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African program for onchocerciasis control 1995-2010: Impact of annual ivermectin mass treatment on off-target infectious diseases.

Abstract

Editor's Abstract:

Since its initiation in 1995, the African Program for Onchocerciasis Control (APOC) has had a substantial impact on the prevalence and burden of onchocerciasis through annual ivermectin mass treatment. Ivermectin is a broad-spectrum anti-parasitic agent that also has an impact on other co-endemic parasitic infections. In this study, we roughly assessed the additional impact of APOC activities on the burden of the most important off-target infections: soil-transmitted helminthiases (STH; ascariasis, trichuriasis, hookworm, and strongyloidiasis), lymphatic filariasis (LF), and scabies. Based on a literature review, we formulated assumptions about the impact of ivermectin treatment on the disease burden of these off-target infections. Using data on the number of ivermectin treatments in APOC regions and the latest estimates of the burden of disease, we then calculated the impact of APOC activities on off-target infections in terms of disability-adjusted life years (DALYs) averted. We conservatively estimated that between 1995 and 2010, annual ivermectin mass treatment has cumulatively averted about 500 thousand DALYs from co-endemic STH infections, LF, and scabies. This impact comprised approximately an additional 5.5% relative to the total burden averted from onchocerciasis (8.9 million DALYs) and indicates that the overall cost-effectiveness of APOC is even higher than previously reported.

More information

Type
Journal Article
Author
Krotneva SP
Coffeng LE
Noma M
Zouré HG M
Bakoné L
Amazigo UV
Vlas SJ
Stolk WA
Year of Publication
2015
Journal
PLoS neglected tropical diseases
Volume
9
Issue
9
Number of Pages
e0004051
Type of Article
literature review
Language
eng
ISSN Number
1935-2735
DOI
10.1371/journal.pntd.0004051
Alternate Journal
PLoS Negl Trop Dis
Publication Language
eng