Geostatistical modelling enables efficient safety assessment for mass drug administration with ivermectin in < i > Loa loa < /i > endemic areas through a combined antibody and LoaScope testing strategy for elimination of onchocerciasis

by Olatunji Johnson, Emanuele Giorgi, Claudio Fronterr è, Benjamin Amoah, Julienne Atsame, Sylvie Ntsame Ella, Marco Biamonte, Kisito Ogoussan, Lee Hundley, Katherine Gass, Peter J. Diggle The elimination of onchocerciasis through community-based Mass Drug Administration (MDA) of ivermectin (Mectizan) is hampered by co-endemicity ofLoa loa, as individuals who are highly co-infected withLoa loa parasites can suffer serious and occasionally fatal neurological reactions from the drug. The test-and-not-treat strategy of testing all individuals participating in MDA has some operational constraints including the cost and limited availability of LoaScope diagnostic tools. As a result, aLoa loa Antibody (Ab) Rapid Test was developed to offer a complementary way of determining the prevalence of loiasis. We develop a joint geostatistical modelling framework for the analysis of Ab and Loascope data to delineate whether an area is safe for MDA. Our results support the use of a two-stage strategy, in which Ab testing is used to identify areas that, with acceptably high probability, are safe or unsafe for MDA, followed by Loascope testing in areas whose safety status is uncertain. This work therefore contributes to the global effort towards the elimination of onchocerciasis as a public health problem by potentially reducing the time and cost required to establish whether an area is safe for MDA.
Source: PLoS Neglected Tropical Diseases - Category: Tropical Medicine Authors: Source Type: research