Open AccessGeostatistical modelling enables efficient safety assessment for mass drug administration with ivermectin in Loa loa endemic areas through a combined antibody and LoaScope testing strategy for elimination of onchocerciasis
Author(s) -
Olatunji Johnson,
Emanuele Giorgi,
Claudio Fronterrè,
Benjamin Amoah,
Julienne Atsame,
Sylvie Ntsame Ella,
Marco A. Biamonte,
Kisito Ogoussan,
Lee Hundley,
Katherine Gass,
Peter J. Diggle
Publication year - 2022
Publication title -
plos neglected tropical diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.99
H-Index - 135
eISSN - 1935-2735
pISSN - 1935-2727
DOI - 10.1371/journal.pntd.0010189
Subject(s) - loa loa , ivermectin , onchocerciasis , mass drug administration , microfilaria , filariasis , food and drug administration , diethylcarbamazine , dirofilaria immitis , medicine , biology , immunology , veterinary medicine , pharmacology , helminths , environmental health , population
The elimination of onchocerciasis through community-based Mass Drug Administration (MDA) of ivermectin (Mectizan) is hampered by co-endemicity of Loa loa , as individuals who are highly co-infected with Loa loa parasites can suffer serious and occasionally fatal neurological reactions from the drug. The test-and-not-treat strategy of testing all individuals participating in MDA has some operational constraints including the cost and limited availability of LoaScope diagnostic tools. As a result, a Loa loa Antibody (Ab) Rapid Test was developed to offer a complementary way of determining the prevalence of loiasis. We develop a joint geostatistical modelling framework for the analysis of Ab and Loascope data to delineate whether an area is safe for MDA. Our results support the use of a two-stage strategy, in which Ab testing is used to identify areas that, with acceptably high probability, are safe or unsafe for MDA, followed by Loascope testing in areas whose safety status is uncertain. This work therefore contributes to the global effort towards the elimination of onchocerciasis as a public health problem by potentially reducing the time and cost required to establish whether an area is safe for MDA.