-azar dermal leishmaniasis are a promising tool to sustain low VL incidence and prevent recrudescence of infection when regular interventions are halted. Our results strongly support the continued development of VL vaccines, as their potential impact on population incidence can be substantial.
Collapse
Affiliation(s)
- Epke A. Le Rutte
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- * E-mail:
| | - Luc E. Coffeng
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Paul M. Kaye
- York Biomedical Research Institute, Hull York Medical School, University of York, York, United Kingdom
| | - Sake J. de Vlas
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| |
Collapse
|
13
|
Le Rutte EA, Chapman LAC, Coffeng LE, Ruiz-Postigo JA, Olliaro PL, Adams ER, Hasker EC, Boelaert MC, Hollingsworth TD, Medley GF, de Vlas SJ. Policy Recommendations From Transmission Modeling for the Elimination of Visceral Leishmaniasis in the Indian Subcontinent. Clin Infect Dis 2019; 66:S301-S308. [PMID: 29860292 PMCID: PMC5982727 DOI: 10.1093/cid/ciy007] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Background Visceral leishmaniasis (VL) has been targeted by the World Health Organization (WHO) and 5 countries in the Indian subcontinent for elimination as a public health problem. To achieve this target, the WHO has developed guidelines consisting of 4 phases of different levels of interventions, based on vector control through indoor residual spraying of insecticide (IRS) and active case detection (ACD). Mathematical transmission models of VL are increasingly used for planning and assessing the efficacy of interventions and evaluating the intensity and timescale required to achieve the elimination target. Methods This paper draws together the key policy-relevant conclusions from recent transmission modeling of VL, and presents new predictions for VL incidence under the interventions recommended by the WHO using the latest transmission models. Results The model predictions suggest that the current WHO guidelines should be sufficient to reach the elimination target in areas that had medium VL endemicities (up to 5 VL cases per 10000 population per year) prior to the start of interventions. However, additional interventions, such as extending the WHO attack phase (intensive IRS and ACD), may be required to bring forward elimination in regions with high precontrol endemicities, depending on the relative infectiousness of different disease stages. Conclusions The potential hurdle that asymptomatic and, in particular, post-kala-azar dermal leishmaniasis cases may pose to reaching and sustaining the target needs to be addressed. As VL incidence decreases, the pool of immunologically naive individuals will grow, creating the potential for new outbreaks.
Collapse
Affiliation(s)
- Epke A Le Rutte
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, The Netherlands
| | - Lloyd A C Chapman
- Zeeman Institute, University of Warwick, Coventry, United Kingdom.,London School of Hygiene and Tropical Medicine, United Kingdom
| | - Luc E Coffeng
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, The Netherlands
| | | | - Piero L Olliaro
- Special Programme for Research and Training in Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Emily R Adams
- Liverpool School of Tropical Medicine, United Kingdom
| | | | | | - T Deirdre Hollingsworth
- Zeeman Institute, University of Warwick, Coventry, United Kingdom.,Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford
| | - Graham F Medley
- London School of Hygiene and Tropical Medicine, United Kingdom
| | - Sake J de Vlas
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, The Netherlands
| |
Collapse
|
14
|
Le Rutte EA, Zijlstra EE, de Vlas SJ. Post-Kala-Azar Dermal Leishmaniasis as a Reservoir for Visceral Leishmaniasis Transmission. Trends Parasitol 2019; 35:590-592. [PMID: 31266711 PMCID: PMC6667731 DOI: 10.1016/j.pt.2019.06.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 06/14/2019] [Accepted: 06/14/2019] [Indexed: 01/08/2023]
Abstract
Post-kala-azar dermal leishmaniasis (PKDL) is a parasitic skin infection which can occur after visceral leishmaniasis (VL). Recent xenodiagnosis studies (Mondal et al., Clin. Infect. Dis., 2018) have uncovered the infectiousness of PKDL. When including this in a transmission model, PKDL cases appear as an important reservoir of infection, likely frustrating the VL elimination efforts on the Indian subcontinent.
