scholarly journals Human population movement can impede the elimination of soil-transmitted helminth transmission in regions with heterogeneity in mass drug administration coverage and transmission potential between villages: a metapopulation analysis

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Carolin Vegvari ◽  
James E. Truscott ◽  
Klodeta Kura ◽  
Roy M. Anderson
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
Human Population ◽  
Sub Saharan Africa ◽  
Population Movement ◽  
Mobility Patterns ◽  
Preventive Chemotherapy ◽  
Cross Sectional ◽  
The Impact ◽  
Human Population Movement

Abstract Background Soil-transmitted helminth (STH) infections affect predominantly socio-economically disadvantaged populations in sub-Saharan Africa, East Asia and the Americas. Previous mathematical modelling studies have evaluated optimal intervention strategies to break STH transmission in clusters of villages. These studies assumed that villages are closed independent units with no movement of people in or out of communities. Here we examine how human population movement, for example, of seasonal migrant labourers, affect the outcome of mass drug administration (MDA) programmes. Results We used a stochastic individual-based metapopulation model to analyse the impact of human population movement at varying rates on STH elimination efforts. Specifically, we looked at seasonal clumped movement events of infected individuals into a village. We showed that even if on average 75% of the entire resident population within a village are treated, an annual rate of 2–3% of the population arriving from an untreated source village can reduce the probability of STH elimination to less than 50% in high-prevalence settings. If a village is infection-free, an annual movement rate of 2–3% from an infected source village imposes a risk of re-introduction of STH of 75% or higher, unless the prevalence in the source village is less than 20%. Even a single arrival of 2–3% of the population can impose a risk of re-introducing STH of 50% or greater depending on the prevalence in the source village. The risk of re-introduction also depends on both the age group of moving individuals and STH species, since the pattern of cross-sectional age-prevalence and age-intensity profiles of infection in the human host are species-specific. Conclusions Planning for STH elimination programmes should account for human mobility patterns in defined regions. We recommend that individuals arriving from areas with ongoing STH transmission should receive preventive chemotherapy for STHs. This can most easily be implemented if migration is seasonal and overlaps with treatment rounds, e.g. seasonal migrant labour. Moreover, transmission hotspots in or near treatment clusters should be eliminated, for example, by implementing appropriate water, sanitation and hygiene (WASH) measures and targeting treatment to individuals living in hotspots.

scholarly journals The potential impact of including pre-school aged children in the praziquantel mass-drug administration programmes on the S.haematobium infections in Malawi: a modelling study

2020 ◽  
Author(s):  
Iwona Hawryluk ◽  
Tara Mangal ◽  
Andrew Nguluwe ◽  
Chikonzero Kambalame ◽  
Stanley Banda ◽  
...  
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
High Intensity ◽  
Transmission Model ◽  
Preventive Chemotherapy ◽  
School Aged Children ◽  
Treatment And Prevention ◽  
One Year ◽  
New Formulation ◽  
The Impact

AbstractBackgroundMass drug administration (MDA) of praziquantel is an intervention used in the treatment and prevention of schistosomiasis. In Malawi, MDA happens annually across high-risk districts and covers around 80% of school aged children and 50% of adults. The current formulation of praziquantel is not approved for use in the preventive chemotherapy for children under 5 years old, known as pre-school aged children (PSAC). However, a new formulation for PSAC will be available by 2022. A comprehensive analysis of the potential additional benefits of including PSAC in the MDA will be critical to guide policy-makers.MethodsWe developed a new individual-based stochastic transmission model of Schistosoma haematobium for the 6 highest prevalence districts of Malawi. The model was used to evaluate the benefits of including PSAC in the MDA campaigns, with respect to the prevalence of high-intensity infections (> 500 eggs per ml of urine) and reaching the elimination target, meaning the prevalence of high-intensity infections under 5% in all sentinel sites. The impact of different MDA frequencies and coverages is quantified by prevalence of high-intensity infection and number of rounds needed to decrease that prevalence below 1%.ResultsIncluding PSAC in the MDA campaigns can reduce the time needed to achieve the elimination target for S. haematobium infections in Malawi by one year. The modelling suggests that in the case of a lower threshold of high-intensity infection, currently set by WHO to 500 eggs per ml of urine, including PSAC in the preventive chemotherapy programmes for 5 years can reduce the number of the high-intensity infection case years for pre-school aged children by up to 9.1 years per 100 children.ConclusionsRegularly treating PSAC in the MDA is likely to lead to overall better health of children as well as a decrease in the severe morbidities caused by persistent schistosomiasis infections and bring forward the date of elimination. Moreover, mass administration of praziquantel to PSAC will decrease the prevalence among the SAC, who are at the most risk of infection.

