Macrofilaricides and onchocerciasis control, mathematical modelling of the prospects for elimination.

Abstract:

BACKGROUND:In most endemic parts of the world, onchocerciasis (river blindness) control relies, or will soon rely, exclusively on mass treatment with the microfilaricide ivermectin. Worldwide eradication of the parasite by means of this drug is unlikely. Macrofilaricidal drugs are currently being developed for human use. METHODS:We used ONCHOSIM, a microsimulation mathematical model of the dynamics of onchocerciasis transmission, to explore the potentials of a hypothetical macrofilaricidal drug for the elimination of onchocerciasis under different epidemiological conditions, as characterized by previous intervention strategies, vectorial capacity and levels of coverage. RESULTS:With a high vector biting rate and poor coverage, a very effective macrofilaricide would appear to have a substantially higher potential for achieving elimination of the parasite than does ivermectin. CONCLUSIONS:Macrofilaricides have a substantially higher potential for achieving onchocerciasis elimination than ivermectin, but high coverage levels are still key. When these drugs become available, onchocerciasis elimination strategies should be reconsidered. In view of the impact of control efforts preceding the introduction of macrofilaricides on the success of elimination, it is important to sustain current control efforts.

journal_name

BMC Public Health

journal_title

BMC public health

authors

Alley WS,van Oortmarssen GJ,Boatin BA,Nagelkerke NJ,Plaisier AP,Remme JH,Lazdins J,Borsboom GJ,Habbema JD

doi

10.1186/1471-2458-1-12

keywords:

subject

Has Abstract

pub_date

2001-01-01 00:00:00

pages

12

issn

1471-2458

journal_volume

1

pub_type

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