Elimination and Eradication of Neglected Tropical Diseases with Mass Drug Administrations: A Survey of Experts

Abstract

BackgroundLymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminths, and trachoma are the five most prevalent neglected tropical diseases in the world, and each is frequently treated with mass drug administrations. We performed a survey of neglected tropical diseases experts to elicit their opinions on the role of mass drug administrations for the elimination of these infections.Methodology/Principal FindingsWe sent an online survey to corresponding authors who had published an article about a neglected tropical disease from 2007 to 2011. Of 825 unique authors who were invited to complete the survey, 365 (44.2%) responded, including 234 (28.4%) who answered questions regarding one of the five most prevalent neglected tropical diseases. Respondents had varying opinions about the goals of programmatic activities for their chosen neglected tropical disease, with elimination or eradication identified as the most important goal by 87% of lymphatic filariasis respondents, 66% of onchocerciasis respondents, 55% of trachoma respondents, 24% of schistosomiasis respondents, and 21% of soil-transmitted helminth respondents. Mass drug administrations, other non-medication health measures, and education were generally thought to be more important for elimination than vector control, development of a new tool, or the presence of a secular trend. Drug resistance was thought to be a major limitation of mass drug administrations for all five neglected tropical diseases. Over half of respondents for lymphatic filariasis and trachoma thought that repeated mass drug administrations could eliminate infection within ten years of the initiation of mass treatments.Conclusions/SignificanceRespondents for lymphatic filariasis, onchocerciasis, and trachoma were more enthusiastic about the prospects of elimination and eradication than were respondents for schistosomiasis or soil-transmitted helminths. Mass drug administrations were generally believed to be among the most important factors for the success of elimination efforts for each of the five neglected tropical diseases, highlighting the opportunity for integrating drug distributions.

Roadmap to a One Health agenda 2030.

“…It is typically targeted with mass drug administration programmes, provision of safe water and sanitation, molluscicide use and education programmes to highlight risks [113]. However, recent changes in the species evolution and changing transmission ecology, including zoonotic spill overs and multi-host pathogenicity and hybridization have been demonstrated [114][115][116][117].…”

Stage-Specific Transcriptome and Proteome Analyses of the Filarial Parasite Onchocerca volvulus and Its Wolbachia Endosymbiont

“…Currently, the strategy for elimination of O. volvulus focuses on controlling transmission through ivermectin-based mass drug administration (MDA) programs that have largely eliminated onchocerciasis in the Americas (3) and that have made significant progress toward that goal in some regions of Africa (4). However, according to recent reports, onchocerciasis cannot be eliminated through MDA with ivermectin solely (5) and may require an estimated 1.30 billion ivermectin treatments until 2045 (6). In addition, ivermectin is contraindicated in areas of coendemicity with Loa loa , where the risk of severe (occasionally fatal) adverse events is associated with high levels of circulating L. loa microfilariae (mf) (7).…”

“…In addition, ivermectin is contraindicated in areas of coendemicity with Loa loa , where the risk of severe (occasionally fatal) adverse events is associated with high levels of circulating L. loa microfilariae (mf) (7). Furthermore, the potential for ivermectin resistance (8), the lack of macrofilaricidal activity by ivermectin, and the long time line (>20 years) needed for transmission interruption (5, 6) have prompted research into the development of new tools (macrofilaricidal drugs, diagnostics, and vaccines), the basis of which relies on a fundamental understanding of the parasite’s biology.…”

Editorial. Nobel Prize in Physiology or Medicine for 2015

“…It was one of the fi rst leading examples of a public -private partnership in international health. Currently, the ivermectin is used in eradication programmes coordinated by the World Health Organization for two devastating tropical diseases -Onchocerciasis and Lymphatic fi lariasis (Bockarie et al, 2013;Keenan et al, 2013). The other major contribution of Dr. Campbell to the parasitology fi eld is Trichinella and Trichinosis book (Campbell, 1983).…”