Collapse
Affiliation(s)
- Epke A Le Rutte
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands; Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, Basel 4002, Switzerland; University of Basel, Basel 4003, Switzerland.
| | - Eduard E Zijlstra
- Rotterdam Centre for Tropical Medicine, Bovenstraat 21, 3077 BB Rotterdam, The Netherlands
| | - Sake J de Vlas
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| |
Collapse
|
15
|
Bulstra CA, Le Rutte EA, Malaviya P, Hasker EC, Coffeng LE, Picado A, Singh OP, Boelaert MC, de Vlas SJ, Sundar S. Visceral leishmaniasis: Spatiotemporal heterogeneity and drivers underlying the hotspots in Muzaffarpur, Bihar, India. PLoS Negl Trop Dis 2018; 12:e0006888. [PMID: 30521529 PMCID: PMC6283467 DOI: 10.1371/journal.pntd.0006888] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 10/01/2018] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Despite the overall decrease in visceral leishmaniasis (VL) incidence on the Indian subcontinent, there remain spatiotemporal clusters or 'hotspots' of new cases. The characteristics of these hotspots, underlying transmission dynamics, and their importance for shaping control strategies are not yet fully understood and are investigated in this study for a VL endemic area of ~100,000 inhabitants in Bihar, India between 2007-2015. METHODOLOGY/PRINCIPAL FINDINGS VL incidence (cases/10,000/year) dropped from 12.3 in 2007 to 0.9 in 2015, which is just below the World Health Organizations' threshold for elimination as a public health problem. Clustering of VL was assessed between subvillages (hamlets), using multiple geospatial and (spatio)temporal autocorrelation and hotspot analyses. One to three hotspots were identified each year, often persisting for 1-5 successive years with a modal radius of ~500m. The relative risk of having VL was 5-86 times higher for inhabitants of hotspots, compared to those living outside hotspots. Hotspots harbour significantly more households from the two lowest asset quintiles (as proxy for socio-economic status). Overall, children and young adelescents (5-14 years) have the highest risk for VL, but within hotspots and at the start of outbreaks, older age groups (35+ years) show a comparable high risk. CONCLUSIONS/SIGNIFICANCE This study demonstrates significant spatiotemporal heterogeneity in VL incidence at subdistrict level. The association between poverty and hotspots confirms that VL is a disease of 'the poorest of the poor' and age patterns suggest a potential role of waning immunity as underlying driver of hotspots. The recommended insecticide spraying radius of 500m around detected VL cases corresponds to the modal hotspot radius found in this study. Additional data on immunity and asymptomatic infection, and the development of spatiotemporally explicit transmission models that simulate hotspot dynamics and predict the impact of interventions at the smaller geographical scale will be crucial tools in sustaining elimination.
Collapse
Affiliation(s)
- Caroline A. Bulstra
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Epke A. Le Rutte
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Paritosh Malaviya
- Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Epco C. Hasker
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Luc E. Coffeng
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Albert Picado
- ISGlobal, Barcelona Institute for Global Health, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
- Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland
| | - Om Prakash Singh
- Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Marleen C. Boelaert
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Sake J. de Vlas
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Shyam Sundar
- Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| |
Collapse
|
16
|
Le Rutte EA, van Straten R, Overgaauw PA. Awareness and control of canine leishmaniosis: A survey among Spanish and French veterinarians. Vet Parasitol 2018; 253:87-93. [DOI: 10.1016/j.vetpar.2018.01.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 01/12/2018] [Indexed: 01/20/2023]
|
17
|
Lenk EJ, Redekop WK, Luyendijk M, Fitzpatrick C, Niessen L, Stolk WA, Tediosi F, Rijnsburger AJ, Bakker R, Hontelez JAC, Richardus JH, Jacobson J, Le Rutte EA, de Vlas SJ, Severens JL. Socioeconomic benefit to individuals of achieving 2020 targets for four neglected tropical diseases controlled/eliminated by innovative and intensified disease management: Human African trypanosomiasis, leprosy, visceral leishmaniasis, Chagas disease. PLoS Negl Trop Dis 2018; 12:e0006250. [PMID: 29534061 PMCID: PMC5849290 DOI: 10.1371/journal.pntd.0006250] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 01/18/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The control or elimination of neglected tropical diseases (NTDs) has targets defined by the WHO for 2020, reinforced by the 2012 London Declaration. We estimated the economic impact to individuals of meeting these targets for human African trypanosomiasis, leprosy, visceral leishmaniasis and Chagas disease, NTDs controlled or eliminated by innovative and intensified disease management (IDM). METHODS A systematic literature review identified information on productivity loss and out-of-pocket payments (OPPs) related to these NTDs, which were combined with projections of the number of people suffering from each NTD, country and year for 2011-2020 and 2021-2030. The ideal scenario in which the WHO's 2020 targets