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Assessing the impact of intervention strategies against Taenia solium cysticercosis using the EPICYST transmission model.
Parasit Vectors. 2017 02 09; 10(1):73.PV

Abstract

BACKGROUND

The pork tapeworm, Taenia solium, and associated human infections, taeniasis, cysticercosis and neurocysticercosis, are serious public health problems, especially in developing countries. The World Health Organization (WHO) has set goals for having a validated strategy for control and elimination of T. solium taeniasis/cysticercosis by 2015 and interventions scaled-up in selected countries by 2020. Timely achievement of these internationally-endorsed targets requires that the relative benefits and effectiveness of potential interventions be explored rigorously within a quantitative framework.

METHODS

A deterministic, compartmental transmission model (EPICYST) was developed to capture the dynamics of the taeniasis/cysticercosis disease system in the human and pig hosts. Cysticercosis prevalence in humans, an outcome of high epidemiological and clinical importance, was explicitly modelled. A next generation matrix approach was used to derive an expression for the basic reproduction number, R 0. A full sensitivity analysis was performed using a methodology based on Latin-hypercube sampling partial rank correlation coefficient index.

RESULTS

EPICYST outputs indicate that chemotherapeutic intervention targeted at humans or pigs would be highly effective at reducing taeniasis and cysticercosis prevalence when applied singly, with annual chemotherapy of humans and pigs resulting, respectively, in 94 and 74% of human cysticercosis cases averted. Improved sanitation, meat inspection and animal husbandry are less effective but are still able to reduce prevalence singly or in combination. The value of R 0 for taeniasis was estimated at 1.4 (95% Credible Interval: 0.5-3.6).

CONCLUSIONS

Human- and pig-targeted drug-focussed interventions appear to be the most efficacious approach from the options currently available. The model presented is a forward step towards developing an informed control and elimination strategy for cysticercosis. Together with its validation against field data, EPICYST will be a valuable tool to help reach the WHO goals and to conduct economic evaluations of interventions in varying epidemiological settings.

Authors+Show Affiliations

Medical Research Council Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, St Mary's Campus, London, W2 1PG, UK. Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, St Mary's Campus, London, W2 1PG, UK.Schistosomiasis Control Initiative, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, St. Mary's Campus, London, W2 1PG, UK. Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, St Mary's Campus, London, W2 1PG, UK.Schistosomiasis Control Initiative, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, St. Mary's Campus, London, W2 1PG, UK. Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, St Mary's Campus, London, W2 1PG, UK. Current address: Research Triangle Institute, 701 13st Street NW, Washington D.C., 20005, USA.Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, St Mary's Campus, London, W2 1PG, UK.Neglected Zoonotic Diseases Team, Department of Neglected Tropical Diseases (NTD), World Health Organization (WHO), 20 Avenue Appia, 1211, Geneva 27, Switzerland.Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, St Mary's Campus, London, W2 1PG, UK. m.basanez@imperial.ac.uk. London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, St Mary's Campus, London, W2 1PG, UK. m.basanez@imperial.ac.uk.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

28183336

Citation

Winskill, Peter, et al. "Assessing the Impact of Intervention Strategies Against Taenia Solium Cysticercosis Using the EPICYST Transmission Model." Parasites & Vectors, vol. 10, no. 1, 2017, p. 73.
Winskill P, Harrison WE, French MD, et al. Assessing the impact of intervention strategies against Taenia solium cysticercosis using the EPICYST transmission model. Parasit Vectors. 2017;10(1):73.
Winskill, P., Harrison, W. E., French, M. D., Dixon, M. A., Abela-Ridder, B., & Basáñez, M. G. (2017). Assessing the impact of intervention strategies against Taenia solium cysticercosis using the EPICYST transmission model. Parasites & Vectors, 10(1), 73. https://doi.org/10.1186/s13071-017-1988-9
Winskill P, et al. Assessing the Impact of Intervention Strategies Against Taenia Solium Cysticercosis Using the EPICYST Transmission Model. Parasit Vectors. 2017 02 9;10(1):73. PubMed PMID: 28183336.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Assessing the impact of intervention strategies against Taenia solium cysticercosis using the EPICYST transmission model. AU - Winskill,Peter, AU - Harrison,Wendy E, AU - French,Michael D, AU - Dixon,Matthew A, AU - Abela-Ridder,Bernadette, AU - Basáñez,María-Gloria, Y1 - 2017/02/09/ PY - 2016/06/16/received PY - 2017/01/14/accepted PY - 2017/2/11/entrez PY - 2017/2/12/pubmed PY - 2017/5/16/medline KW - Basic reproduction number KW - Cysticercosis KW - EPICYST KW - Intervention KW - Latin-hypercube sampling KW - Mathematical modelling KW - Neurocysticercosis KW - Partial rank correlation coefficient index KW - Taenia solium KW - Taeniasis KW - Tapeworm SP - 73 EP - 73 JF - Parasites & vectors JO - Parasit Vectors VL - 10 IS - 1 N2 - BACKGROUND: The pork tapeworm, Taenia solium, and associated human infections, taeniasis, cysticercosis and neurocysticercosis, are serious public health problems, especially in developing countries. The World Health Organization (WHO) has set goals for having a validated strategy for control and elimination of T. solium taeniasis/cysticercosis by 2015 and interventions scaled-up in selected countries by 2020. Timely achievement of these internationally-endorsed targets requires that the relative benefits and effectiveness of potential interventions be explored rigorously within a quantitative framework. METHODS: A deterministic, compartmental transmission model (EPICYST) was developed to capture the dynamics of the taeniasis/cysticercosis disease system in the human and pig hosts. Cysticercosis prevalence in humans, an outcome of high epidemiological and clinical importance, was explicitly modelled. A next generation matrix approach was used to derive an expression for the basic reproduction number, R 0. A full sensitivity analysis was performed using a methodology based on Latin-hypercube sampling partial rank correlation coefficient index. RESULTS: EPICYST outputs indicate that chemotherapeutic intervention targeted at humans or pigs would be highly effective at reducing taeniasis and cysticercosis prevalence when applied singly, with annual chemotherapy of humans and pigs resulting, respectively, in 94 and 74% of human cysticercosis cases averted. Improved sanitation, meat inspection and animal husbandry are less effective but are still able to reduce prevalence singly or in combination. The value of R 0 for taeniasis was estimated at 1.4 (95% Credible Interval: 0.5-3.6). CONCLUSIONS: Human- and pig-targeted drug-focussed interventions appear to be the most efficacious approach from the options currently available. The model presented is a forward step towards developing an informed control and elimination strategy for cysticercosis. Together with its validation against field data, EPICYST will be a valuable tool to help reach the WHO goals and to conduct economic evaluations of interventions in varying epidemiological settings. SN - 1756-3305 UR - https://www.unboundmedicine.com/medline/citation/28183336/Assessing_the_impact_of_intervention_strategies_against_Taenia_solium_cysticercosis_using_the_EPICYST_transmission_model_ L2 - https://parasitesandvectors.biomedcentral.com/articles/10.1186/s13071-017-1988-9 DB - PRIME DP - Unbound Medicine ER -