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Modeling the Impact and Costs of Semiannual Mass Drug Administration for Accelerated Elimination of Lymphatic Filariasis

Identifieur interne : 004329 ( Pmc/Curation ); précédent : 004328; suivant : 004330

Modeling the Impact and Costs of Semiannual Mass Drug Administration for Accelerated Elimination of Lymphatic Filariasis

Auteurs : Wilma A. Stolk [Pays-Bas] ; Quirine A. Ten Bosch [Pays-Bas] ; Sake J. De Vlas [Pays-Bas] ; Peter U. Fischer [États-Unis] ; Gary J. Weil [États-Unis] ; Ann S. Goldman [États-Unis]

Source :

RBID : PMC:3536806

Abstract

The Global Program to Eliminate Lymphatic Filariasis (LF) has a target date of 2020. This program is progressing well in many countries. However, progress has been slow in some countries, and others have not yet started their mass drug administration (MDA) programs. Acceleration is needed. We studied how increasing MDA frequency from once to twice per year would affect program duration and costs by using computer simulation modeling and cost projections. We used the LYMFASIM simulation model to estimate how many annual or semiannual MDA rounds would be required to eliminate LF for Indian and West African scenarios with varied pre-control endemicity and coverage levels. Results were used to estimate total program costs assuming a target population of 100,000 eligibles, a 3% discount rate, and not counting the costs of donated drugs. A sensitivity analysis was done to investigate the robustness of these results with varied assumptions for key parameters. Model predictions suggested that semiannual MDA will require the same number of MDA rounds to achieve LF elimination as annual MDA in most scenarios. Thus semiannual MDA programs should achieve this goal in half of the time required for annual programs. Due to efficiency gains, total program costs for semiannual MDA programs are projected to be lower than those for annual MDA programs in most scenarios. A sensitivity analysis showed that this conclusion is robust. Semiannual MDA is likely to shorten the time and lower the cost required for LF elimination in countries where it can be implemented. This strategy may improve prospects for global elimination of LF by the target year 2020.


