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African Program for Onchocerciasis Control 1995-2010: Impact of Annual Ivermectin Mass Treatment on Off-Target Infectious Diseases.

Krotneva SP, Coffeng LE, Noma M, Zouré HG, Bakoné L, Amazigo UV, de Vlas SJ, Stolk WA - PLoS Negl Trop Dis (2015)

Bottom Line: Since its initiation in 1995, the African Program for Onchocerciasis Control (APOC) has had a substantial impact on the prevalence and burden of onchocerciasis through annual ivermectin mass treatment.Ivermectin is a broad-spectrum anti-parasitic agent that also has an impact on other co-endemic parasitic infections.This impact comprised approximately an additional 5.5% relative to the total burden averted from onchocerciasis (8.9 million DALYs) and indicates that the overall cost-effectiveness of APOC is even higher than previously reported.

View Article: PubMed Central - PubMed

Affiliation: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.

ABSTRACT
Since its initiation in 1995, the African Program for Onchocerciasis Control (APOC) has had a substantial impact on the prevalence and burden of onchocerciasis through annual ivermectin mass treatment. Ivermectin is a broad-spectrum anti-parasitic agent that also has an impact on other co-endemic parasitic infections. In this study, we roughly assessed the additional impact of APOC activities on the burden of the most important off-target infections: soil-transmitted helminthiases (STH; ascariasis, trichuriasis, hookworm, and strongyloidiasis), lymphatic filariasis (LF), and scabies. Based on a literature review, we formulated assumptions about the impact of ivermectin treatment on the disease burden of these off-target infections. Using data on the number of ivermectin treatments in APOC regions and the latest estimates of the burden of disease, we then calculated the impact of APOC activities on off-target infections in terms of disability-adjusted life years (DALYs) averted. We conservatively estimated that between 1995 and 2010, annual ivermectin mass treatment has cumulatively averted about 500 thousand DALYs from co-endemic STH infections, LF, and scabies. This impact comprised approximately an additional 5.5% relative to the total burden averted from onchocerciasis (8.9 million DALYs) and indicates that the overall cost-effectiveness of APOC is even higher than previously reported.

No MeSH data available.


Related in: MedlinePlus

Sensitivity analysis for the impact of assumed parameter values on the total averted burden.For each parameter (y-axis), the figure between brackets indicates the relative amount by which it was varied in the sensitivity analysis.
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pntd.0004051.g001: Sensitivity analysis for the impact of assumed parameter values on the total averted burden.For each parameter (y-axis), the figure between brackets indicates the relative amount by which it was varied in the sensitivity analysis.

Mentions: Fig 1 shows the results of the sensitivity analyses. Changing individual βx parameters by 20% resulted in estimates very similar to the main estimate. Obviously, increasing or decreasing all βx parameters simultaneously by 20% resulted in ±20% deviations from the main estimate of 493 thousand DALYs averted. Assumed no clustering of STH and EPSDs in APOC areas (hix = 1.0) or clustering of all infections but LF in all countries (hix = 1.5) resulted in 16% lower and 19% higher estimates of total DALYs averted, respectively.


African Program for Onchocerciasis Control 1995-2010: Impact of Annual Ivermectin Mass Treatment on Off-Target Infectious Diseases.

Krotneva SP, Coffeng LE, Noma M, Zouré HG, Bakoné L, Amazigo UV, de Vlas SJ, Stolk WA - PLoS Negl Trop Dis (2015)

Sensitivity analysis for the impact of assumed parameter values on the total averted burden.For each parameter (y-axis), the figure between brackets indicates the relative amount by which it was varied in the sensitivity analysis.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4581698&req=5

pntd.0004051.g001: Sensitivity analysis for the impact of assumed parameter values on the total averted burden.For each parameter (y-axis), the figure between brackets indicates the relative amount by which it was varied in the sensitivity analysis.
Mentions: Fig 1 shows the results of the sensitivity analyses. Changing individual βx parameters by 20% resulted in estimates very similar to the main estimate. Obviously, increasing or decreasing all βx parameters simultaneously by 20% resulted in ±20% deviations from the main estimate of 493 thousand DALYs averted. Assumed no clustering of STH and EPSDs in APOC areas (hix = 1.0) or clustering of all infections but LF in all countries (hix = 1.5) resulted in 16% lower and 19% higher estimates of total DALYs averted, respectively.

Bottom Line: Since its initiation in 1995, the African Program for Onchocerciasis Control (APOC) has had a substantial impact on the prevalence and burden of onchocerciasis through annual ivermectin mass treatment.Ivermectin is a broad-spectrum anti-parasitic agent that also has an impact on other co-endemic parasitic infections.This impact comprised approximately an additional 5.5% relative to the total burden averted from onchocerciasis (8.9 million DALYs) and indicates that the overall cost-effectiveness of APOC is even higher than previously reported.

View Article: PubMed Central - PubMed

Affiliation: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.

ABSTRACT
Since its initiation in 1995, the African Program for Onchocerciasis Control (APOC) has had a substantial impact on the prevalence and burden of onchocerciasis through annual ivermectin mass treatment. Ivermectin is a broad-spectrum anti-parasitic agent that also has an impact on other co-endemic parasitic infections. In this study, we roughly assessed the additional impact of APOC activities on the burden of the most important off-target infections: soil-transmitted helminthiases (STH; ascariasis, trichuriasis, hookworm, and strongyloidiasis), lymphatic filariasis (LF), and scabies. Based on a literature review, we formulated assumptions about the impact of ivermectin treatment on the disease burden of these off-target infections. Using data on the number of ivermectin treatments in APOC regions and the latest estimates of the burden of disease, we then calculated the impact of APOC activities on off-target infections in terms of disability-adjusted life years (DALYs) averted. We conservatively estimated that between 1995 and 2010, annual ivermectin mass treatment has cumulatively averted about 500 thousand DALYs from co-endemic STH infections, LF, and scabies. This impact comprised approximately an additional 5.5% relative to the total burden averted from onchocerciasis (8.9 million DALYs) and indicates that the overall cost-effectiveness of APOC is even higher than previously reported.

No MeSH data available.


Related in: MedlinePlus