Development and evaluation of a Markov model to predict changes in schistosomiasis prevalence in response to praziquantel treatment: a case study of Schistosoma mansoni in Uganda and Mali

Deol, Arminder K.; Webster, Joanne P.; Walker, Martin; Basáñez, María‐Gloria; Hollingsworth, T. Déirdre; Fleming, Fiona; Montresor, Antonio; French, Michael

doi:10.1186/s13071-016-1824-7

Cited by 6 publications

(6 citation statements)

References 22 publications

(15 reference statements)

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“…8,9 Unfortunately, even countries that have successfully implemented the recommended preventive chemotherapy strategy for schistosomiasis and STH—i.e., repeated treatment of school-aged children at WHO-recommended ≥75% coverage—have met challenges in achieving optimal morbidity control or the more ambitious goal of transmission elimination. 8,10,11 This finding is consistent with estimates by the Global Burden of Disease (GBD) study and others that have documented how progress has lagged behind for schistosomiasis and STH relative to many other NTDs. 12 To address this challenge, in light of the past decade of data and experience from the field, we re-visit the global strategy for preventive chemotherapy and complementary interventions against schistosomiasis and STH.…”

Section: Introductionsupporting

confidence: 86%

A call to strengthen the global strategy against schistosomiasis and soil-transmitted helminthiasis: the time is now

Addiss

Hotez

et al. 2017

The Lancet Infectious Diseases

148

124

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Summary In 2001, the World Health Assembly (WHA) passed the landmark WHA 54.19 resolution for global scale up of mass administration of anthelminthic drugs for morbidity control of schistosomiasis and soil-transmitted helminthiasis (STH), which affect over 1.5 billion of the world's poorest people. Since then, over a decade of research and experience has yielded critical new knowledge on the control and elimination of these helminthiases. However, the global strategy has remained largely unchanged since the original 2001 WHA resolution and associated World Health Organization (WHO) guidelines on preventive chemotherapy. Here, we highlight recent advances that, taken together, support a call to revise the global strategy and guidelines for preventive chemotherapy and complementary interventions against schistosomiasis and STH. This includes the development of guidance that is specific to goals of “morbidity control” and “elimination of transmission.” We quantify the result of forgoing this opportunity by computing the yearly disease burden, mortality, and lost economic productivity associated with maintaining status quo. Without change, we estimate that the population of sub-Saharan Africa will likely lose 2.3 million disability-adjusted life years and US$3.5 billion of economic productivity every year, which is comparable to recent acute epidemics, including the 2014 Ebola and 2015 Zika epidemics. We propose that the time is now to strengthen the global strategy to address the substantial disease burden of schistosomiasis and STH.

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Section: Introductionsupporting

confidence: 86%

A call to strengthen the global strategy against schistosomiasis and soil-transmitted helminthiasis: the time is now

Addiss

Hotez

et al. 2017

The Lancet Infectious Diseases

148

124

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“…Data mining systems aim to extract implicit, previously unknown and potentially valuable relationships and patterns from large amounts of data to provide clear and useful information through advanced processes of selecting, exploring, and modeling [ 27 , 28 ]. Recent years have seen a rapid development of data mining technology [ 29 , 30 ].Currently, predictive models are being used in the clinical setting to improve diagnostic and prognostic accuracy and enhance clinical decision-making [ 28 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of three data mining models for prediction of advanced schistosomiasis prognosis in the Hubei province

