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. 2015 Apr 10;9(4):e0003664.
doi: 10.1371/journal.pntd.0003664. eCollection 2015 Apr.

Control, elimination, and eradication of river blindness: scenarios, timelines, and ivermectin treatment needs in Africa

Young Eun Kim  1 , Jan H F Remme  2 , Peter Steinmann  1 , Wilma A Stolk  3 , Jean-Baptiste Roungou  4 , Fabrizio Tediosi  1
Affiliations

Control, elimination, and eradication of river blindness: scenarios, timelines, and ivermectin treatment needs in Africa

Young Eun Kim et al. PLoS Negl Trop Dis. .

Erratum in

Abstract

River blindness (onchocerciasis) causes severe itching, skin lesions, and vision impairment including blindness. More than 99% of all current cases are found in sub-Saharan Africa. Fortunately, vector control and community-directed treatment with ivermectin have significantly reduced morbidity. Studies in Mali and Senegal proved the feasibility of elimination with ivermectin administration. The treatment goal is shifting from control to elimination in endemic African regions. Given limited resources, national and global policymakers need a rigorous analysis comparing investment options. For this, we developed scenarios for alternative treatment goals and compared treatment timelines and drug needs between the scenarios. Control, elimination, and eradication scenarios were developed with reference to current standard practices, large-scale studies, and historical data. For each scenario, the timeline when treatment is expected to stop at country level was predicted using a dynamical transmission model, and ivermectin treatment needs were predicted based on population in endemic areas, treatment coverage data, and the frequency of community-directed treatment. The control scenario requires community-directed treatment with ivermectin beyond 2045 with around 2.63 billion treatments over 2013-2045; the elimination scenario, until 2028 in areas where feasible, but beyond 2045 in countries with operational challenges, around 1.48 [corrected] billion treatments; and the eradication scenario, lasting until 2040, around 1.30 billion treatments. The eradication scenario is the most favorable in terms of the timeline of the intervention phase and treatment needs. For its realization, strong health systems and political will are required to overcome epidemiological and political challenges.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Total population living in ongoing and potential new project areas in endemic African countries (numbers, % of total population in endemic regions), 2014.
Fig 2
Fig 2. Years when CDTi is expected to be stopped in endemic African regions.
Fig 3
Fig 3. One-way deterministic sensitivity analysis for the years when CDTi is expected to be stopped in endemic African regions.
CONTROL also applies to the countries with feasibility concerns in the elimination scenario. ELIMINATION excludes countries with feasibility concerns.
Fig 4
Fig 4. Cumulative number of ivermectin treatments and annual number of projects with ongoing CDTi in endemic African regions, 2013–2045.
Fig 5
Fig 5. Difference in the cumulative number of ivermectin treatments between scenarios, 2013–2045.
Fig 6
Fig 6. One-way deterministic sensitivity analysis for the cumulative number of ivermectin treatments over 2013–2045.
See this image and copyright information in PMC

References

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