are met was compared with a counterfactual scenario that assumed the situation of 1990 stayed unaltered. Economic benefit equaled the difference between the two scenarios. Values are reported in 2005 US$, purchasing power parity-adjusted, discounted at 3% per annum from 2010. Probabilistic sensitivity analyses were used to quantify the degree of uncertainty around the base-case impact estimate. RESULTS The total global productivity gained for the four IDM-NTDs was I$ 23.1 (I$ 15.9 -I$ 34.0) billion in 2011-2020 and I$ 35.9 (I$ 25.0 -I$ 51.9) billion in 2021-2030 (2.5th and 97.5th percentiles in brackets), corresponding to US$ 10.7 billion (US$ 7.4 -US$ 15.7) and US$ 16.6 billion (US$ 11.6 -US$ 24.0). Reduction in OPPs was I$ 14 billion (US$ 6.7 billion) and I$ 18 billion (US$ 10.4 billion) for the same periods. CONCLUSIONS We faced important limitations to our work, such as finding no OPPs for leprosy. We had to combine limited data from various sources, heterogeneous background, and of variable quality. Nevertheless, based on conservative assumptions and subsequent uncertainty analyses, we estimate that the benefits of achieving the targets are considerable. Under plausible scenarios, the economic benefits far exceed the necessary investments by endemic country governments and their development partners. Given the higher frequency of NTDs among the poorest households, these investments represent good value for money in the effort to improve well-being, distribute the world's prosperity more equitably and reduce inequity.
Collapse
Affiliation(s)
- Edeltraud J. Lenk
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - William K. Redekop
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Marianne Luyendijk
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Christopher Fitzpatrick
- Department of control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Louis Niessen
- Centre for Applied Health Research and Delivery, Department of International Public Health, Liverpool School of Tropical Medicine and University of Liverpool, Liverpool, United Kingdom
| | - Wilma A. Stolk
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Fabrizio Tediosi
- Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland
| | | | - Roel Bakker
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Jan A. C. Hontelez
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Jan H. Richardus
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Julie Jacobson
- Global Health Program, Bill & Melinda Gates Foundation, Seattle, Washington, United States of America
| | - Epke A. Le Rutte
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Sake J. de Vlas
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Johan L. Severens
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| |
Collapse
|
18
|
Jervis S, Chapman LAC, Dwivedi S, Karthick M, Das A, Le Rutte EA, Courtenay O, Medley GF, Banerjee I, Mahapatra T, Chaudhuri I, Srikantiah S, Hollingsworth TD. Variations in visceral leishmaniasis burden, mortality and the pathway to care within Bihar, India. Parasit Vectors 2017; 10:601. [PMID: 29216905 PMCID: PMC5719561 DOI: 10.1186/s13071-017-2530-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Accepted: 11/12/2017] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Visceral leishmaniasis (VL) has been targeted by the WHO for elimination as a public health problem (< 1 case/10,000 people/year) in the Indian sub-continent (ISC) by 2020. Bihar State in India, which accounts for the majority of cases in the ISC, remains a major target for this elimination effort. However, there is considerable spatial, temporal and sub-population variation in occurrence of the disease and the pathway to care, which is largely unexplored and a threat to achieving the target. METHODS Data from 6081 suspected VL patients who reported being clinically diagnosed during 2012-2013 across eight districts in Bihar were analysed. Graphical comparisons and Chi-square tests were used to determine differences in the burden of identified cases by season, district, age and sex. Log-linear regression models were fitted to onset (of symptoms)-to-diagnosis and onset-to-treatment waiting times to estimate their associations with age, sex, district and various socio-economic factors (SEFs). Logistic regression models were used to identify factors associated with mortality. RESULTS Comparisons of VL caseloads suggested an annual cycle peaking in January-March. A 17-fold variation in the burden of identified cases across districts and under-representation of young children (0-5 years) relative to age-specific populations in Bihar were observed. Women accounted for a significantly lower proportion of the reported cases than men (41 vs 59%, P < 0.0001). Age, district of residence, house wall materials, caste, treatment cost, travelling for diagnosis and the number of treatments for symptoms before diagnosis were identified as correlates of waiting times. Mortality was associated with age, district of residence, onset-to-treatment waiting time, treatment duration, cattle ownership and cost of diagnosis. CONCLUSIONS The distribution of VL in Bihar is highly heterogeneous, and reported caseloads and associated mortality vary significantly across different districts, posing different challenges to the elimination campaign. Socio-economic factors are important correlates of these differences, suggesting that elimination will require tailoring to population and sub-population circumstances.
