Validation of a spatial agent-based model for Taenia solium transmission ("CystiAgent") against a large prospective trial of control strategies in northern Peru.
Validation of a spatial agent-based model for Taenia solium transmission ("CystiAgent") against a large prospective trial of control strategies in northern Peru.
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DOI：
10.1371/journal.pntd.0009885
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发表时间：
2021-10
影响因子：
3.8
通讯作者：
Cysticercosis Working Group in Peru.
中科院分区：
文献类型：
--
作者：
Pray IW;Pizzitutti F;Bonnet G;Gonzales-Gustavson E;Wakeland W;Pan WK;Lambert WE;Gonzalez AE;Garcia HH;O'Neal SE;Cysticercosis Working Group in Peru.
猪肉绦虫（猪带绦虫）是一种寄生蠕虫，对世界各地的贫困农村人口造成重大的健康和经济负担。正如世界卫生组织所承认的那样，实现控制T。solium缺乏一个准确和有效的模拟模型来研究传播和评估可用的控制和消除战略。CystiAgent是T. solium是T. solium模型能够代表传播的关键空间和环境特征，并模拟有空间针对性的干预措施，如环形战略。我们根据环形策略试验（Ring Strategy Trial，RING）的结果对CystiAgent进行了验证，RING是一项在北方秘鲁进行的大型随机分组试验，评价了6种独特的T.在23个村庄进行了控制。为了进行验证，在CystiAgent中复制了每种干预策略，并将模拟的人带绦虫病、猪囊虫病和猪血清发病率与试验的患病率估计值进行了比较。结果表明，CystiAgent产生的传播下降，在响应的六个干预策略，但高估了干预措施在大多数村庄的效果;模拟的人带绦虫病和猪囊虫病的患病率在试验结束时的中位数分别为0.53和5.0个百分点，低于在试验结束时观察到的患病率。CystiAgent的验证代表了开发准确可靠的T。可以用来填补我们对T.氦气传输和控制。为了提高模型的准确性，未来的版本将受益于猪免疫力和抗性、抗蠕虫治疗的田间有效性以及驱动T.包括传播和接触T.环境中的虫卵。神经囊尾蚴病是由食入猪带绦虫卵引起的，是世界各地人类癫痫的主要原因。广泛的工具来对抗T。目前，可获得的抗寄生虫药物包括用于猪和人的抗寄生虫治疗、猪疫苗和卫生改善;然而，用于人群以最大化有效性和可行性的理想干预组合尚不清楚。传播模型是一种可用于比较和评估不同干预策略的工具，但目前还没有可用的T。solium模型的准确性已经过测试。在这项研究中，我们通过将模型的模拟结果与各种T.控制措施。该模型使用来自这些村庄的流行病学观察数据进行校准，并评估其再现T。控制措施。验证表明，该模型能够重现疾病的基线水平，但通常高估了每种干预措施对传播的影响。这些结果将使我们能够识别当前模型的局限性，以改善未来的版本，并代表了一个工具，设计和评估未来的计划，以控制和消除T。索利亚
The pork tapeworm (Taenia solium) is a parasitic helminth that imposes a major health and economic burden on poor rural populations around the world. As recognized by the World Health Organization, a key barrier for achieving control of T. solium is the lack of an accurate and validated simulation model with which to study transmission and evaluate available control and elimination strategies. CystiAgent is a spatially-explicit agent based model for T. solium that is unique among T. solium models in its ability to represent key spatial and environmental features of transmission and simulate spatially targeted interventions, such as ring strategy. We validated CystiAgent against results from the Ring Strategy Trial (RST)–a large cluster-randomized trial conducted in northern Peru that evaluated six unique interventions for T. solium control in 23 villages. For the validation, each intervention strategy was replicated in CystiAgent, and the simulated prevalences of human taeniasis, porcine cysticercosis, and porcine seroincidence were compared against prevalence estimates from the trial. Results showed that CystiAgent produced declines in transmission in response to each of the six intervention strategies, but overestimated the effect of interventions in the majority of villages; simulated prevalences for human taenasis and porcine cysticercosis at the end of the trial were a median of 0.53 and 5.0 percentages points less than prevalence observed at the end of the trial, respectively. The validation of CystiAgent represented an important step towards developing an accurate and reliable T. solium transmission model that can be deployed to fill critical gaps in our understanding of T. solium transmission and control. To improve model accuracy, future versions would benefit from improved data on pig immunity and resistance, field effectiveness of anti-helminthic treatment, and factors driving spatial clustering of T. solium infections including dispersion and contact with T. solium eggs in the environment. Neurocysticercosis, caused by the ingestion of Taenia solium eggs, is a major cause of human epilepsy around the world. A wide spectrum of tools to fight T. solium is are now available and include antiparasitic treatment for pigs and humans, porcine vaccines, and sanitation improvements; however, the ideal combination of interventions applied to populations to maximize effectiveness and feasibility is not known. Transmission models are one tool that can be used to compare and evaluate different intervention strategies, but no currently available T. solium models have been tested for accuracy. In this research, we validated our model (“CystiAgent”) by comparing simulations of the model to the results of a large-scale trial testing a variety of T. solium control interventions. The model was calibrated using observed epidemiological data from these villages and evaluated for its ability to reproduce the effect of T. solium control interventions. The validation showed that the model was able to reproduce the baseline levels of disease, but generally overestimated the effect that each intervention would have on transmission. These results will allow us to identify limitations of the current model to improve future versions, and represent a step forward in the creation of a tool to design and evaluate future programs to control and eliminate T. solium.
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DOI：
10.4269/ajtmh.1996.54.391
发表时间：
1996-04-01
影响因子：
3.3
作者：
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通讯作者：
LopezUrbina, MT
DOI：
10.4269/ajtmh.2009.81.433
发表时间：
2009-09-01
影响因子：
3.3
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影响因子：
3.3
作者：
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Garcia, Hector H.
影响因子：
1.2
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影响因子：
4
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