scholarly journals Does mass drug administration for community-based scabies control works? The experience in Ethiopia

2020 ◽  
Vol 14 (06.1) ◽  
pp. 78S-85S
Author(s):  
Wendemagegn Enbiale ◽  
Ashenafi Ayalew ◽  
Teklehaymanot Gebrehiwot ◽  
Yared Mulu ◽  
Muluken Azage ◽  
...  
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
Cross Sectional Study ◽  
Political Commitment ◽  
Cure Rate ◽  
Community Based ◽  
Cross Sectional ◽  
The North ◽  
The Impact ◽  
North Gondar Zone

Introduction: After a scabies outbreak in Amhara Region, Ethiopia in 2015/2016, the Regional Health Bureau performed an extensive Mass Drug Administration (MDA). In May 2017, we collected data to assess the impact of the treatment on the scabies control. Methodology. We retrieved baseline data from the 2015/16 burden assessment: campaign organization and administration information. We did a community based cross-sectional study using a structured questionnaire on disease and treatment history plus the presence or absence of active scabies in three Zones. We selected households using stratified random sampling deployed 7581 questionnaires and performed key informant interviews. Results: 46.3% had a previous scabies diagnosis in the last 2 years of which 86.1% received treatment, and the cure rate was 90.6%. Fifteen months after intervention the scabies prevalence was 21.0 % (67.3% new cases and 32.7% recurrences). The highest burden of new cases (93.1%) was found in the North Gondar zone. The likelihood of treatment failure was higher for treatments offered in clinics (12.2%) as opposed to via the campaign (7.9%). Failure to follow the guidelines, shortage of medicine and lack of leadership prioritization were identified as reasons for resurgence of the disease. Conclusions: We demonstrated that community engagement is essential in the success of scabies MDA, alongside strong political commitment, and guideline adherence. Effectiveness and sustainability of the MDA was compromised by the failing of proper contact treatment, surveillance and case management.

scholarly journals Impact of Annual versus Semiannual Mass Drug Administration with Ivermectin and Albendazole on Helminth Infections in Southeastern Liberia

2021 ◽  
Author(s):  
Obiora A. Eneanya ◽  
Lincoln Gankpala ◽  
Charles W. Goss ◽  
Fatorma K. Bolay ◽  
Gary J. Weil ◽  
...  
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
Wuchereria Bancrofti ◽  
Infection Prevalence ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Helminth Infections ◽  
Helminthic Infections ◽  
Prevalence Estimates ◽  
The Impact

We compared the impact of three rounds of annual and five rounds of semiannual mass drug administration (MDA) with albendazole plus ivermectin on helminthic infections in Liberia. Repeated annual cross-sectional community surveys were conducted between 2013 and 2019 in individuals of 5 years and older. Primary outcome was the change of infection prevalence estimates from baseline to month 36 (12 months after the last treatment). After three rounds of annual MDA, Wuchereria bancrofti circulating filarial antigen (CFA) and microfilaria (Mf) prevalence estimates decreased from 19.7% to 4.3% and from 8.6% to 0%, respectively; after semiannual MDA, CFA and Mf prevalences decreased from 37.8% to 16.8% and 17.9% to 1%, respectively. Mixed effects logistic regression models indicated that the odds of having Mf decreased by 97% (P < 0.001) at month 36 (similar odds for annual and semiannual MDA zones). A parallel analysis showed that the odds of CFA were reduced by 83% and 69% at 36 months in the annual and semiannual treatment zones, respectively (P < 0.001). Onchocerca volvulus Mf prevalence decreased slightly after multiple MDA rounds in both treatment zones. Reductions in hookworm and Trichuris trichiura prevalences and intensities were slightly greater in the annual treatment zone. Ascaris lumbricoides prevalence rates were relatively unchanged, although infection intensities decreased sharply throughout. Results show that annual and semiannual MDA were equally effective for reducing LF and soil-transmitted helminth infection parameters over a 3-year period, and reductions recorded at month 36 were sustained by routine annual MDA through month 72.

