Abstract
BackgroundAmongst the world’s poorest populations, availability of anthelmintic treatments for the control of soil transmitted helminths (STH) by mass or targeted chemotherapy has increased dramatically in recent years. However, the design of community based treatment programmes to achieve the greatest impact on transmission is still open to debate. Questions include: who should be treated, how often should they be treated, how long should treatment be continued for?MethodsSimulation and analysis of a dynamic transmission model and novel data analyses suggest refinements of the World Health Organization guidelines for the community based treatment of STH.ResultsThis analysis shows that treatment levels and frequency must be much higher, and the breadth of coverage across age classes broader than is typically the current practice, if transmission is to be interrupted by mass chemotherapy alone.ConclusionsWhen planning interventions to reduce transmission, rather than purely to reduce morbidity, current school-based interventions are unlikely to be enough to achieve the desired results.
Highlights
Amongst the world’s poorest populations, availability of anthelmintic treatments for the control of soil transmitted helminths (STH) by mass or targeted chemotherapy has increased dramatically in recent years
These two states are separated by a ‘breakpoint’ in transmission close to which parasite population growth is greatly restricted and below which the population decays to extinction [17]
Using the parameter estimates for the key epidemiological and biological processes defined in the Additional file 1: Table S2, treatment outcomes are explored for a wide range of effective treatment scenarios for the three major age groupings that can be treated
Summary
Amongst the world’s poorest populations, availability of anthelmintic treatments for the control of soil transmitted helminths (STH) by mass or targeted chemotherapy has increased dramatically in recent years. Amongst the world’s poorest populations, funding for the control of soil transmitted helminths (STH) by mass or targeted chemotherapy has increased steadily in the past 10 years due to generous donations from international aid agencies in the richer countries, philanthropic organisations and pharmaceutical companies [1]. About how best to deliver community based treatment programmes for STH infections to obtain the greatest impact These include the following: who should be treated, how often should they be treated, how long should treatment be continued for, can treatment intervals be increased as worm loads fall, and can transmission. We use a mathematical model to investigate the possibility of local elimination of parasites within a community by regular chemotherapeutic interventions and its dependence on the underlying strength of transmission (a) All countries (b) Africa
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