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Evaluating elimination thresholds and stopping criteria for interventions against the vector-borne macroparasitic disease, lymphatic filariasis, using mathematical modelling

Medicine and Health

Evaluating elimination thresholds and stopping criteria for interventions against the vector-borne macroparasitic disease, lymphatic filariasis, using mathematical modelling

S. Sharma, M. E. Smith, et al.

This study by Swarnali Sharma and colleagues reveals critical insights into the dynamics of lymphatic filariasis (LF) interventions using EPIFIL transmission models. The importance of understanding parasite extinction dynamics for the WHO Transmission Assessment Survey (TAS) is emphasized, warning against operationally convenient stopping criteria that may threaten global LF elimination goals.... show more
Abstract
We leveraged the ability of EPIFIL transmission models fit to field data to evaluate the use of the WHO Transmission Assessment Survey (TAS) for supporting Lymphatic Filariasis (LF) intervention stopping decisions. Our results indicate that understanding the underlying parasite extinction dynamics, particularly the protracted transient dynamics involved in shifts to the extinct state, is crucial for understanding the impacts of using TAS for determining the achievement of LF elimination. These findings warn that employing stopping criteria set for operational purposes, as employed in the TAS strategy, without a full consideration of the dynamics of extinction could seriously undermine the goal of achieving global LF elimination.
Publisher
Communications Biology
Published On
Feb 27, 2023
Authors
Swarnali Sharma, Morgan E. Smith, Shakir Bilal, Edwin Michael
DOI
https://doi.org/10.1038/s42003-022-04391-9
Tags
Lymphatic filariasis
Transmission Assessment Survey
EPIFIL models
parasite extinction dynamics
public health
intervention strategies

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