02241nas a2200313   4500000000100000008004100001260003700042653002400079653005700103653001200160100001400172700001300186700001700199700001200216700001300228700001200241700001600253700001500269700001400284700001200298700001400310700001100324245022700335856009900562300001300661490000700674520123200681022001401913       2022                            d  bPublic Library of Science (PLoS)10aInfectious Diseases10aPublic Health, Environmental and Occupational Health10aLoa loa1 aJohnson O1 aGiorgi E1 aFronterrè C1 aAmoah B1 aAtsame J1 aElla SN1 aBiamonte MA1 aOgoussan K1 aHundley L1 aGass KM1 aDiggle PJ1 aZhou X00aGeostatistical modelling enables efficient safety assessment for mass drug administration with ivermectin in Loa loa endemic areas through a combined antibody and LoaScope testing strategy for elimination of onchocerciasis  uhttps://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0010189&type=printable  ae00101890 v163 a<p>The elimination of onchocerciasis through community-based Mass Drug Administration (MDA) of ivermectin (Mectizan) is hampered by co-endemicity of Loa loa, as individuals who are highly co-infected with Loa loa parasites can suffer serious and occasionally fatal neurological reactions from the drug. The test-and-not-treat strategy of testing all individuals participating in MDA has some operational constraints including the cost and limited availability of LoaScope diagnostic tools. As a result, a Loa loa Antibody (Ab) Rapid Test was developed to offer a complementary way of determining the prevalence of loiasis. We develop a joint geostatistical modelling framework for the analysis of Ab and Loascope data to delineate whether an area is safe for MDA. Our results support the use of a two-stage strategy, in which Ab testing is used to identify areas that, with acceptably high probability, are safe or unsafe for MDA, followed by Loascope testing in areas whose safety status is uncertain. This work therefore contributes to the global effort towards the elimination of onchocerciasis as a public health problem by potentially reducing the time and cost required to establish whether an area is safe for MDA.</p>
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