TY - JOUR
T1 - An Ensemble Framework for Projecting the Impact of Lymphatic Filariasis Interventions Across Sub-Saharan Africa at a Fine Spatial Scale
AU - Touloupou, Panayiota
AU - Fronterre, Claudio
AU - Cano, Jorge
AU - Prada, Joaquin M.
AU - Smith, Morgan
AU - Kontoroupis, Periklis
AU - Brown, Paul
AU - Rivera, Rocio Caja
AU - De Vlas, Sake J.
AU - Gunawardena, Sharmini
AU - Irvine, Michael A.
AU - Njenga, Sammy M.
AU - Reimer, Lisa
AU - Seife, Fikre
AU - Sharma, Swarnali
AU - Michael, Edwin
AU - Stolk, Wilma A.
AU - Pulan, Rachel
AU - Spencer, Simon E.F.
AU - Hollingsworth, T. Deirdre
N1 - Publisher Copyright:
© 2024 The Author(s).
PY - 2024/5/15
Y1 - 2024/5/15
N2 - Background: Lymphatic filariasis (LF) is a neglected tropical disease targeted for elimination as a public health problem by 2030. Although mass treatments have led to huge reductions in LF prevalence, some countries or regions may find it difficult to achieve elimination by 2030 owing to various factors, including local differences in transmission. Subnational projections of intervention impact are a useful tool in understanding these dynamics, but correctly characterizing their uncertainty is challenging. Methods: We developed a computationally feasible framework for providing subnational projections for LF across 44 sub-Saharan African countries using ensemble models, guided by historical control data, to allow assessment of the role of subnational heterogeneities in global goal achievement. Projected scenarios include ongoing annual treatment from 2018 to 2030, enhanced coverage, and biannual treatment. Results: Our projections suggest that progress is likely to continue well. However, highly endemic locations currently deploying strategies with the lower World Health Organization recommended coverage (65%) and frequency (annual) are expected to have slow decreases in prevalence. Increasing intervention frequency or coverage can accelerate progress by up to 5 or 6 years, respectively. Conclusions: While projections based on baseline data have limitations, our methodological advancements provide assessments of potential bottlenecks for the global goals for LF arising from subnational heterogeneities. In particular, areas with high baseline prevalence may face challenges in achieving the 2030 goals, extending the "tail"of interventions. Enhancing intervention frequency and/or coverage will accelerate progress. Our approach facilitates preimplementation assessments of the impact of local interventions and is applicable to other regions and neglected tropical diseases.
AB - Background: Lymphatic filariasis (LF) is a neglected tropical disease targeted for elimination as a public health problem by 2030. Although mass treatments have led to huge reductions in LF prevalence, some countries or regions may find it difficult to achieve elimination by 2030 owing to various factors, including local differences in transmission. Subnational projections of intervention impact are a useful tool in understanding these dynamics, but correctly characterizing their uncertainty is challenging. Methods: We developed a computationally feasible framework for providing subnational projections for LF across 44 sub-Saharan African countries using ensemble models, guided by historical control data, to allow assessment of the role of subnational heterogeneities in global goal achievement. Projected scenarios include ongoing annual treatment from 2018 to 2030, enhanced coverage, and biannual treatment. Results: Our projections suggest that progress is likely to continue well. However, highly endemic locations currently deploying strategies with the lower World Health Organization recommended coverage (65%) and frequency (annual) are expected to have slow decreases in prevalence. Increasing intervention frequency or coverage can accelerate progress by up to 5 or 6 years, respectively. Conclusions: While projections based on baseline data have limitations, our methodological advancements provide assessments of potential bottlenecks for the global goals for LF arising from subnational heterogeneities. In particular, areas with high baseline prevalence may face challenges in achieving the 2030 goals, extending the "tail"of interventions. Enhancing intervention frequency and/or coverage will accelerate progress. Our approach facilitates preimplementation assessments of the impact of local interventions and is applicable to other regions and neglected tropical diseases.
UR - http://www.scopus.com/inward/record.url?scp=85191431169&partnerID=8YFLogxK
U2 - 10.1093/cid/ciae071
DO - 10.1093/cid/ciae071
M3 - Article
C2 - 38662704
AN - SCOPUS:85191431169
SN - 1058-4838
VL - 78
SP - S108-S116
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
ER -
