Towards Evidence-based Control of Opisthorchis viverrini.

Transmission of the carcinogenic liver fluke Opisthorchis viverrini is ongoing across Southeast Asia. Endemic countries within the region are in different stages of achieving control. However, evidence on which interventions are the most effective for reducing parasite transmission, and the resulting liver cancer, is currently lacking. Quantitative modelling can be used to evaluate different control measures against O. viverrini and assist the design of clinical trials. In this article we evaluate the epidemiological parameters that underpin models of O. viverrini and the data necessary for their estimation, with the aim of developing evidence-based strategies for parasite control at a national or regional level. Halting the transmission of O. viverrini is crucial to preventing cases of cholangiocarcinoma, yet there is no consensus on the best strategies for large-scale parasite control. Quantitative modelling can provide insights and guide control programmes more rapidly and using fewer resources than clinical trials. To give reliable output, models depend on making accurate assumptions and using parameters inferred from relevant datasets. Mathematical models of O. viverrini dynamics have recently been published and provide a valuable starting point. However, many key epidemiological processes remain poorly understood, including the links between parasite exposure, anthelmintic treatment, and carcinogenesis. We highlight areas where new studies are required to fill knowledge gaps. Recent developments in statistical modelling and parasite genomics provide opportunities to make rapid gains. [ABSTRACT FROM AUTHOR]