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      2021                            d  bPublic Library of Science (PLoS)10aPublic Health, Environmental and Occupational Health10aInfectious Diseases1 aCromwell EA1 aOsborne JCP1 aUnnasch TR1 aBasáñez M1 aGass KM1 aBarbre KA1 aHill E1 aJohnson KB1 aDonkers KM1 aShirude S1 aSchmidt CA1 aAdekanmbi V1 aAdetokunboh OO1 aAfarideh M1 aAhmadpour E1 aAhmed MB1 aAkalu TY1 aAl-Aly Z1 aAlanezi FM1 aAlanzi TM1 aAlipour V1 aAndrei CL1 aAnsari F1 aAnsha MG1 aAnvari D1 aAppiah SCY1 aArabloo J1 aArnold BF1 aAusloos M1 aAyanore MA1 aBaig AA1 aBanach M1 aBarac A1 aBärnighausen TW1 aBayati M1 aBhattacharyya K1 aBhutta ZA1 aBibi S1 aBijani A1 aBohlouli S1 aBohluli M1 aBrady OJ1 aBragazzi NL1 aButt ZA1 aCarvalho F1 aChatterjee S1 aChattu VK1 aChattu SK1 aCormier NM1 aDahlawi SMA1 aDamiani G1 aDaoud F1 aDarwesh AM1 aDaryani A1 aDeribe K1 aDharmaratne SD1 aDiaz D1 aDo HT1 aEl Sayed Zaki M1 aEl Tantawi M1 aElemineh DA1 aFaraj A1 aFasihi Harandi M1 aFatahi Y1 aFeigin VL1 aFernandes E1 aFoigt NA1 aForoutan M1 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S00aPredicting the environmental suitability for onchocerciasis in Africa as an aid to elimination planning  uhttps://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0008824&type=printable  ae00088240 v153 a<jats:p>Recent evidence suggests that, in some foci, elimination of onchocerciasis from Africa may be feasible with mass drug administration (MDA) of ivermectin. To achieve continental elimination of transmission, mapping surveys will need to be conducted across all implementation units (IUs) for which endemicity status is currently unknown. Using boosted regression tree models with optimised hyperparameter selection, we estimated environmental suitability for onchocerciasis at the 5 × 5-km resolution across Africa. In order to classify IUs that include locations that are environmentally suitable, we used receiver operating characteristic (ROC) analysis to identify an optimal threshold for suitability concordant with locations where onchocerciasis has been previously detected. This threshold value was then used to classify IUs (more suitable or less suitable) based on the location within the IU with the largest mean prediction. Mean estimates of environmental suitability suggest large areas across West and Central Africa, as well as focal areas of East Africa, are suitable for onchocerciasis transmission, consistent with the presence of current control and elimination of transmission efforts. The ROC analysis identified a mean environmental suitability index of 0·71 as a threshold to classify based on the location with the largest mean prediction within the IU. Of the IUs considered for mapping surveys, 50·2% exceed this threshold for suitability in at least one 5 × 5-km location. The formidable scale of data collection required to map onchocerciasis endemicity across the African continent presents an opportunity to use spatial data to identify areas likely to be suitable for onchocerciasis transmission. National onchocerciasis elimination programmes may wish to consider prioritising these IUs for mapping surveys as human resources, laboratory capacity, and programmatic schedules may constrain survey implementation, and possibly delaying MDA initiation in areas that would ultimately qualify.</jats:p>  a1935-2735