Collapse
Affiliation(s)
- Sarah Jervis
- School of Life Sciences, University of Warwick, Gibbet Hill Campus, Coventry, CV4 7AL, UK.
| | - Lloyd A C Chapman
- School of Life Sciences, University of Warwick, Gibbet Hill Campus, Coventry, CV4 7AL, UK.
| | - Shweta Dwivedi
- CARE India Solutions for Sustainable Development, Patna, Bihar, India
| | - Morchan Karthick
- CARE India Solutions for Sustainable Development, Patna, Bihar, India
| | - Aritra Das
- CARE India Solutions for Sustainable Development, Patna, Bihar, India
| | - Epke A Le Rutte
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Orin Courtenay
- School of Life Sciences, University of Warwick, Gibbet Hill Campus, Coventry, CV4 7AL, UK
| | - Graham F Medley
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | | | - Tanmay Mahapatra
- CARE India Solutions for Sustainable Development, Patna, Bihar, India
| | | | | | | |
Collapse
|
19
|
Le Rutte EA, Chapman LAC, Coffeng LE, Jervis S, Hasker EC, Dwivedi S, Karthick M, Das A, Mahapatra T, Chaudhuri I, Boelaert MC, Medley GF, Srikantiah S, Hollingsworth TD, de Vlas SJ. Elimination of visceral leishmaniasis in the Indian subcontinent: a comparison of predictions from three transmission models. Epidemics 2017; 18:67-80. [PMID: 28279458 PMCID: PMC5340844 DOI: 10.1016/j.epidem.2017.01.002] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 01/06/2017] [Accepted: 01/07/2017] [Indexed: 12/23/2022] Open
Abstract
We present three transmission models of visceral leishmaniasis (VL) in the Indian subcontinent (ISC) with structural differences regarding the disease stage that provides the main contribution to transmission, including models with a prominent role of asymptomatic infection, and fit them to recent case data from 8 endemic districts in Bihar, India. Following a geographical cross-validation of the models, we compare their predictions for achieving the WHO VL elimination targets with ongoing treatment and vector control strategies. All the transmission models suggest that the WHO elimination target (<1 new VL case per 10,000 capita per year at sub-district level) is likely to be met in Bihar, India, before or close to 2020 in sub-districts with a pre-control incidence of 10 VL cases per 10,000 people per year or less, when current intervention levels (60% coverage of indoor residual spraying (IRS) of insecticide and a delay of 40days from onset of symptoms to treatment (OT)) are maintained, given the accuracy and generalizability of the existing data regarding incidence and IRS coverage. In settings with a pre-control endemicity level of 5/10,000, increasing the effective IRS coverage from 60 to 80% is predicted to lead to elimination of VL 1-3 years earlier (depending on the particular model), and decreasing OT from 40 to 20days to bring elimination forward by approximately 1year. However, in all instances the models suggest that L. donovani transmission will continue after 2020 and thus that surveillance and control measures need to remain in place until the longer-term aim of breaking transmission is achieved.
