What does the COVID-19 pandemic mean for the next decade of onchocerciasis control and elimination?

Author:

Hamley Jonathan I D12ORCID,Blok David J3,Walker Martin14,Milton Philip12,Hopkins Adrian D5,Hamill Louise C6,Downs Philip6,de Vlas Sake J3,Stolk Wilma A3,Basáñez Maria-Gloria12ORCID

Affiliation:

1. London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine (St Mary's campus), Imperial College London, Norfolk Place, London W2 1PG, UK

2. MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine (St Mary's campus), Imperial College London, Norfolk Place, London W2 1PG, UK

3. Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands

4. London Centre for Neglected Tropical Disease Research (LCNTDR), Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, Hatfield AL9  7TA, UK

5. Neglected and Disabling Diseases of Poverty Consultant, Kent, UK

6. Sightsavers, 35 Perrymount Road, Haywards Heath, RH16 3BW, UK

Abstract

Abstract Background Mass drug administration (MDA) of ivermectin for onchocerciasis has been disrupted by the coronavirus disease 2019 (COVID-19) pandemic. Mathematical modelling can help predict how missed/delayed MDA will affect short-term epidemiological trends and elimination prospects by 2030. Methods Two onchocerciasis transmission models (EPIONCHO-IBM and ONCHOSIM) are used to simulate microfilarial prevalence trends, elimination probabilities and age profiles of Onchocerca volvulus microfilarial prevalence and intensity for different treatment histories and transmission settings, assuming no interruption, a 1-y (2020) interruption or a 2-y (2020–2021) interruption. Biannual MDA or increased coverage upon MDA resumption are investigated as remedial strategies. Results Programmes with shorter MDA histories and settings with high pre-intervention endemicity will be the most affected. Biannual MDA is more effective than increasing coverage for mitigating COVID-19’s impact on MDA. Programmes that had already switched to biannual MDA should be minimally affected. In high-transmission settings with short treatment history, a 2-y interruption could lead to increased microfilarial load in children (EPIONCHO-IBM) and adults (ONCHOSIM). Conclusions Programmes with shorter (annual MDA) treatment histories should be prioritised for remedial biannual MDA. Increases in microfilarial load could have short- and long-term morbidity and mortality repercussions. These results can guide decision-making to mitigate the impact of COVID-19 on onchocerciasis elimination.

Funder

Bill and Melinda Gates Foundation

Medical Research Council

Department for International Development, UK

European Union

European and Developing Countries Clinical Trials Partnership

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Public Health, Environmental and Occupational Health,General Medicine,Parasitology

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