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Elimination of transmission of onchocerciasis (river blindness) with long-term ivermectin mass drug administration with or without vector control in sub-Saharan Africa: a systematic review and meta-analysis.

التفاصيل البيبلوغرافية
العنوان: Elimination of transmission of onchocerciasis (river blindness) with long-term ivermectin mass drug administration with or without vector control in sub-Saharan Africa: a systematic review and meta-analysis.
المؤلفون: Mutono N; Centre for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi, Kenya; Paul G Allen School for Global Health, Washington State University, Pullman, WA, USA. Electronic address: mutono.nyamai@uonbi.ac.ke., Basáñez MG; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK; London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK., James A; Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands., Stolk WA; Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands., Makori A; Centre for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi, Kenya; Paul G Allen School for Global Health, Washington State University, Pullman, WA, USA., Kimani TN; Centre for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi, Kenya; Paul G Allen School for Global Health, Washington State University, Pullman, WA, USA; Ministry of Health Kenya, Kiambu Town, Kenya., Hollingsworth TD; Big Data Institute, University of Oxford, Oxford, UK., Vasconcelos A; Big Data Institute, University of Oxford, Oxford, UK., Dixon MA; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK; London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK., de Vlas SJ; Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands., Thumbi SM; Centre for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi, Kenya; Paul G Allen School for Global Health, Washington State University, Pullman, WA, USA; Institute of Immunology and Infection Research, University of Edinburgh, Edinburgh, UK.
المصدر: The Lancet. Global health [Lancet Glob Health] 2024 May; Vol. 12 (5), pp. e771-e782. Date of Electronic Publication: 2024 Mar 11.
نوع المنشور: Meta-Analysis; Systematic Review; Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Ltd Country of Publication: England NLM ID: 101613665 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2214-109X (Electronic) Linking ISSN: 2214109X NLM ISO Abbreviation: Lancet Glob Health
أسماء مطبوعة: Original Publication: [England] : Elsevier Ltd. 2013-
مواضيع طبية MeSH: Ivermectin*/administration & dosage , Ivermectin*/therapeutic use , Mass Drug Administration* , Onchocerciasis, Ocular*/epidemiology , Onchocerciasis, Ocular*/prevention & control , Onchocerciasis, Ocular*/drug therapy, Humans ; Africa South of the Sahara/epidemiology ; Animals ; Onchocerciasis/epidemiology ; Onchocerciasis/transmission ; Onchocerciasis/prevention & control ; Onchocerciasis/drug therapy ; Disease Eradication ; Insect Control/methods ; Antiparasitic Agents/administration & dosage ; Antiparasitic Agents/therapeutic use
مستخلص: Background: WHO has proposed elimination of transmission of onchocerciasis (river blindness) by 2030. More than 99% of cases of onchocerciasis are in sub-Saharan Africa. Vector control and mass drug administration of ivermectin have been the main interventions for many years, with varying success. We aimed to identify factors associated with elimination of onchocerciasis transmission in sub-Saharan Africa.
Methods: For this systematic review and meta-analysis we searched for published articles reporting epidemiological or entomological assessments of onchocerciasis transmission status in sub-Saharan Africa, with or without vector control. We searched MEDLINE, PubMed, Web of Science, Embase, Cochrane Central Register of Controlled Trials, African Index Medicus, and Google Scholar databases for all articles published from database inception to Aug 19, 2023, without language restrictions. The search terms used were "onchocerciasis" AND "ivermectin" AND "mass drug administration". The three inclusion criteria were (1) focus or foci located in Africa, (2) reporting of elimination of transmission or at least 10 years of ivermectin mass drug administration in the focus or foci, and (3) inclusion of at least one of the following assessments: microfilarial prevalence, nodule prevalence, Ov16 antibody seroprevalence, and blackfly infectivity prevalence. Epidemiological modelling studies and reviews were excluded. Four reviewers (NM, AJ, AM, and TNK) extracted data in duplicate from the full-text articles using a data extraction tool developed in Excel with columns recording the data of interest to be extracted, and a column where important comments for each study could be highlighted. We did not request any individual-level data from authors. Foci were classified as achieving elimination of transmission, being close to elimination of transmission, or with ongoing transmission. We used mixed-effects meta-regression models to identify factors associated with transmission status. This study is registered in PROSPERO, CRD42022338986.
Findings: Of 1525 articles screened after the removal of duplicates, 75 provided 282 records from 238 distinct foci in 19 (70%) of the 27 onchocerciasis-endemic countries in sub-Saharan Africa. Elimination of transmission was reported in 24 (9%) records, being close to elimination of transmission in 86 (30%) records, and ongoing transmission in 172 (61%) records. I 2 was 83·3% (95% CI 79·7 to 86·3). Records reporting 10 or more years of continuous mass drug administration with 80% or more therapeutic coverage of the eligible population yielded significantly higher odds of achieving elimination of transmission (log-odds 8·5 [95% CI 3·5 to 13·5]) or elimination and being close to elimination of transmission (42·4 [18·7 to 66·1]) than those with no years achieving 80% coverage or more. Reporting 15-19 years of ivermectin mass drug administration (22·7 [17·2 to 28·2]) and biannual treatment (43·3 [27·2 to 59·3]) were positively associated with elimination and being close to elimination of transmission compared with less than 15 years and no biannual mass drug administration, respectively. Having had vector control without vector elimination (-42·8 [-59·1 to -26·5]) and baseline holoendemicity (-41·97 [-60·6 to -23·2]) were associated with increased risk of ongoing transmission compared with no vector control and hypoendemicity, respectively. Blackfly disappearance due to vector control or environmental change contributed to elimination of transmission.
Interpretation: Mass drug administration duration, frequency, and coverage; baseline endemicity; and vector elimination or disappearance are important determinants of elimination of onchocerciasis transmission in sub-Saharan Africa. Our findings underscore the importance of improving and sustaining high therapeutic coverage and increasing treatment frequency if countries are to achieve elimination of onchocerciasis transmission.
Funding: The Bill & Melinda Gates Foundation and Neglected Tropical Diseases Modelling Consortium, UK Medical Research Council, and Global Health EDCTP3 Joint Undertaking.
Translations: For the Swahili, French, Spanish and Portuguese translations of the abstract see Supplementary Materials section.
Competing Interests: Declaration of interests We declare no competing interests.
(Copyright © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)
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معلومات مُعتمدة: INV-030046 United States GATES Bill & Melinda Gates Foundation
المشرفين على المادة: 70288-86-7 (Ivermectin)
0 (Antiparasitic Agents)
تواريخ الأحداث: Date Created: 20240314 Date Completed: 20240807 Latest Revision: 20240807
رمز التحديث: 20240808
مُعرف محوري في PubMed: PMC11009120
DOI: 10.1016/S2214-109X(24)00043-3
PMID: 38484745
قاعدة البيانات: MEDLINE
الوصف
تدمد:2214-109X
DOI:10.1016/S2214-109X(24)00043-3