Url:
DOI: 10.1371/journal.pntd.0001984
PubMed: 23301115
PubMed Central: 3536806

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PMC:3536806

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<p>The Global Program to Eliminate Lymphatic Filariasis (LF) has a target date of 2020. This program is progressing well in many countries. However, progress has been slow in some countries, and others have not yet started their mass drug administration (MDA) programs. Acceleration is needed. We studied how increasing MDA frequency from once to twice per year would affect program duration and costs by using computer simulation modeling and cost projections. We used the LYMFASIM simulation model to estimate how many annual or semiannual MDA rounds would be required to eliminate LF for Indian and West African scenarios with varied pre-control endemicity and coverage levels.
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were used to estimate total program costs assuming a target population of 100,000 eligibles, a 3% discount rate, and not counting the costs of donated drugs. A sensitivity analysis was done to investigate the robustness of these results with varied assumptions for key parameters. Model predictions suggested that semiannual MDA will require the same number of MDA rounds to achieve LF elimination as annual MDA in most scenarios. Thus semiannual MDA programs should achieve this goal in half of the time required for annual programs. Due to efficiency gains, total program costs for semiannual MDA programs are projected to be lower than those for annual MDA programs in most scenarios. A sensitivity analysis showed that this conclusion is robust. Semiannual MDA is likely to shorten the time and lower the cost required for LF elimination in countries where it can be implemented. This strategy may improve prospects for global elimination of LF by the target year 2020.</p>
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<name sortKey="Saklokham, K" uniqKey="Saklokham K">K Saklokham</name>
</author>
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<name sortKey="Chanthavisouk, C" uniqKey="Chanthavisouk C">C Chanthavisouk</name>
</author>
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<name sortKey="Nakhonesid Fish, V" uniqKey="Nakhonesid Fish V">V Nakhonesid-Fish</name>
</author>
<author>
<name sortKey="Strandgaard, H" uniqKey="Strandgaard H">H Strandgaard</name>
</author>
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<name sortKey="Sinuon, M" uniqKey="Sinuon M">M Sinuon</name>
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<name sortKey="Tsuyuoka, R" uniqKey="Tsuyuoka R">R Tsuyuoka</name>
</author>
<author>
<name sortKey="Socheat, D" uniqKey="Socheat D">D Socheat</name>
</author>
<author>
<name sortKey="Montresor, A" uniqKey="Montresor A">A Montresor</name>
</author>
<author>
<name sortKey="Palmer, K" uniqKey="Palmer K">K Palmer</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Nakyanzi, Jk" uniqKey="Nakyanzi J">JK Nakyanzi</name>
</author>
<author>
<name sortKey="Kitutu, Fe" uniqKey="Kitutu F">FE Kitutu</name>
</author>
<author>
<name sortKey="Oria, H" uniqKey="Oria H">H Oria</name>
</author>
<author>
<name sortKey="Kamba, Pf" uniqKey="Kamba P">PF Kamba</name>
</author>
</analytic>
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<analytic>
<author>
<name sortKey="Michael, E" uniqKey="Michael E">E Michael</name>
</author>
<author>
<name sortKey="Gambhir, M" uniqKey="Gambhir M">M Gambhir</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Stolk, Wa" uniqKey="Stolk W">WA Stolk</name>
</author>
<author>
<name sortKey="De Vlas, Sj" uniqKey="De Vlas S">SJ de Vlas</name>
</author>
<author>
<name sortKey="Habbema, Jd" uniqKey="Habbema J">JD Habbema</name>
</author>
</analytic>
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<analytic>
<author>
<name sortKey="Coulibaly, Y" uniqKey="Coulibaly Y">Y Coulibaly</name>
</author>
<author>
<name sortKey="Cavalli, A" uniqKey="Cavalli A">A Cavalli</name>
</author>
<author>
<name sortKey="Van Dormael, M" uniqKey="Van Dormael M">M van Dormael</name>
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<name sortKey="Polman, K" uniqKey="Polman K">K Polman</name>
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<author>
<name sortKey="Kegels, G" uniqKey="Kegels G">G Kegels</name>
</author>
</analytic>
</biblStruct>
</listBibl>
</div1>
</back>
</TEI>
<pmc article-type="research-article">
<pmc-dir>properties open_access</pmc-dir>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">PLoS Negl Trop Dis</journal-id>
<journal-id journal-id-type="iso-abbrev">PLoS Negl Trop Dis</journal-id>
<journal-id journal-id-type="publisher-id">plos</journal-id>
<journal-id journal-id-type="pmc">plosntds</journal-id>
<journal-title-group>
<journal-title>PLoS Neglected Tropical Diseases</journal-title>
</journal-title-group>
<issn pub-type="ppub">1935-2727</issn>
<issn pub-type="epub">1935-2735</issn>
<publisher>
<publisher-name>Public Library of Science</publisher-name>
<publisher-loc>San Francisco, USA</publisher-loc>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">23301115</article-id>
<article-id pub-id-type="pmc">3536806</article-id>
<article-id pub-id-type="publisher-id">PNTD-D-12-00392</article-id>
<article-id pub-id-type="doi">10.1371/journal.pntd.0001984</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Research Article</subject>
</subj-group>
<subj-group subj-group-type="Discipline-v2">
<subject>Biology</subject>
<subj-group>
<subject>Computational Biology</subject>
<subj-group>
<subject>Population Modeling</subject>
<subj-group>
<subject>Infectious Disease Modeling</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v2">
<subject>Medicine</subject>
<subj-group>
<subject>Global Health</subject>
</subj-group>
<subj-group>
<subject>Infectious Diseases</subject>
<subj-group>
<subject>Neglected Tropical Diseases</subject>
<subj-group>
<subject>Lymphatic Filariasis</subject>
</subj-group>
</subj-group>
<subj-group>
<subject>Infectious Disease Control</subject>
<subject>Infectious Disease Modeling</subject>
</subj-group>
</subj-group>
<subj-group>
<subject>Public Health</subject>
<subj-group>
<subject>Preventive Medicine</subject>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v2">
<subject>Social and Behavioral Sciences</subject>
<subj-group>
<subject>Economics</subject>
<subj-group>
<subject>Health Economics</subject>
<subj-group>
<subject>Cost Effectiveness</subject>