scholarly journals Mass Drug Administration Interruption by COVID-19 reportedly increases lymphatic filarial attacks, pains, and perceived increased lymphatic filarial infection transmission in rural Ghana

2021 ◽  
Author(s):  
Alexander Kwarteng ◽  
Yarhands Dissou Arthur ◽  
Samuel Opoku Asiedu ◽  
John Kanyiri Yamba ◽  
Emmanuel Kobla Amewu ◽  
...  
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
Neglected Tropical Diseases ◽  
Cross Sectional Study ◽  
P Value ◽  
Chi Square ◽  
Statistical Tool ◽  
Cross Sectional ◽  
Rural Ghana ◽  
The Impact

Abstract BackgroundLike all other diseases, the advent of the COVID-19 pandemic has been implicated to impact the elimination schedule and control of neglected tropical diseases such as human lymphatic filarial (LF) infections in endemic countries. However, it is unclear the extent to which delays in mass drug administration has affected people living with chronic lymphatic filarial pathology in rural Ghana as a result of the COVID-19 pandemic, and thus remain to be investigated. MethodTo address this, a cross-sectional study where 133 LF participants from 8 LF-endemic communities in the Ahanta West District of Ghana were recruited to assess the impact of MDA interruptions as a result of COVID-19 among individuals presenting with the filarial pathology. Here, the chi-square test of independence was used as a statistical tool to assess the dependency: 1) between MDA interruption and filarial attacks 2) between MDA interruption and filarial-related pains 3) between MDA interruption and a perceived increase in LF transmission.ResultsStudy participants were asked whether the MDA interruption has affected them in any way. Here, 81% of the patients indicated yes, it had. In addition, we sought to investigate whether MDA interruption has resulted in increased filarial attacks and pains. At this, 68% of the study respondents reported an increase in filarial attacks. Similarly, 65% reported an increase in filarial-related pains. The study further reported that filarial attacks (B=14.997, df=1, p-value <0.001) and pains (a=11.773, df=1, p-value <0.001) are dependent on MDA interruption. Next, we further report that the perceived increase in LF transmission is dependent on MDA interruption (c=9.415, df=1, p-value=0.002). ConclusionIn this study, MDA interruption is reported to increase filarial attacks, filarial-related pains, and a perceived LF transmission increase in the study communities. This study's findings are important and urgent, suggesting that sustained MDA interruption in LF-endemic communities could further worsen LF patients' plight as filarial attacks, pains, and transmission could increase. Therefore, the need to immediately identify alternative modes of MDA distribution in LF-endemic areas where mass treatment has been halted in the wake of COVID-19 to prevent an unwarranted surge in LF attacks, pains, and transmission.

scholarly journals Impact of mass drug administration of azithromycin for trachoma elimination on prevalence and azithromycin resistance of genital Mycoplasma genitalium infection

2019 ◽  
Vol 95 (7) ◽  
pp. 522-528 ◽  
Author(s):  
Mark Andrew Harrison ◽  
Emma Michele Harding-Esch ◽  
Michael Marks ◽  
Marcus James Pond ◽  
Robert Butcher ◽  
...  
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
Secondary Analysis ◽  
Mycoplasma Genitalium ◽  
Nucleic Acid Amplification ◽  
23S Rrna ◽  
Island Population ◽  
Cross Sectional ◽  
The Impact ◽  
Azithromycin Resistance

