Sequential modelling of the effects of mass drug treatments on anopheline-mediated lymphatic filariasis infection in Papua New Guinea

Singh, Brajendra K, Bockarie, Moses, Gambhir, Manoj, Siba, Peter M, Tisch, Daniel J, Kazura, James and Michael, Edwin (2013) 'Sequential modelling of the effects of mass drug treatments on anopheline-mediated lymphatic filariasis infection in Papua New Guinea'. PLoS ONE, Vol 8, Issue 6, e67004.

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Abstract

BACKGROUND
Lymphatic filariasis (LF) has been targeted by the WHO for global eradication leading to the implementation of large scale intervention programs based on annual mass drug administrations (MDA) worldwide. Recent work has indicated that locality-specific bio-ecological complexities affecting parasite transmission may complicate the prediction of LF extinction endpoints, casting uncertainty on the achievement of this initiative. One source of difficulty is the limited quantity and quality of data used to parameterize models of parasite transmission, implying the important need to update initially-derived parameter values. Sequential analysis of longitudinal data following annual MDAs will also be important to gaining new understanding of the persistence dynamics of LF. Here, we apply a Bayesian statistical-dynamical modelling framework that enables assimilation of information in human infection data recorded from communities in Papua New Guinea that underwent annual MDAs, into our previously developed model of parasite transmission, in order to examine these questions in LF ecology and control.

RESULTS
Biological parameters underlying transmission obtained by fitting the model to longitudinal data remained stable throughout the study period. This enabled us to reliably reconstruct the observed baseline data in each community. Endpoint estimates also showed little variation. However, the updating procedure showed a shift towards higher and less variable values for worm kill but not for any other drug-related parameters. An intriguing finding is that the stability in key biological parameters could be disrupted by a significant reduction in the vector biting rate prevailing in a locality.

CONCLUSIONS
Temporal invariance of biological parameters in the face of intervention perturbations indicates a robust adaptation of LF transmission to local ecological conditions. The results imply that understanding the mechanisms that underlie locally adapted transmission dynamics will be integral to identifying points of system fragility, and thus countermeasures to reliably facilitate LF extinction both locally and globally.

Item Type:	Article
Subjects:	QV Pharmacology > QV 38 Drug action. QX Parasitology > Insects. Other Parasites > QX 515 Anopheles WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WA Public Health > Statistics. Surveys > WA 950 Theory or methods of medical statistics. Epidemiologic methods WC Communicable Diseases > Tropical and Parasitic Diseases > WC 770 Therapy WC Communicable Diseases > Tropical and Parasitic Diseases > WC 880 Filariasis and related conditions (General)
Faculty: Department:	Biological Sciences > Department of Tropical Disease Biology
Digital Object Identifer (DOI):	https://doi.org/10.1371/journal.pone.0067004
Depositing User:	Mary Creegan
Date Deposited:	26 Nov 2014 14:41
Last Modified:	06 Feb 2018 13:07
URI:	https://archive.lstmed.ac.uk/id/eprint/4558

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