Abstract
BackgroundThe pork tapeworm, Taenia solium, is a serious public health problem in rural low-resource areas of Latin America, Africa and Asia, where the associated conditions of nuerocysticercosis (NCC) and porcine cysticercosis cause substantial health and economic harms. An accurate and validated transmission model for T. solium would serve as an important new tool for control and elimination, as it would allow for comparison of available intervention strategies, and prioritization of the most effective strategies for control and elimination efforts.MethodsWe developed a spatially-explicit agent-based model (ABM) for T. solium (“CystiAgent”) that differs from prior T. solium models by including a spatial framework and behavioral parameters such as pig roaming, open human defecation, and human travel. In this article, we introduce the structure and function of the model, describe the data sources used to parameterize the model, and apply sensitivity analyses (Latin hypercube sampling-partial rank correlation coefficient (LHS-PRCC)) to evaluate model parameters.ResultsLHS-PRCC analysis of CystiAgent found that the parameters with the greatest impact on model uncertainty were the roaming range of pigs, the infectious duration of human taeniasis, use of latrines, and the set of “tuning” parameters defining the probabilities of infection in humans and pigs given exposure to T. solium.ConclusionsCystiAgent is a novel ABM that has the ability to model spatial and behavioral features of T. solium transmission not available in other models. There is a small set of impactful model parameters that contribute uncertainty to the model and may impact the accuracy of model projections. Field and laboratory studies to better understand these key components of transmission may help reduce uncertainty, while current applications of CystiAgent may consider calibration of these parameters to improve model performance. These results will ultimately allow for improved interpretation of model validation results, and usage of the model to compare available control and elimination strategies for T. solium.
Highlights
The pork tapeworm, Taenia solium, is a serious public health problem in rural low-resource areas of Latin America, Africa and Asia, where the associated conditions of nuerocysticercosis (NCC) and porcine cysticercosis cause substantial health and economic harms
This was consistent with the target prevalence of 23.2%, which was estimated from the baseline data for the test village in the Ring Strategy Trial
When the ring treatment intervention and mass treatment interventions were applied to the simulation village, each demonstrated a significant reduction in the prevalence of human taeniasis and porcine cysticercosis
Summary
The pork tapeworm, Taenia solium, is a serious public health problem in rural low-resource areas of Latin America, Africa and Asia, where the associated conditions of nuerocysticercosis (NCC) and porcine cysticercosis cause substantial health and economic harms. Control and elimination of T. solium transmission in endemic areas is known to be achievable [4, 5] through strategic application of available drugs to treat human taeniasis [6, 7] and porcine cysticercosis [8], and a vaccine to prevent infection in pigs [5, 9]. Despite these effective tools, there remains limited evidence on which to base decisions about which interventions or strategic combinations of interventions are most likely to be successful in different endemic regions. In 2012, WHO called for T. solium models to be deployed to identify a set of validated strategies that could be implemented in several countries by 2020 [10], and recently, the 2030 goals reinforced modeling as a priority for T. solium control and elimination [11]
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