BackgroundMass drug administration (MDA) of 20 mg/kg (maximum 1 g in adults) azithromycin for ocular Chlamydia trachomatis (CT) infection is a key component of the WHO trachoma elimination strategy. However, this dose may be suboptimal in Mycoplasma genitalium infection and may encourage emergence of antimicrobial resistance (AMR) to azithromycin.ObjectivesTo determine the effect of MDA for trachoma elimination on M. genitalium prevalence, strain type and azithromycin resistance.MethodsA secondary analysis of CT-negative vulvovaginal swabs from three outpatient antenatal clinics (Honiara, Solomon Islands) from patients recruited either pre-MDA, or 10 months post-MDA in two cross-sectional surveys was carried out. Swabs were tested for M. genitalium infection using Fast Track Diagnostics Urethritis Plus nucleic acid amplification assay. M. genitalium-positive samples were subsequently tested for azithromycin resistance by sequencing domain V of the 23S rRNA DNA region of M. genitalium and underwent phylogenetic analysis by dual locus sequence typing.ResultsM. genitalium prevalence was 11.9% (28/236) in women pre-MDA and 10.9% (28/256) 10 months post-MDA (p=0.7467). Self-reported receipt of azithromycin as part of MDA was 49.2% in women recruited post-MDA and 17.9% (5/28) in those who tested M. genitalium positive. Of samples sequenced (21/28 pre-MDA, 22/28 post-MDA), all showed a macrolide susceptible genotype. Strain typing showed that sequence types diverged into two lineages, with a suggestion of strain replacement post-MDA.ConclusionA single round of azithromycin MDA in an island population with high baseline M. genitalium prevalence did not appear to impact on either prevalence or azithromycin resistance, in contrast to reported decreased genital CT prevalence in the same population. This may be due to limitations such as sample size, including CT-negative samples only, and low MDA coverage. Further investigation of the impact of multiple rounds of MDA on M. genitalium azithromycin AMR in antibiotic experienced and naïve populations is warranted.

scholarly journals Coverage Validation survey for lymphatic filariasis treatment in Itang special district of Gambella regional state of Ethiopia; Cross sectional study

2020 ◽  
Author(s):  
Abinet Teshome ◽  
Zerihun Zerdo ◽  
Mekuria Asnakew ◽  
Chuchu Churko ◽  
Manaye Yihune ◽  
...  
Keyword(s):  
Lymphatic Filariasis ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Target Population ◽  
Health Extension Workers ◽  
Preventive Chemotherapy ◽  
Cross Sectional ◽  
Treatment Coverage ◽  
Regional State ◽  
Special District

Abstract Background Coverage validation survey provides a more precise estimate of preventive chemotherapy coverage and avoids the biases, as well as some of the errors that can affect reported coverage. This coverage validation survey was done to know the difference between the reported coverage from district of Itang special for Ivermectin and Albendazole given for Lymphatic Filariasis with the actual coverage in the selected district. Methods Itang special district from Gambella region was purposively selected for lymphatic filariasis treatment coverage survey. The survey was done by using segments from each district whereby 30 segments were selected from the district. The name of the kebeles and the segments where the survey was carried out were selected by using random selection method. After getting the total number of households in each selected kebele from the village chief the number of segments to be visited was computed by dividing the number of households to 50 and 16 households were visited from each segment and eligible individuals aged 5 and above were interviewed. Data for variables related to coverage of the IVM plus ALB were collected using Survey CTO software. Location of each household and the kebele chief office was recorded by using Global positioning system. Information about the kebele including population size, number of households in the kebele, last dates of mass drug administration were gathered primarily from village chiefs when available and headmasters and health extension workers when unavailable. Results The coverage validation survey result shows that the coverage for lymphatic Filariasis treatment was 81.5% in Itang special district of Gambella regional state. From 825 individuals that reported that they were offered the treatment 823(99.6%) swallowed the drug. The main reason for not being offered ivermectin and Albendazole during the mass drug administration campaigns because they were missing class during those dates (37.2%). Conclusion The data collected from Itang special woreda of Gambella Region shows that the treatment coverage is higher than the recommended coverage of 65% of the target population should be treated. Different factors play a role for this achievement including using different treatment sites such as schools, community centers and home to home by using health development armies for those children not attending schools and for nomadic communities such as the one in Gambella Regional state. Keywords Lymphatic Filariasis, Ivermectin, Albendazole, Coverage

scholarly journals Impact of Mass Drug Administration on Prevalence of Schistosomiasis in Eight Riverine Communities in the Asuogyaman District of the Eastern Region, Ghana

2020 ◽  
pp. 18-32
Author(s):  
Quartey Abass ◽  
John Yao Bedzo ◽  
Stephen Manortey
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
Geographical Area ◽  
Bivariate Analysis ◽  
Disease Rate ◽  
Significant Variable ◽  
Eastern Region ◽  
Cross Sectional ◽  
High Prevalence ◽  
The Impact