Collapse
Affiliation(s)
- Epke A Le Rutte
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Lloyd A C Chapman
- School of Life Sciences, University of Warwick, Gibbet Hill Campus, Coventry CV4 7AL, United Kingdom
| | - Luc E Coffeng
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Sarah Jervis
- School of Life Sciences, University of Warwick, Gibbet Hill Campus, Coventry CV4 7AL, United Kingdom
| | - Epco C Hasker
- Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium
| | - Shweta Dwivedi
- CARE India Solutions for Sustainable Development, Patna, Bihar, India
| | - Morchan Karthick
- CARE India Solutions for Sustainable Development, Patna, Bihar, India
| | - Aritra Das
- CARE India Solutions for Sustainable Development, Patna, Bihar, India
| | - Tanmay Mahapatra
- CARE India Solutions for Sustainable Development, Patna, Bihar, India
| | | | - Marleen C Boelaert
- Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium
| | - Graham F Medley
- London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom
| | | | - T Deirdre Hollingsworth
- School of Life Sciences, University of Warwick, Gibbet Hill Campus, Coventry CV4 7AL, United Kingdom
| | - Sake J de Vlas
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| |
Collapse
|
20
|
Le Rutte EA, Coffeng LE, Bontje DM, Hasker EC, Postigo JAR, Argaw D, Boelaert MC, De Vlas SJ. Feasibility of eliminating visceral leishmaniasis from the Indian subcontinent: explorations with a set of deterministic age-structured transmission models. Parasit Vectors 2016; 9:24. [PMID: 26787302 PMCID: PMC4717541 DOI: 10.1186/s13071-016-1292-0] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 12/31/2015] [Indexed: 02/02/2023] Open
Abstract
Background Visceral leishmaniasis (VL) is a neglected tropical disease transmitted by sandflies. On the Indian subcontinent (ISC), VL is targeted for elimination as a public health problem by 2017. In the context of VL, the elimination target is defined as an annual VL incidence of <1 per 10,000 capita at (sub-)district level. Interventions focus on vector control, surveillance and on diagnosing and treating VL cases. Many endemic areas have not yet achieved optimal control due to logistical, biological as well as technical challenges. We used mathematical modelling to quantify VL transmission dynamics and predict the feasibility of achieving the VL elimination target with current control strategies under varying assumptions about the reservoir of infection in humans. Methods We developed three deterministic age-structured transmission models with different main reservoirs of infection in humans: asymptomatic infections (model 1), reactivation of infection after initial infection (model 2), and post kala-azar dermal leishmaniasis (PKDL; model 3). For each model, we defined four sub-variants based on different assumptions about the duration of immunity and age-patterns in exposure to sandflies. All 12 model sub-variants were fitted to data from the KalaNet study in Bihar (India) and Nepal, and the best sub-variant was selected per model. Predictions were made for optimal and sub-optimal indoor residual spraying (IRS) effectiveness for three different levels of VL endemicity. Results Structurally different models explained the KalaNet data equally well. However, the predicted impact of IRS varied substantially between models, such that a conclusion about reaching the VL elimination targets for the ISC heavily depends on assumptions about the main reservoir of infection in humans: asymptomatic cases, recovered (immune) individuals that reactivate, or PKDL cases. Conclusions Available data on the impact of IRS so far suggest one model is probably closest to reality (model 1). According to this model, elimination of VL (incidence of <1 per 10,000) by 2017 is only feasible in low and medium endemic settings with optimal IRS. In highly endemic settings and settings with sub-optimal IRS, additional interventions will be required. Electronic supplementary material The online version of this article (doi:10.1186/s13071-016-1292-0) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Epke A Le Rutte
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - Luc E Coffeng
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - Daniel M Bontje
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - Epco C Hasker
- Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium.
| | | | - Daniel Argaw
- World Health Organization, Avenue Appia 20, 1211, Geneva, Switzerland.
| | - Marleen C Boelaert
- Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium.