<subject>Cost-Minimization Analysis</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Modeling the Impact and Costs of Semiannual Mass Drug Administration for Accelerated Elimination of Lymphatic Filariasis</article-title>
<alt-title alt-title-type="running-head">Semiannual MDA to Eliminate LF: Impact and Costs</alt-title>
</title-group>
<contrib-group>
<contrib contrib-type="author" equal-contrib="yes">
<name>
<surname>Stolk</surname>
<given-names>Wilma A.</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="corresp" rid="cor1">
<sup>*</sup>
</xref>
</contrib>
<contrib contrib-type="author" equal-contrib="yes">
<name>
<surname>ten Bosch</surname>
<given-names>Quirine A.</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="author-notes" rid="fn1">
<sup>¤</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>de Vlas</surname>
<given-names>Sake J.</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Fischer</surname>
<given-names>Peter U.</given-names>
</name>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Weil</surname>
<given-names>Gary J.</given-names>
</name>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Goldman</surname>
<given-names>Ann S.</given-names>
</name>
<xref ref-type="aff" rid="aff3">
<sup>3</sup>
</xref>
</contrib>
</contrib-group>
<aff id="aff1">
<label>1</label>
<addr-line>Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands</addr-line>
</aff>
<aff id="aff2">
<label>2</label>
<addr-line>Infectious Diseases Division, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri, United States of America</addr-line>
</aff>
<aff id="aff3">
<label>3</label>
<addr-line>Department of Epidemiology and Biostatistics, The George Washington University School of Public Health and Health Services, Washington, D. C., United States of America</addr-line>
</aff>
<contrib-group>
<contrib contrib-type="editor">
<name>
<surname>Basáñez</surname>
<given-names>María-Gloria</given-names>
</name>
<role>Editor</role>
<xref ref-type="aff" rid="edit1"></xref>
</contrib>
</contrib-group>
<aff id="edit1">
<addr-line>Imperial College London, United Kingdom</addr-line>
</aff>
<author-notes>
<corresp id="cor1">* E-mail:
<email>w.stolk@erasmusmc.nl</email>
</corresp>
<fn fn-type="conflict">
<p>The authors have declared that no competing interests exist.</p>
</fn>
<fn fn-type="con">
<p>Conceived and designed the experiments: GJW WAS QAtB SJdV PUF ASG. Performed the experiments: QAtB WAS ASG. Analyzed the data: QAtB WAS ASG GJW PUF SJdV. Wrote the paper: WAS QAtB SJdV PUF GJW ASG.</p>
</fn>
<fn id="fn1" fn-type="current-aff">
<label>¤</label>
<p>Current address: Department of Biological Sciences, University of Notre Dame, Notre Dame, Indiana, United States of America</p>
</fn>
</author-notes>
<pub-date pub-type="collection">
<month>1</month>
<year>2013</year>
</pub-date>
<pub-date pub-type="epub">
<day>3</day>
<month>1</month>
<year>2013</year>
</pub-date>
<volume>7</volume>
<issue>1</issue>
<elocation-id>e1984</elocation-id>
<history>
<date date-type="received">
<day>30</day>
<month>3</month>
<year>2012</year>
</date>
<date date-type="accepted">
<day>7</day>
<month>11</month>
<year>2012</year>
</date>
</history>
<permissions>
<copyright-year>2013</copyright-year>
<copyright-holder>Stolk et al</copyright-holder>
<license>
<license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p>
</license>
</permissions>
<abstract>
<p>The Global Program to Eliminate Lymphatic Filariasis (LF) has a target date of 2020. This program is progressing well in many countries. However, progress has been slow in some countries, and others have not yet started their mass drug administration (MDA) programs. Acceleration is needed. We studied how increasing MDA frequency from once to twice per year would affect program duration and costs by using computer simulation modeling and cost projections. We used the LYMFASIM simulation model to estimate how many annual or semiannual MDA rounds would be required to eliminate LF for Indian and West African scenarios with varied pre-control endemicity and coverage levels.
<xref ref-type="sec" rid="s3">Results</xref>
were used to estimate total program costs assuming a target population of 100,000 eligibles, a 3% discount rate, and not counting the costs of donated drugs. A sensitivity analysis was done to investigate the robustness of these results with varied assumptions for key parameters. Model predictions suggested that semiannual MDA will require the same number of MDA rounds to achieve LF elimination as annual MDA in most scenarios. Thus semiannual MDA programs should achieve this goal in half of the time required for annual programs. Due to efficiency gains, total program costs for semiannual MDA programs are projected to be lower than those for annual MDA programs in most scenarios. A sensitivity analysis showed that this conclusion is robust. Semiannual MDA is likely to shorten the time and lower the cost required for LF elimination in countries where it can be implemented. This strategy may improve prospects for global elimination of LF by the target year 2020.</p>
</abstract>
<abstract abstract-type="summary">
<title>Author Summary</title>
<p>The Global Program to Eliminate Lymphatic Filariasis (LF) employs annual mass drug administration (MDA) of antifilarial drugs to reduce infection rates in populations and interrupt transmission. While this program is working well in many countries, progress has been slow in others, and some countries have not yet started MDA programs. We used computer simulation modeling and cost projections to study how increasing MDA frequency from once to twice per year would affect program duration and costs. Our results suggest that semiannual MDA is likely to reduce the time required to eliminate LF by 50% and reduce total program costs (excluding the cost of donated drugs) in most situations. For these and other reasons, we expect semiannual MDA to be superior to annual MDA in most endemic settings. Semiannual MDA should be considered as a means of accelerating LF elimination in areas where it can be implemented, because this may improve prospects for global elimination of LF by the target year 2020.</p>
</abstract>
<funding-group>
<funding-statement>This research was funded by the Bill & Melinda Gates Foundation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The findings and conclusions contained within are those of the authors and do not necessarily reflect positions or policies of the Bill & Melinda Gates Foundation.</funding-statement>
</funding-group>
<counts>
<page-count count="13"></page-count>
</counts>
</article-meta>
</front>
</pmc>
</record>

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