Background: The incidence of schistosomiasis in Ghana and more specifically in the Asuogyaman District had become a noticeable record following the creation of the Akosombo Dam in the early 1960s. This has inevitably since placed an enormous burden on the health service delivery systems in the geographical area. Mass Drug Administration (MDA) of Praziquantel has been used worldwide as a preventive and treatment intervention measure for the disease, and the study area is no exception. The study, therefore, aimed to assess the impact of MDA on the prevalence and associated risk factors of schistosomiasis in eight (8) selected riverine communities within the district. Methods: A descriptive retrospective cross-sectional study was conducted involving 896 respondents with ages ranging from 2 to 82 years and a mean age of 17±13.78 years. Data were obtained from the Volta River Authority (VRA) Public Health and Environmental Department. Pearson’s chi-square tests and logistic regression models were used to assess the association and predict the relationship between variables. Findings: Out of the 896 respondents, 93 (10.4 %) tested positive for Schistosoma haematobium. Proportionally, the Nyameben community had a high prevalence of 25.8% while Mami-Waterkope, and Mangoase both had a low prevalence of 3.2 %. The average uptake of Praziquantel was 41% across the study area. From the bivariate analysis, the respondents’ community of residence was noted as the only statistically significant variable contributing to infection. Respondents aged 13-39 were 1.68 times more likely to be infected compared to their younger counterparts after controlling for all other covariates in the predictive model. Conclusion: Mass Drug Administration had a tremendous effect on reducing the prevalence of urinary schistosomiasis to the present level of 10.4%. However, some “hotspots” like the Nyameben community will require special attention to reduce the high prevalence disease rate. Communities with low uptake of Praziquantel had a relatively high prevalence of schistosomiasis.

scholarly journals Coverage evaluation surveys following soil-transmitted helminthiasis and schistosomiasis mass drug administration in Wolaita Zone of Ethiopia—The Geshiyaro project

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0260722
Author(s):  
Ewnetu Firdawek Liyew ◽  
Melkie Chernet ◽  
Habtamu Belay ◽  
Rosie Maddren ◽  
Toby Landeryou ◽  
...  
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
Cross Sectional Study ◽  
World Health ◽  
Size Analysis ◽  
Preventive Chemotherapy ◽  
Cross Sectional ◽  
Change Communication ◽  
Sanitation And Hygiene ◽  
Health Organization

Introduction The Geshiyaro project aims to break transmission of soil-transmitted helminths and schistosomiasis in the Wolaita Zone of Ethiopia through a combination of two interventions: behavior change communication (BCC) for increased water, sanitation and hygiene (WaSH) infrastructure use alongside preventive chemotherapy (PC) using albendazole (ALB) and praziquantel (PZQ), targeted to reach 90% treatment coverage. Coverage evaluation surveys (CES) were conducted post-treatment, and the resultant survey coverage was compared to reported administrative coverage. This provided a secondary confirmation of the Geshiyaro project coverages, and is used to monitor the success of each Mass Drug Administration (MDA) round. Methods A community-based cross-sectional study was conducted in 13 woredas (districts) of the Wolaita Zone. All eligible individuals from the selected households were invited for an interview. The study design, sample size, analysis and report writing were conducted according to the World Health Organization (WHO) CES guidelines for PC. Results The study interviewed a total of 3,568 households and 18,875 individuals across 13 woredas in the Wolaita Zone. Overall, the survey coverage across all studied woredas was 81.5% (95% CI; 80.9–82.0%) for both ALB and PZQ. Reported administrative coverage across all studied woredas was higher than survey coverage, 92.7% and 91.2% for ALB and PZQ, respectively. A significant portion of individuals (17.6%) were not offered PC. The predominant reason for not achieving the target coverage of 90% was beneficiary absenteeism during MDA (6.6% ALB, 6.8% PZQ), followed by drug distributors failing to reach all households (4.7% ALB, 4.8% PZQ), and beneficiaries not informed of the program (1.3% ALB, 1.7% PZQ). Conclusion Programmatic actions will need to be taken during the next MDA campaign to achieve the targeted Geshiyaro project coverage threshold across data collection and program engagement. Adequate training and supervision on recording and reporting administrative coverage should be provided, alongside improved social mobilization of treated communities to increase participation, and strengthened institutional partnerships and communication.