Guo

Zhou

et al. 2018

PLoS Negl Trop Dis

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BackgroundIn order to better assist medical professionals, this study aimed to develop and compare the performance of three models—a multivariate logistic regression (LR) model, an artificial neural network (ANN) model, and a decision tree (DT) model—to predict the prognosis of patients with advanced schistosomiasis residing in the Hubei province.Methodology/Principal findingsSchistosomiasis surveillance data were collected from a previous study based on a Hubei population sample including 4136 advanced schistosomiasis cases. The predictive models use LR, ANN, and DT methods. From each of the three groups, 70% of the cases (2896 cases) were used as training data for the predictive models. The remaining 30% of the cases (1240 cases) were used as validation groups for performance comparisons between the three models. Prediction performance was evaluated using area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and accuracy. Univariate analysis indicated that 16 risk factors were significantly associated with a patient’s outcome of prognosis. In the training group, the mean AUC was 0.8276 for LR, 0.9267 for ANN, and 0.8229 for DT. In the validation group, the mean AUC was 0.8349 for LR, 0.8318 for ANN, and 0.8148 for DT. The three models yielded similar results in terms of accuracy, sensitivity, and specificity.Conclusions/SignificancePredictive models for advanced schistosomiasis prognosis, respectively using LR, ANN and DT models were proved to be effective approaches based on our dataset. The ANN model outperformed the LR and DT models in terms of AUC.

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“…Drug selection has been linked to lower effective population sizes [15] and can reduce genetic diversity of parasites in the laboratory [16]. In the field, treatment generally reduces prevalence and intensity of parasites in targeted populations and individuals [17, 18], but can also measurably reduce transmission rates across the population, influencing infections in individuals beyond the treated group [19–21]. However, treatments can also select for reduced drug efficacy and/or increase in resistance in populations [22–25].…”

Section: Introductionmentioning

confidence: 99%

Two-year longitudinal survey reveals high genetic diversity of Schistosoma mansoni with adult worms surviving praziquantel treatment at the start of mass drug administration in Uganda

et al. 2019

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BackgroundA key component of schistosomiasis control is mass drug administration with praziquantel. While control interventions have been successful in several endemic regions, mass drug administration has been less effective in others. Here we focus on the impact of repeated praziquantel treatment on the population structure and genetic diversity of Schistosoma mansoni.MethodsWe examined S. mansoni epidemiology, population genetics, and variation in praziquantel susceptibility in parasites isolated from children across three primary schools in a high endemicity region at the onset of the Ugandan National Control Programme. Children were sampled at 11 timepoints over two years, including one week and four weeks post-praziquantel treatment to evaluate short-term impacts on clearance and evidence of natural variation in susceptibility to praziquantel.ResultsPrevalence of S. mansoni was 85% at baseline. A total of 3576 miracidia larval parasites, isolated from 203 individual children, were genotyped at seven loci. Overall, genetic diversity was high and there was low genetic differentiation, indicating high rates of parasite gene flow. Schistosome siblings were found both pre-treatment and four weeks post-treatment, demonstrating adult worms surviving treatment and natural praziquantel susceptibility variation in these populations at the beginning of mass drug administration. However, we did not find evidence for selection on these parasites. While genetic diversity decreased in the short-term (four weeks post-treatment), diversity did not decrease over the entire period despite four rounds of mass treatment. Furthermore, within-host genetic diversity was affected by host age, host sex, infection intensity and recent praziquantel treatment.ConclusionsOur findings suggest that praziquantel treatments have short-term impacts on these parasite populations but impacts were transient and no long-term reduction in genetic diversity was observed. High gene flow reduces the likelihood of local adaptation, so even though parasites surviving treatment were observed, these were likely to be diluted at the beginning of the Ugandan National Control Programme. Together, these results suggest that MDA in isolation may be insufficient to reduce schistosome populations in regions with high genetic diversity and gene flow.

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Development and evaluation of a Markov model to predict changes in schistosomiasis prevalence in response to praziquantel treatment: a case study of Schistosoma mansoni in Uganda and Mali

Cited by 6 publications

References 22 publications

A call to strengthen the global strategy against schistosomiasis and soil-transmitted helminthiasis: the time is now

A call to strengthen the global strategy against schistosomiasis and soil-transmitted helminthiasis: the time is now

Comparison of three data mining models for prediction of advanced schistosomiasis prognosis in the Hubei province

Two-year longitudinal survey reveals high genetic diversity of Schistosoma mansoni with adult worms surviving praziquantel treatment at the start of mass drug administration in Uganda

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