Global Eradication of Lymphatic Filariasis: The Value of Chronic Disease Control in Parasite Elimination Programmes
Identifieur interne : 006B03 ( Main/Exploration ); précédent : 006B02; suivant : 006B04Global Eradication of Lymphatic Filariasis: The Value of Chronic Disease Control in Parasite Elimination Programmes
Auteurs : Edwin Michael [Royaume-Uni] ; Mwele N. Malecela [Tanzanie] ; Mihail Zervos [Royaume-Uni] ; James W. Kazura [États-Unis]Source :
- PLoS ONE [ 1932-6203 ] ; 2008.
Descripteurs français
- KwdFr :
- MESH :
- usage thérapeutique : Filaricides, Filariose lymphatique.
- épidémiologie : Filariose lymphatique.
- Animaux, Contrôle des maladies contagieuses, Filariose lymphatique, Humains, Microfilaria, Prévalence, Santé mondiale, Wuchereria bancrofti.
English descriptors
- KwdEn :
- MESH :
- chemical , therapeutic use : Filaricides.
- drug effects : Microfilariae.
- epidemiology : Elephantiasis, Filarial.
- methods : Communicable Disease Control.
- prevention & control : Elephantiasis, Filarial.
- transmission : Elephantiasis, Filarial.
- Animals, Global Health, Humans, Prevalence, Wuchereria bancrofti.
Abstract
The ultimate goal of the global programme against lymphatic filariasis is eradication through irrevocable cessation of transmission using 4 to 6 years of annual single dose mass drug administration. The costs of eradication, managerial impediments to executing national control programmes, and scientific uncertainty about transmission endpoints, are challenges to the success of this effort, especially in areas of high endemicity where financial resources are limited. We used a combined analysis of empirical community data describing the association between infection and chronic disease prevalence, mathematical modelling, and economic analyses to identify and evaluate the feasibility of setting an infection target level at which the chronic pathology attributable to lymphatic filariasis - lymphoedema of the extremities and hydroceles - becomes negligible in the face of continuing transmission as a first stage option in achieving the elimination of this parasitic disease. The results show that microfilaria prevalences below a threshold of 3.55% at a blood sampling volume of 1 ml could constitute readily achievable and sustainable targets to control lymphatic filarial disease. They also show that as a result of the high marginal cost of curing the last few individuals to achieve elimination, maximal benefits can occur at this threshold. Indeed, a key finding from our coupled economic and epidemiological analysis is that when initial uncertainty regarding eradication occurs and prospects for resolving this uncertainty over time exist, it is economically beneficial to adopt a flexible, sequential, eradication strategy based on controlling chronic disease initially.
Url:
DOI: 10.1371/journal.pone.0002936
PubMed: 18698350
PubMed Central: 2490717
Affiliations:
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The costs of eradication, managerial impediments to executing national control programmes, and scientific uncertainty about transmission endpoints, are challenges to the success of this effort, especially in areas of high endemicity where financial resources are limited. We used a combined analysis of empirical community data describing the association between infection and chronic disease prevalence, mathematical modelling, and economic analyses to identify and evaluate the feasibility of setting an infection target level at which the chronic pathology attributable to lymphatic filariasis - lymphoedema of the extremities and hydroceles - becomes negligible in the face of continuing transmission as a first stage option in achieving the elimination of this parasitic disease. The results show that microfilaria prevalences below a threshold of 3.55% at a blood sampling volume of 1 ml could constitute readily achievable and sustainable targets to control lymphatic filarial disease. They also show that as a result of the high marginal cost of curing the last few individuals to achieve elimination, maximal benefits can occur at this threshold. Indeed, a key finding from our coupled economic and epidemiological analysis is that when initial uncertainty regarding eradication occurs and prospects for resolving this uncertainty over time exist, it is economically beneficial to adopt a flexible, sequential, eradication strategy based on controlling chronic disease initially.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Royaume-Uni</li><li>Tanzanie</li><li>États-Unis</li></country><region><li>Angleterre</li><li>Grand Londres</li><li>Ohio</li></region><settlement><li>Londres</li></settlement></list><tree><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Michael, Edwin" sort="Michael, Edwin" uniqKey="Michael E" first="Edwin" last="Michael">Edwin Michael</name></region><name sortKey="Zervos, Mihail" sort="Zervos, Mihail" uniqKey="Zervos M" first="Mihail" last="Zervos">Mihail Zervos</name></country><country name="Tanzanie"><noRegion><name sortKey="Malecela, Mwele N" sort="Malecela, Mwele N" uniqKey="Malecela M" first="Mwele N." last="Malecela">Mwele N. Malecela</name></noRegion></country><country name="États-Unis"><region name="Ohio"><name sortKey="Kazura, James W" sort="Kazura, James W" uniqKey="Kazura J" first="James W." last="Kazura">James W. Kazura</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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