Update of transmission modelling and projections of gambiense human African trypanosomiasis in the Mandoul focus, Chad
Update of transmission modelling and projections of gambiense human African trypanosomiasis in the Mandoul focus, Chad
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乍得曼杜尔焦点冈比亚人类非洲锥虫病传播模型和预测的更新
DOI：
10.1101/2021.09.22.21263989
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Rock K
中科院分区：
文献类型：
--
作者：
Rock K
背景近年来，冈比亚人类非洲锥虫病（gHAT）感染的病媒控制、筛查和治疗计划导致乍得曼杜勒重点地区的病例迅速下降。为了代表人类和采采蝇之间的传播生物学，我们之前开发了一个机械传播模型，该模型适用于2000年至2013年之间的数据，该数据表明到2015年传播被中断。本研究概述了对该模型的改进，以：（1）评估尽管病例报告水平较低，但是否已经消除了传播;（2）量化加强干预在减少传播中的作用;（3）预测不同策略下gHAT在Mandoul地区未来10年的传播轨迹（2000-2019年）和一系列模型改进。这些包括如何将诊断特异性纳入模型和改进拟合方法（增加观察到的病例报告的方差以及如何捕获漏报和被动筛查的改进）。并排比较拟合的情况下data.ResultsWe估计，被动检测率有所增加，由于自2015年以来，在固定的卫生设施的诊断可用性的改善，由2.1倍的第1阶段检测，和1.5倍的第2阶段。我们发现，虽然主动筛查的诊断算法估计具有高度特异性（95%可信区间（CI）99.9- 100%，特异性= 99.9%），但高筛查和低感染水平意味着最近报告的一些未经寄生虫学确认的病例可能是假阳性。我们还发现，通过模型拟合估计的焦点范围的舌蝇减少（95%CI 96.1 - 99.6%，减少= 99.1%）与以前通过监测陷阱的舌蝇捕获量下降测量的减少相当。与以前的结果一致，该模型表明，传输中断2015年由于加强干预措施。ConclusionsWe建议，额外的确证性测试在Mandoul进行，以确保残局可以仔细监测。如果有一个强大的被动监测系统，对病例进行更具体的测量，将更好地告知何时停止主动筛查和病媒控制是安全的。图形摘要
BackgroundIn recent years, a programme of vector control, screening and treatment ofgambiensehuman African trypanosomiasis (gHAT) infections led to a rapid decline in cases in the Mandoul focus of Chad. To represent the biology of transmission between humans and tsetse, we previously developed a mechanistic transmission model, fitted to data between 2000 and 2013 which suggested that transmission was interrupted by 2015. The present study outlines refinements to the model to: (1) Assess whether elimination of transmission has already been achieved despite low-level case reporting; (2) quantify the role of intensified interventions in transmission reduction; and (3) predict the trajectory of gHAT in Mandoul for the next decade under different strategies.MethodOur previous gHAT transmission model for Mandoul was updated using human case data (2000–2019) and a series of model refinements. These include how diagnostic specificity is incorporated into the model and improvements to the fitting method (increased variance in observed case reporting and how underreporting and improvements to passive screening are captured). A side-by-side comparison of fitting to case data was performed between the models.ResultsWe estimated that passive detection rates have increased due to improvements in diagnostic availability in fixed health facilities since 2015, by 2.1-fold for stage 1 detection, and 1.5-fold for stage 2. We find that whilst the diagnostic algorithm for active screening is estimated to be highly specific (95% credible interval (CI) 99.9–100%, Specificity = 99.9%), the high screening and low infection levels mean that some recently reported cases with no parasitological confirmation might be false positives. We also find that the focus-wide tsetse reduction estimated through model fitting (95%CI96.1–99.6%, Reduction = 99.1%) is comparable to the reduction previously measured by the decline in tsetse catches from monitoring traps. In line with previous results, the model suggests that transmission was interrupted in 2015 due to intensified interventions.ConclusionsWe recommend that additional confirmatory testing is performed in Mandoul to ensure the endgame can be carefully monitored. More specific measurement of cases, would better inform when it is safe to stop active screening and vector control, provided there is a strong passive surveillance system in place.Graphical Abstract
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影响因子：
3.7
作者：
Wamboga C;Matovu E;Bessell PR;Picado A;Biéler S;Ndung'u JM
通讯作者：
Ndung'u JM
DOI：
10.1098/rsif.2020.0540
发表时间：
2020-12
期刊：
Journal of the Royal Society, Interface
影响因子：
--
作者：
Aliee M;Rock KS;Keeling MJ
通讯作者：
Keeling MJ
影响因子：
3.8
作者：
Jamonneau V;Ilboudo H;Kaboré J;Kaba D;Koffi M;Solano P;Garcia A;Courtin D;Laveissière C;Lingue K;Büscher P;Bucheton B
通讯作者：
Bucheton B
DOI：
10.1079/pavsnnr202015028
发表时间：
2020-01-01
期刊：
CABI Reviews
影响因子：
--
作者：
Davis, Christopher N.;Rock, Kat S.;Keeling, Matt J.
通讯作者：
Keeling, Matt J.
影响因子：
3.8
作者：
Jamonneau V;Bucheton B;Kaboré J;Ilboudo H;Camara O;Courtin F;Solano P;Kaba D;Kambire R;Lingue K;Camara M;Baelmans R;Lejon V;Büscher P
通讯作者：
Büscher P