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Philos Trans R Soc Lond B Biol Sci. 2014 May 12;369(1645):20130435. doi: 10.1098/rstb.2013.0435. Print 2014.

The coverage and frequency of mass drug administration required to eliminate persistent transmission of soil-transmitted helminths.

Author information

1
London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, , St Marys Campus, Norfolk Place, London W2 1PG, UK.

Abstract

A combination of methods, including mathematical model construction, demographic plus epidemiological data analysis and parameter estimation, are used to examine whether mass drug administration (MDA) alone can eliminate the transmission of soil-transmitted helminths (STHs). Numerical analyses suggest that in all but low transmission settings (as defined by the magnitude of the basic reproductive number, R0), the treatment of pre-school-aged children (pre-SAC) and school-aged children (SAC) is unlikely to drive transmission to a level where the parasites cannot persist. High levels of coverage (defined as the fraction of an age group effectively treated) are required in pre-SAC, SAC and adults, if MDA is to drive the parasite below the breakpoint under which transmission is eliminated. Long-term solutions to controlling helminth infections lie in concomitantly improving the quality of the water supply, sanitation and hygiene (WASH). MDA, however, is a very cost-effective tool in long-term control given that most drugs are donated free by the pharmaceutical industry for poor regions of the world. WASH interventions, by lowering the basic reproductive number, can facilitate the ability of MDA to interrupt transmission.

KEYWORDS:

chemotherapy; elimination; modelling; school-based intervention; soil-transmitted helminths

PMID:
24821921
PMCID:
PMC4024228
DOI:
10.1098/rstb.2013.0435
[Indexed for MEDLINE]
Free PMC Article

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