Seasonally timed treatment programs for Ascaris lumbricoides to increase impact-An investigation using mathematical models

PLoS Negl Trop Dis. 2018 Jan 18;12(1):e0006195. doi: 10.1371/journal.pntd.0006195. eCollection 2018 Jan.

Abstract

There is clear empirical evidence that environmental conditions can influence Ascaris spp. free-living stage development and host reinfection, but the impact of these differences on human infections, and interventions to control them, is variable. A new model framework reflecting four key stages of the A. lumbricoides life cycle, incorporating the effects of rainfall and temperature, is used to describe the level of infection in the human population alongside the environmental egg dynamics. Using data from South Korea and Nigeria, we conclude that settings with extreme fluctuations in rainfall or temperature could exhibit strong seasonal transmission patterns that may be partially masked by the longevity of A. lumbricoides infections in hosts; we go on to demonstrate how seasonally timed mass drug administration (MDA) could impact the outcomes of control strategies. For the South Korean setting the results predict a comparative decrease of 74.5% in mean worm days (the number of days the average individual spend infected with worms across a 12 month period) between the best and worst MDA timings after four years of annual treatment. The model found no significant seasonal effect on MDA in the Nigerian setting due to a narrower annual temperature range and no rainfall dependence. Our results suggest that seasonal variation in egg survival and maturation could be exploited to maximise the impact of MDA in certain settings.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Anthelmintics / administration & dosage*
  • Ascariasis / drug therapy
  • Ascariasis / epidemiology*
  • Ascariasis / prevention & control*
  • Ascariasis / transmission
  • Ascaris lumbricoides / drug effects*
  • Chemoprevention / methods*
  • Humans
  • Mass Drug Administration / methods*
  • Models, Theoretical
  • Nigeria / epidemiology
  • Rain
  • Republic of Korea / epidemiology
  • Seasons
  • Temperature

Substances

  • Anthelmintics

Grants and funding

ELD and TDH acknowledge funding from EPSRC (https://www.epsrc.ac.uk/) Institutional Sponsorship of the University of Warwick from the Global Challenges Research Fund. ELD, JET, RMA and TDH gratefully acknowledge funding of the NTD Modelling Consortium by the Bill and Melinda Gates Foundation (www.gatesfoundation.org/) in partnership with the Task Force for Global Health. The views, opinions, assumptions or any other information set out in this article should not be attributed to Bill & Melinda Gates Foundation and The Task Force for Global Health or any person connected with them. BL is financially supported through a post-doctoral fellowship of the Research Foundation - Flanders (www.fwo.be). JV is financially supported through an International Coordination Action Plan of the Research Foundation - Flanders (www.fwo.be). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.