Heterogeneity in transmission parameters of hookworm infection within the baseline data from the TUMIKIA study in Kenya.


Journal

Parasites & vectors
ISSN: 1756-3305
Titre abrégé: Parasit Vectors
Pays: England
ID NLM: 101462774

Informations de publication

Date de publication:
16 Sep 2019
Historique:
received: 08 05 2019
accepted: 26 08 2019
entrez: 17 9 2019
pubmed: 17 9 2019
medline: 18 12 2019
Statut: epublish

Résumé

As many countries with endemic soil-transmitted helminth (STH) burdens achieve high coverage levels of mass drug administration (MDA) to treat school-aged and pre-school-aged children, understanding the detailed effects of MDA on the epidemiology of STH infections is desirable in formulating future policies for morbidity and/or transmission control. Prevalence and mean intensity of infection are characterized by heterogeneity across a region, leading to uncertainty in the impact of MDA strategies. In this paper, we analyze this heterogeneity in terms of factors that govern the transmission dynamics of the parasite in the host population. Using data from the TUMIKIA study in Kenya (cluster STH prevalence range at baseline: 0-63%), we estimated these parameters and their variability across 120 population clusters in the study region, using a simple parasite transmission model and Gibbs-sampling Monte Carlo Markov chain techniques. We observed great heterogeneity in R Our results show that lower prevalence is associated with higher degrees of aggregation and hence prevalence alone is not a good indicator of transmission intensity. As a consequence, approaches to MDA and monitoring and evaluation of community infection status may need to be adapted as transmission elimination is aimed for by targeted treatment approaches.

Sections du résumé

BACKGROUND BACKGROUND
As many countries with endemic soil-transmitted helminth (STH) burdens achieve high coverage levels of mass drug administration (MDA) to treat school-aged and pre-school-aged children, understanding the detailed effects of MDA on the epidemiology of STH infections is desirable in formulating future policies for morbidity and/or transmission control. Prevalence and mean intensity of infection are characterized by heterogeneity across a region, leading to uncertainty in the impact of MDA strategies. In this paper, we analyze this heterogeneity in terms of factors that govern the transmission dynamics of the parasite in the host population.
RESULTS RESULTS
Using data from the TUMIKIA study in Kenya (cluster STH prevalence range at baseline: 0-63%), we estimated these parameters and their variability across 120 population clusters in the study region, using a simple parasite transmission model and Gibbs-sampling Monte Carlo Markov chain techniques. We observed great heterogeneity in R
CONCLUSIONS CONCLUSIONS
Our results show that lower prevalence is associated with higher degrees of aggregation and hence prevalence alone is not a good indicator of transmission intensity. As a consequence, approaches to MDA and monitoring and evaluation of community infection status may need to be adapted as transmission elimination is aimed for by targeted treatment approaches.

Identifiants

pubmed: 31522687
doi: 10.1186/s13071-019-3686-2
pii: 10.1186/s13071-019-3686-2
pmc: PMC6745791
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

442

Subventions

Organisme : Medical Research Council
ID : MR/N00597X/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/R015600/1
Pays : United Kingdom
Organisme : Bill & Melinda Gates Foundation
ID : OPP1129535
Pays : United States
Organisme : Children's Investment Fund Foundation
ID : R-1701-01771

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Auteurs

James E Truscott (JE)

London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Imperial College London, St Mary's Campus, London, W2 1PG, UK. j.truscott@imperial.ac.uk.
MRC Centre for Global Infectious Disease Analysis, Imperial College London, St Mary's Campus, London, W2 1PG, UK. j.truscott@imperial.ac.uk.
The DeWorm3 Project, The Natural History Museum, London, SW7 5BD, UK. j.truscott@imperial.ac.uk.

Alison K Ower (AK)

London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Imperial College London, St Mary's Campus, London, W2 1PG, UK.
MRC Centre for Global Infectious Disease Analysis, Imperial College London, St Mary's Campus, London, W2 1PG, UK.

Marleen Werkman (M)

London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Imperial College London, St Mary's Campus, London, W2 1PG, UK.
MRC Centre for Global Infectious Disease Analysis, Imperial College London, St Mary's Campus, London, W2 1PG, UK.
The DeWorm3 Project, The Natural History Museum, London, SW7 5BD, UK.

Katherine Halliday (K)

The DeWorm3 Project, The Natural History Museum, London, SW7 5BD, UK.
Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK.

William E Oswald (WE)

The DeWorm3 Project, The Natural History Museum, London, SW7 5BD, UK.
Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK.

Paul M Gichuki (PM)

Eastern & Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya.

Carlos Mcharo (C)

Eastern & Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya.

Simon Brooker (S)

Bill & Melinda Gates Foundation, Seattle, WA, USA.

Sammy M Njenga (SM)

Eastern & Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya.

Charles Mwandariwo (C)

Eastern & Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya.

Judd L Walson (JL)

London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Imperial College London, St Mary's Campus, London, W2 1PG, UK.
The DeWorm3 Project, The Natural History Museum, London, SW7 5BD, UK.
Departments of Global Health, Medicine (Infectious Disease), Pediatrics and Epidemiology, University of Washington, Seattle, USA.

Rachel Pullan (R)

Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK.

Roy Anderson (R)

London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Imperial College London, St Mary's Campus, London, W2 1PG, UK.
MRC Centre for Global Infectious Disease Analysis, Imperial College London, St Mary's Campus, London, W2 1PG, UK.
The DeWorm3 Project, The Natural History Museum, London, SW7 5BD, UK.

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