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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DOI：
10.1186/s40249-022-00934-8
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发表时间：
2022-01-24
影响因子：
8.1
通讯作者：
Peka M
中科院分区：
文献类型：
--
作者：
Rock KS;Huang CI;Crump RE;Bessell PR;Brown PE;Tirados I;Solano P;Antillon M;Picado A;Mbainda S;Darnas J;Crowley EH;Torr SJ;Peka M
近年来，一项针对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尔疫区病例迅速下降。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，该模型表明传播在 2015 年之前被中断。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，但是否已经实现了消除传播； (2) 量化强化干预措施在减少传播方面的作用； (3)预测不同策略下曼杜尔未来十年gHAT的轨迹。我们之前的 Mandoul gHAT 传播模型使用人类病例数据（2000-2019 年）和一系列模型改进进行了更新。其中包括如何将诊断特异性纳入模型以及对拟合方法的改进（观察到的病例报告的差异增加以及如何捕捉漏报和被动筛查的改进）。对模型之间的案例数据拟合进行了并排比较。我们估计，由于自 2015 年以来固定医疗机构诊断可用性的提高，被动检出率有所增加，第一阶段检测增加了 2.1 倍，第二阶段增加了 1.5 倍。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病例没有寄生虫学确认可能是误报。我们还发现，通过模型拟合估计的全焦点采采蝇减少量（95% CI 96.1–99.6%，减少量 = 99.1%）与之前通过监测陷阱捕获采采蝇量减少所测得的减少量相当。与之前的结果一致，该模型表明，由于加强干预，传播在 2015 年被中断。我们建议在曼杜尔进行额外的验证性测试，以确保可以仔细监控残局。如果有强大的被动监测系统，对病例进行更具体的测量，可以更好地告知何时可以安全地停止主动筛查和病媒控制。在线版本包含可在 10.1186/s40249-022-00934-8 获取的补充材料。
In recent years, a programme of vector control, screening and treatment of gambiense human 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. Our 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. We 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% CI 96.1–99.6%, 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. We 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. The online version contains supplementary material available at 10.1186/s40249-022-00934-8.
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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
影响因子：
1.8
作者：
Checchi F;Funk S;Chandramohan D;Haydon DT;Chappuis F
通讯作者：
Chappuis F
影响因子：
4.3
作者：
Crump RE;Huang CI;Knock ES;Spencer SEF;Brown PE;Mwamba Miaka E;Shampa C;Keeling MJ;Rock KS
通讯作者：
Rock KS
DOI：
10.1093/cid/ciab190
发表时间：
2021-06-14
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Davis CN;Castaño MS;Aliee M;Patel S;Miaka EM;Keeling MJ;Spencer SEF;Chitnis N;Rock KS
通讯作者：
Rock KS