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Elimination or Resurgence: Modelling Lymphatic Filariasis After Reaching the 1% Microfilaremia Prevalence Threshold.
The Journal of Infectious Diseases ( IF 6.4 ) Pub Date : 2019-12-19 , DOI: 10.1093/infdis/jiz647
Joaquin M Prada 1 , Emma L Davis 2, 3 , Panayiota Touloupou 4 , Wilma A Stolk 5 , Periklis Kontoroupis 5 , Morgan E Smith 6 , Swarnali Sharma 6 , Edwin Michael 6 , Sake J de Vlas 5 , T Déirdre Hollingsworth 3
Affiliation  

The low prevalence levels associated with lymphatic filariasis elimination pose a challenge for effective disease surveillance. As more countries achieve the World Health Organization criteria for halting mass treatment and move on to surveillance, there is increasing reliance on the utility of transmission assessment surveys (TAS) to measure success. However, the long-term disease outcomes after passing TAS are largely untested. Using 3 well-established mathematical models, we show that low-level prevalence can be maintained for a long period after halting mass treatment and that true elimination (0% prevalence) is usually slow to achieve. The risk of resurgence after achieving current targets is low and is hard to predict using just current prevalence. Although resurgence is often quick (<5 years), it can still occur outside of the currently recommended postintervention surveillance period of 4–6 years. Our results highlight the need for ongoing and enhanced postintervention monitoring, beyond the scope of TAS, to ensure sustained success.

中文翻译:

消除或死灰复燃:在达到 1% 微丝虫血症患病率阈值后对淋巴丝虫病进行建模。

与消除淋巴丝虫病相关的低患病率对有效的疾病监测提出了挑战。随着越来越多的国家达到世界卫生组织停止大规模治疗的标准并转向监测,人们越来越依赖传播评估调查(TAS)来衡量成功与否。然而,通过 TAS 后的长期疾病结果很大程度上未经测试。使用 3 个完善的数学模型,我们表明,在停止大规模治疗后,低水平的患病率可以维持很长一段时间,而真正的消除(0% 患病率)通常很难实现。实现当前目标后复发的风险很低,并且仅使用当前的患病率很难预测。尽管复发通常很快(<5 年),但在目前建议的 4-6 年干预后监测期之外仍然可能发生。我们的结果强调,需要在 TAS 范围之外进行持续和加强的干预后监测,以确保持续成功。
更新日期:2019-12-19
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