Sensitivity Analysis of a Transmission Interruption Model for the Soil-Transmitted Helminth Infections in Kenya

Abstract

As the world rallies toward the endgame of soil-transmitted helminths (STH) elimination by the year 2030, there is a need for efficient and robust mathematical models that would enable STH programme managers to target the scarce resources and interventions, increase treatment coverage among specific sub-groups of the population, and develop reliable surveillance systems that meet sensitivity and specificity requirements for the endgame of STH elimination. However, the considerable complexities often associated with STH-transmission models underpin the need for specifying a large number of parameters and inputs, which are often available with considerable degree of uncertainty. Additionally, the model may behave counter-intuitive especially when there are non-linearities in multiple input-output relationships. In this study, we performed a global sensitivity analysis (GSA), based on a variance decomposition method: extended Fourier Amplitude Sensitivity Test (eFAST), to a recently developed STH-transmission model in Kenya (an STH endemic country) to; (1) robustly compute sensitivity index (SI) for each parameter, (2) rank the parameters in order of their importance (from most to least influential), and (3) quantify the influence of each parameter, singly and cumulatively, on the model output. The sensitivity analysis (SA) results demonstrated that the model outcome (STH worm burden elimination in the human host) was significantly sensitive to some key parameter groupings: combined effect of improved water source and sanitation (ϕ), rounds of treatment offered (τ), efficacy of the drug used during treatment (h), proportion of the adult population treated (ga: akin to community-wide treatment), mortality rate of the mature worms in the human host (μ), and the strength of the -dependence of worm egg production (γ). For STH control programmes to effectively reach the endgame (STH elimination in the entire community), these key parameter groupings need to be targeted since together they contribute to a strategic public health intervention.

Epidemiology of soil-transmitted helminthiasis among school-aged children in pastoralist communities of Kenya: A cross-sectional study

“…These findings underscore that depending exclusively on MDA is inadequate to achieve STH elimination, given the persistently high STH burden in Narok County despite numerous MDA rounds. Studies indicate that additional approaches such as enhancing access to clean water and better sanitation practices, as well as using more effective drugs, should be implemented to attain the goal of eradicating STH [ 32 ]. It is plausible that the results can be attributed to the high likelihood of individuals being re-infected even after receiving multiple rounds of treatment and studies have emphasized the importance of implementing other approaches to complement MDA [ 33 ].…”

Inferring Parameters of Pyramidal Neuron Excitability in Mouse Models of Alzheimer’s Disease Using Biophysical Modeling and Deep Learning

“…Following Okoyo et al. ( 2022 ) and Marino et al. ( 2008 ), parameters with S T values over 0.1 (above the gray dotted line) were determined to be highly influential on the model output (Color figure online) …”