Non-compliance to Mass Drug Administration Associated with the Low Perception of the Community Members About their Susceptibility to Lymphatic Filariasis in Ankobra, Ghana

2020 ◽  
Vol 20 (2) ◽  
pp. 167-174
Author(s):  
Ilo Dicko ◽  
Yaya Ibrahim Coulibaly ◽  
Modibo Sangaré ◽  
Bismark Sarfo ◽  
Priscillia Awo Nortey
Keyword(s):  
Lymphatic Filariasis ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Health Workers ◽  
Compliance Rate ◽  
Cross Sectional Study ◽  
Cluster Sampling ◽  
Cross Sectional ◽  
Improve Compliance ◽  
Degree Of Association

Background: Lymphatic filariasis (LF) is a parasitic disease that has been targeted for elimination through the Mass Drug Administration (MDA.) Although the MDA started in the Ankobra community in Ghana in 2000, LF prevalence as reported in 2014 was relatively high (4.5%). Non-compliance to the MDA has been associated with the persistent LF prevalence in endemic regions. Objective: This study determined the factors associated with the non-compliance to the MDA among patients living in the Ankobra community, Ghana. Methods: A cross-sectional study using a one-stage cluster sampling method was used to collect data between June and July, 2017 in Ankobra. Questionnaires were used to collect data from health workers, the MDA drug distributors and study participants in Ankobra. Data analysis was performed using STATA 14. Logistic regression was used to measure the degree of association between the dependent (non-compliance) and independent variables. Non-compliance rate was defined as the percentage of individuals who self-reported that they did not actually swallow the drugs provided during the MDA. Results: The MDA coverage and non-compliance rates were 73.5% (147/200) and 33.33% (49/147) respectively. The main reason for non-compliance was fear of drug adverse events (75.51%, 37/49). Thought of “not being susceptible to LF” was significantly associated with the non-compliance (aOR= 2.83, [CI= 1.15, 6.98]). Conclusion: Health education about the susceptibility of residents getting LF disease in endemic community must be intensified to improve compliance to MDA medication ingestion and thus meet the Global Elimination of Lymphatic Filariasis by 2020.

scholarly journals Feasibility of onchocerciasis elimination using a “test-and-not-treat” strategy in Loa loa co-endemic areas

2020 ◽  
Author(s):  
David J Blok ◽  
Joseph Kamgno ◽  
Sebastien D Pion ◽  
Hugues C Nana-Djeunga ◽  
Yannick Niamsi-Emalio ◽  
...  
Keyword(s):  
Adverse Events ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Treatment Duration ◽  
Loa Loa ◽  
Serious Adverse Events ◽  
Endemic Areas ◽  
The Individual ◽  
The Impact ◽  
Main Strategy

Abstract Background Mass drug administration (MDA) with ivermectin is the main strategy for onchocerciasis elimination. Ivermectin is generally safe but associated with serious adverse events in individuals with high Loa loa microfilarial densities (MFD). Therefore, ivermectin MDA is not recommended in areas where onchocerciasis is hypo-endemic and L. loa is co-endemic. To eliminate onchocerciasis in those areas, a test-and-not-treat (TaNT) strategy has been proposed. We investigated whether onchocerciasis elimination can be achieved using TaNT and the required duration. Methods We used the individual-based model ONCHOSIM to predict the impact of TaNT on onchocerciasis microfilarial (mf) prevalence. We simulated pre-control mf prevalence levels from 2-40%. The impact of TaNT was simulated under varying levels of participation, systematic non-participation and exclusion from ivermectin due to high L. loa MFD. For each scenario, we assessed the time to elimination, defined as bringing onchocerciasis mf prevalence below 1.4%. Results In areas with 30-40% pre-control mf prevalence, the model predicted that it would take between 14 and 16 years to bring the mf prevalence below 1.4% using conventional MDA, assuming 65% participation. TaNT would increase the time to elimination by up to 1.5 years, depending on the level of systematic non-participation and the exclusion rate. At lower exclusion rates (≤2.5%), the delay would be less than six months. Conclusions Our model predicts that onchocerciasis can be eliminated using TaNT in L. loa co-endemic areas. The required treatment duration using TaNT would be only slightly longer than in areas with conventional MDA, provided that participation is good.

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