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An Integrated District Mapping Strategy for Loiasis to Enable Safe Mass Treatment for Onchocerciasis in Gabon.
- Source :
-
The American journal of tropical medicine and hygiene [Am J Trop Med Hyg] 2021 Nov 15; Vol. 106 (2), pp. 732-739. Date of Electronic Publication: 2021 Nov 15. - Publication Year :
- 2021
-
Abstract
- The lack of a WHO-recommended strategy for onchocerciasis treatment with ivermectin in hypo-endemic areas co-endemic with loiasis is an impediment to global onchocerciasis elimination. New loiasis diagnostics (LoaScope; Loa antibody rapid test) and risk prediction tools may enable safe mass treatment decisions in co-endemic areas. In 2017-2018, an integrated mapping strategy for onchocerciasis, lymphatic filariasis (LF), and loiasis, aimed at enabling safe ivermectin treatment decisions, was piloted in Gabon. Three ivermectin-naïve departments suspected to be hypo-endemic were selected and up to 100 adults per village across 30 villages in each of the three departments underwent testing for indicators of onchocerciasis, LF, and loiasis. An additional 67 communities in five adjoining departments were tested for loiasis to extend the prevalence and intensity predictions and possibly expand the boundaries of areas deemed safe for ivermectin treatment. Integrated testing in the three departments revealed within-department heterogeneity for all the three diseases, highlighting the value of a mapping approach that relies on cluster-based sampling rather than sentinel sites. These results suggest that safe mass treatment of onchocerciasis may be possible at the subdepartment level, even in departments where loiasis is present. Beyond valuable epidemiologic data, the study generated insight into the performance of various diagnostics and the feasibility of an integrated mapping approach utilizing new diagnostic and modeling tools. Further research should explore how programs can combine these diagnostic and risk prediction tools into a feasible programmatic strategy to enable safe treatment decisions where loiasis and onchocerciasis are co-endemic.
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Animals
Antiparasitic Agents therapeutic use
Disease Eradication methods
Endemic Diseases
Female
Gabon epidemiology
Humans
Loa drug effects
Loiasis drug therapy
Male
Middle Aged
Onchocerciasis drug therapy
Prevalence
Young Adult
Geographic Mapping
Loiasis epidemiology
Mass Drug Administration methods
Onchocerciasis epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1476-1645
- Volume :
- 106
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- The American journal of tropical medicine and hygiene
- Publication Type :
- Academic Journal
- Accession number :
- 34781262
- Full Text :
- https://doi.org/10.4269/ajtmh.21-0799