An Ensemble Framework for Projecting the Impact of Lymphatic Filariasis Interventions Across Sub-Saharan Africa at a Fine Spatial Scale

Panayiota Touloupou*, Claudio Fronterre, Jorge Cano, Joaquin M Prada, Morgan Smith, Periklis Kontoroupis, Paul Brown, Rocio Caja Rivera, Sake J de Vlas, Sharmini Gunawardena, Michael A Irvine, Sammy M Njenga, Lisa Reimer, Fikre Seife, Swarnali Sharma, Edwin Michael, Wilma A Stolk, Rachel Pulan, Simon E F Spencer, T Déirdre Hollingsworth

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

57 Downloads (Pure)

Abstract

Background: Lymphatic filariasis (LF) is a neglected tropical disease targeted for elimination as a public health problem by 2030. Although mass treatments have led to huge reductions in LF prevalence, some countries or regions may find it difficult to achieve elimination by 2030 owing to various factors, including local differences in transmission. Subnational projections of intervention impact are a useful tool in understanding these dynamics, but correctly characterizing their uncertainty is challenging.

Methods: We developed a computationally feasible framework for providing subnational projections for LF across 44 sub-Saharan African countries using ensemble models, guided by historical control data, to allow assessment of the role of subnational heterogeneities in global goal achievement. Projected scenarios include ongoing annual treatment from 2018 to 2030, enhanced coverage, and biannual treatment.

Results: Our projections suggest that progress is likely to continue well. However, highly endemic locations currently deploying strategies with the lower World Health Organization recommended coverage (65%) and frequency (annual) are expected to have slow decreases in prevalence. Increasing intervention frequency or coverage can accelerate progress by up to 5 or 6 years, respectively.

Conclusions: While projections based on baseline data have limitations, our methodological advancements provide assessments of potential bottlenecks for the global goals for LF arising from subnational heterogeneities. In particular, areas with high baseline prevalence may face challenges in achieving the 2030 goals, extending the “tail” of interventions. Enhancing intervention frequency and/or coverage will accelerate progress. Our approach facilitates preimplementation assessments of the impact of local interventions and is applicable to other regions and neglected tropical diseases.
Original languageEnglish
Pages (from-to)S108–S116
Number of pages9
JournalClinical Infectious Diseases
Volume78
Issue numberSupplement_2
Early online date25 Apr 2024
DOIs
Publication statusPublished - 15 May 2024

Keywords

  • fine-scale spatial projections
  • lymphatic filariasis
  • linking maps with models
  • ensemble models
  • intervention impact

Fingerprint

Dive into the research topics of 'An Ensemble Framework for Projecting the Impact of Lymphatic Filariasis Interventions Across Sub-Saharan Africa at a Fine Spatial Scale'. Together they form a unique fingerprint.

Cite this