| | - Sake J De Vlas
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
| |
Collapse
|
21
|
Hollingsworth TD, Adams ER, Anderson RM, Atkins K, Bartsch S, Basáñez MG, Behrend M, Blok DJ, Chapman LAC, Coffeng L, Courtenay O, Crump RE, de Vlas SJ, Dobson A, Dyson L, Farkas H, Galvani AP, Gambhir M, Gurarie D, Irvine MA, Jervis S, Keeling MJ, Kelly-Hope L, King C, Lee BY, Le Rutte EA, Lietman TM, Ndeffo-Mbah M, Medley GF, Michael E, Pandey A, Peterson JK, Pinsent A, Porco TC, Richardus JH, Reimer L, Rock KS, Singh BK, Stolk W, Swaminathan S, Torr SJ, Townsend J, Truscott J, Walker M, Zoueva A. Quantitative analyses and modelling to support achievement of the 2020 goals for nine neglected tropical diseases. Parasit Vectors 2015; 8:630. [PMID: 26652272 PMCID: PMC4674954 DOI: 10.1186/s13071-015-1235-1] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 12/01/2015] [Indexed: 12/30/2022] Open
Abstract
Quantitative analysis and mathematical models are useful tools in informing strategies to control or eliminate disease. Currently, there is an urgent need to develop these tools to inform policy to achieve the 2020 goals for neglected tropical diseases (NTDs). In this paper we give an overview of a collection of novel model-based analyses which aim to address key questions on the dynamics of transmission and control of nine NTDs: Chagas disease, visceral leishmaniasis, human African trypanosomiasis, leprosy, soil-transmitted helminths, schistosomiasis, lymphatic filariasis, onchocerciasis and trachoma. Several common themes resonate throughout these analyses, including: the importance of epidemiological setting on the success of interventions; targeting groups who are at highest risk of infection or re-infection; and reaching populations who are not accessing interventions and may act as a reservoir for infection,. The results also highlight the challenge of maintaining elimination 'as a public health problem' when true elimination is not reached. The models elucidate the factors that may be contributing most to persistence of disease and discuss the requirements for eventually achieving true elimination, if that is possible. Overall this collection presents new analyses to inform current control initiatives. These papers form a base from which further development of the models and more rigorous validation against a variety of datasets can help to give more detailed advice. At the moment, the models' predictions are being considered as the world prepares for a final push towards control or elimination of neglected tropical diseases by 2020.
Collapse
Affiliation(s)
| | - Emily R Adams
- Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | | | - Katherine Atkins
- London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Sarah Bartsch
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | | | | | - David J Blok
- Erasmus University Medical Center, 3015 CE, Rotterdam, Netherlands
| | | | - Luc Coffeng
- Erasmus University Medical Center, 3015 CE, Rotterdam, Netherlands
| | | | - Ron E Crump
- University of Warwick, Coventry, CV4 7AL, UK
| | - Sake J de Vlas
- Erasmus University Medical Center, 3015 CE, Rotterdam, Netherlands
| | - Andy Dobson
- Princeton University, New Jersey, NJ, 08544, USA
| | | | | | | | | | - David Gurarie
- Case Western Reserve University, Cleveland, OH, 44106, USA
| | | | | | | | | | - Charles King
- Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Bruce Y Lee
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Epke A Le Rutte
- Erasmus University Medical Center, 3015 CE, Rotterdam, Netherlands
| | - Thomas M Lietman
- University of California, San Francisco, San Francisco, CA, 94143, USA
| | | | - Graham F Medley
- London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Edwin Michael
- University of Notre Dame, South Bend, IN, 47556, USA
| | | | | | - Amy Pinsent
- Monash University, Melbourne, VIC, 3800, Australia
| | - Travis C Porco
- University of California, San Francisco, San Francisco, CA, 94143, USA
| | | | - Lisa Reimer
- Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Kat S Rock
- University of Warwick, Coventry, CV4 7AL, UK
| | | | - Wilma Stolk
- Erasmus University Medical Center, 3015 CE, Rotterdam, Netherlands
| | | | - Steve J Torr
- Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | | | | | | | | |
Collapse
|