Publications Scientifiques

[ Article ] Forecasting the efectiveness of the DeWorm3 trial in interrupting the transmission of soil-transmitted helminths in three study sites in Benin, India and Malawi

Date de soumission: 19-02-2021
Année de Publication: 2021
Entité/Laboratoire Laboratoire de Parasitologie et Ecologie Parasitaire (LPEP)
Document type : Article
Discipline(s) : Parasitologie
Titre Forecasting the efectiveness of the DeWorm3 trial in interrupting the transmission of soil-transmitted helminths in three study sites in Benin, India and Malawi
Auteurs Truscott James E. [1], IBIKOUNLE MOUDACHIROU [6],
Journal: Parasite & vectors
Catégorie Journal: Internationale
Impact factor: 3.43
Volume Journal: 14
DOI: 10.1186/s13071-020-04572-7
Resume Background: The DeWorm3 project is an ongoing cluster-randomised trial assessing the feasibility of interrupting the transmission of soil-transmitted helminths (STH) through mass drug administration (MDA) using study sites in India, Malawi and Benin. In this article, we describe an approach which uses a combination of statistical and math‑ ematical methods to forecast the outcome of the trial with respect to its stated goal of reducing the prevalence of infection to below 2%. Methods: Our approach is frst to defne the local patterns of transmission within each study site, which is achieved by statistical inference of key epidemiological parameters using the baseline epidemiological measures of age-related prevalence and intensity of STH infection which have been collected by the DeWorm3 trials team. We use these inferred parameters to calibrate an individual-based stochastic simulation of the trial at the cluster and study site level, which is subsequently run to forecast the future prevalence of STH infections. The simulator takes into account both the uncertainties in parameter estimation and the variability inherent in epidemiological and demographic pro‑ cesses in the simulator. We interpret the forecast results from our simulation with reference to the stated goal of the DeWorm3 trial, to achieve a target of ≤ 2% prevalence at a point 24 months post-cessation of MDA. Results: Simulated output predicts that the two arms will be distinguishable from each other in all three country sites at the study end point. In India and Malawi, measured prevalence in the intervention arm is below the thresh‑ old with a high probability (90% and 95%, respectively), but in Benin the heterogeneity between clusters prevents the arm prevalence from being reduced below the threshold value. At the level of individual study arms within each site, heterogeneity among clusters leads to a very low probability of achieving complete elimination in an interven‑ tion arm, yielding a post-study scenario with widespread elimination but a few ‘hot spot’ areas of persisting STH transmission.
Mots clés Soil-transmitted helminths, Transmission interruption, Individual-based simulator, Heterogeneity
Pages 2 - 13
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