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Predictive Value of Ov16 Antibody Prevalence in Different Subpopulations for Elimination of African Onchocerciasis.

Authors
  • Coffeng, Luc E1
  • Stolk, Wilma A1
  • Golden, Allison2
  • de Los Santos, Tala2
  • Domingo, Gonzalo J2
  • de Vlas, Sake J1
  • 1 Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands. , (Netherlands)
  • 2 PATH, Seattle, Washington.
Type
Published Article
Journal
American journal of epidemiology
Publication Date
Sep 01, 2019
Volume
188
Issue
9
Pages
1723–1732
Identifiers
DOI: 10.1093/aje/kwz109
PMID: 31062838
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The World Health Organization currently recommends assessing elimination of onchocerciasis by testing whether Ov16 antibody prevalence in children aged 0-9 years is below 0.1%. However, the certainty of evidence for this recommendation is considered to be low. We used the established ONCHOSIM model to investigate the predictive value of different Ov16-antibody prevalence thresholds in various age groups for elimination of onchocerciasis in a variety of endemic settings and for various mass drug administration scenarios. According to our simulations, the predictive value of Ov16 antibody prevalence for elimination depends highly on the precontrol epidemiologic situation, history of mass drug administration, the age group that is sampled, and the chosen Ov16-antibody prevalence threshold. The Ov16 antibody prevalence in children aged 5-14 years performs best in predicting elimination. Appropriate threshold values for this age group start at 2.0% for very highly endemic areas; for lower-endemic areas, even higher threshold values are safe to use. Guidelines can be improved by sampling school-aged children, which also is operationally more feasible than targeting children under age 10 years. The use of higher threshold values allows sampling of substantially fewer children. Further improvement can be achieved by taking a differentiated sampling approach based on precontrol endemicity. © The Author(s) 2019. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

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