Title
Insights from quantitative and mathematical modelling on the proposed WHO 2030 goals for chagas disease [version 1; peer review: 2 approved]
Date Issued
01 November 2019
Access level
open access
Resource Type
journal article
Author(s)
Fabrizio M.d.C.
Schweigmann N.J.
Cohen J.E.
Zu Dohna H.
e Gürtler R.
Cucunubá Z.M.
Nouvellet P.
Gourbière S.
Villar J.C.
Rabinovich J.E.
Abad-Franch F.
Dobson A.P.
Basañez M.G.
University of Pennsylvania
Publisher(s)
F1000 Research Ltd
Abstract
Chagas disease (CD) persists as one of the neglected tropical diseases (NTDs) with a particularly large impact in the Americas. The World Health Organization (WHO) recently proposed goals for CD elimination as a public health problem to be reached by 2030 by means of achieving intradomiciliary transmission interruption (IDTI), blood transfusion and transplant transmission interruption, diagnostic and treatment scaling-up and prevention and control of congenital transmission. The NTD Modelling Consortium has developed mathematical models to study Trypanosoma cruzi transmission dynamics and the potential impact of control measures. Modelling insights have shown that IDTI is feasible in areas with sustained vector control programmes and no presence of native triatomine vector populations. However, IDTI in areas with native vectors it is not feasible in a sustainable manner. Combining vector control with trypanocidal treatment can reduce the timeframes necessary to reach operational thresholds for IDTI (<2% seroprevalence in children aged <5 years), but the most informative age groups for serological monitoring are yet to be identified. Measuring progress towards the 2030 goals will require availability of vector surveillance and seroprevalence data at a fine scale, and a more active surveillance system, as well as a better understanding of the risks of vector re-colonization and disease resurgence after vector control cessation. Also, achieving scaling-up in terms of access to treatment to the expected levels (75%) will require a substantial increase in screening asymptomatic populations, which is anticipated to become very costly as CD prevalence decreases. Further modelling work includes refining and extending mathematical models (including transmission dynamics and statistical frameworks) to predict transmission at a sub-national scale, and developing quantitative tools to inform IDTI certification, post-certification and re-certification protocols. Potential perverse incentives associated with operational thresholds are discussed. These modelling insights aim to inform discussions on the goals and treatment guidelines for CD.
Volume
3
Language
English
OCDE Knowledge area
Epidemiología
Salud pública, Salud ambiental
Subjects
Scopus EID
2-s2.0-85078532176
Source
Gates Open Research
ISSN of the container
25724754
Sponsor(s)
Grant information: ZMC, PN, APD and MGB acknowledge funding of the NTD Modelling Consortium by the Bill and Melinda Gates Foundation
ZMC, PN, APD and MGB acknowledge funding of the NTD Modelling Consortium by the Bill and Melinda Gates Foundation [OPP1184344]. ZMC acknowledges MRC Fellowship grant MR/R024855/1. ZMC and MGB acknowledge joint Centre funding from the UK Medical Research Council and Department for International Development [MR/R015600/1]. MZL acknowledges grants [NIH5R01AI101229-05; NIH 5R01HD075869-05; NIH 1R01AI146129-01].
[OPP1184344]. ZMC acknowledges MRC Fellowship grant MR/R024855/1. ZMC and MGB acknowledge joint Centre funding from the UK Medical Research Council and Department for International Development [MR/R015600/1]. MZL acknowledges grants [NIH 5R01AI101229-05; NIH 5R01HD075869-05; NIH 1R01AI146129-01].
Sources of information:
Directorio de Producción Científica
Scopus