Geospatial modeling of pre-intervention nodule prevalence of Onchocerca volvulus in Ethiopia as an aid to onchocerciasis elimination.

<h4>Background</h4>Onchocerciasis is a neglected tropical filarial disease transmitted by the bites of blackflies, causing blindness and severe skin lesions. The change in focus for onchocerciasis management from control to elimination requires thorough mapping of pre-control endemicity...

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Main Authors: Himal Shrestha, Karen McCulloch, Shannon M Hedtke, Warwick N Grant
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2022-07-01
Series:PLoS Neglected Tropical Diseases
Online Access:https://doi.org/10.1371/journal.pntd.0010620
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author Himal Shrestha
Karen McCulloch
Shannon M Hedtke
Warwick N Grant
author_facet Himal Shrestha
Karen McCulloch
Shannon M Hedtke
Warwick N Grant
author_sort Himal Shrestha
collection DOAJ
description <h4>Background</h4>Onchocerciasis is a neglected tropical filarial disease transmitted by the bites of blackflies, causing blindness and severe skin lesions. The change in focus for onchocerciasis management from control to elimination requires thorough mapping of pre-control endemicity to identify areas requiring interventions and to monitor progress. Onchocerca volvulus nodule prevalence in sub-Saharan Africa is spatially continuous and heterogeneous, and highly endemic areas may contribute to transmission in areas of low endemicity or vice-versa. Ethiopia is one such onchocerciasis-endemic country with heterogeneous O. volvulus nodule prevalence, and many districts are still unmapped despite their potential for onchocerciasis transmission.<h4>Methodology/principle findings</h4>A Bayesian geostatistical model was fitted for retrospective pre-intervention nodule prevalence data collected from 916 unique sites and 35,077 people across Ethiopia. We used multiple environmental, socio-demographic, and climate variables to estimate the pre-intervention prevalence of O. volvulus nodules across Ethiopia and to explore their relationship with prevalence. Prevalence was high in southern and northwestern Ethiopia and low in Ethiopia's central and eastern parts. Distance to the nearest river (RR: 0.9850, 95% BCI: 0.9751-0.995), precipitation seasonality (RR: 0.9837, 95% BCI: 0.9681-0.9995), and flow accumulation (RR: 0.9586, 95% BCI: 0.9321-0.9816) were negatively associated with O. volvulus nodule prevalence, while soil moisture (RR: 1.0218, 95% BCI: 1.0135-1.0302) was positively associated. The model estimated the number of pre-intervention cases of O. volvulus nodules in Ethiopia to be around 6.48 million (95% BCI: 3.53-13.04 million).<h4>Conclusions/significance</h4>Nodule prevalence distribution was correlated with habitat suitability for vector breeding and associated biting behavior. The modeled pre-intervention prevalence can be used as a guide for determining priorities for elimination mapping in regions of Ethiopia that are currently unmapped, most of which have comparatively low infection prevalence.
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spelling doaj.art-cb6c39bb605044adbecc3722180de71e2022-12-22T03:06:49ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352022-07-01167e001062010.1371/journal.pntd.0010620Geospatial modeling of pre-intervention nodule prevalence of Onchocerca volvulus in Ethiopia as an aid to onchocerciasis elimination.Himal ShresthaKaren McCullochShannon M HedtkeWarwick N Grant<h4>Background</h4>Onchocerciasis is a neglected tropical filarial disease transmitted by the bites of blackflies, causing blindness and severe skin lesions. The change in focus for onchocerciasis management from control to elimination requires thorough mapping of pre-control endemicity to identify areas requiring interventions and to monitor progress. Onchocerca volvulus nodule prevalence in sub-Saharan Africa is spatially continuous and heterogeneous, and highly endemic areas may contribute to transmission in areas of low endemicity or vice-versa. Ethiopia is one such onchocerciasis-endemic country with heterogeneous O. volvulus nodule prevalence, and many districts are still unmapped despite their potential for onchocerciasis transmission.<h4>Methodology/principle findings</h4>A Bayesian geostatistical model was fitted for retrospective pre-intervention nodule prevalence data collected from 916 unique sites and 35,077 people across Ethiopia. We used multiple environmental, socio-demographic, and climate variables to estimate the pre-intervention prevalence of O. volvulus nodules across Ethiopia and to explore their relationship with prevalence. Prevalence was high in southern and northwestern Ethiopia and low in Ethiopia's central and eastern parts. Distance to the nearest river (RR: 0.9850, 95% BCI: 0.9751-0.995), precipitation seasonality (RR: 0.9837, 95% BCI: 0.9681-0.9995), and flow accumulation (RR: 0.9586, 95% BCI: 0.9321-0.9816) were negatively associated with O. volvulus nodule prevalence, while soil moisture (RR: 1.0218, 95% BCI: 1.0135-1.0302) was positively associated. The model estimated the number of pre-intervention cases of O. volvulus nodules in Ethiopia to be around 6.48 million (95% BCI: 3.53-13.04 million).<h4>Conclusions/significance</h4>Nodule prevalence distribution was correlated with habitat suitability for vector breeding and associated biting behavior. The modeled pre-intervention prevalence can be used as a guide for determining priorities for elimination mapping in regions of Ethiopia that are currently unmapped, most of which have comparatively low infection prevalence.https://doi.org/10.1371/journal.pntd.0010620
spellingShingle Himal Shrestha
Karen McCulloch
Shannon M Hedtke
Warwick N Grant
Geospatial modeling of pre-intervention nodule prevalence of Onchocerca volvulus in Ethiopia as an aid to onchocerciasis elimination.
PLoS Neglected Tropical Diseases
title Geospatial modeling of pre-intervention nodule prevalence of Onchocerca volvulus in Ethiopia as an aid to onchocerciasis elimination.
title_full Geospatial modeling of pre-intervention nodule prevalence of Onchocerca volvulus in Ethiopia as an aid to onchocerciasis elimination.
title_fullStr Geospatial modeling of pre-intervention nodule prevalence of Onchocerca volvulus in Ethiopia as an aid to onchocerciasis elimination.
title_full_unstemmed Geospatial modeling of pre-intervention nodule prevalence of Onchocerca volvulus in Ethiopia as an aid to onchocerciasis elimination.
title_short Geospatial modeling of pre-intervention nodule prevalence of Onchocerca volvulus in Ethiopia as an aid to onchocerciasis elimination.
title_sort geospatial modeling of pre intervention nodule prevalence of onchocerca volvulus in ethiopia as an aid to onchocerciasis elimination
url https://doi.org/10.1371/journal.pntd.0010620
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