Modeling the effectiveness of One Health interventions against the zoonotic hookworm Ancylostoma ceylanicum

Martin Walker; Sébastien Lambert; M Inês Neves; Andrew D Worsley; Rebecca Traub; Vito Colella

doi:10.3389/fmed.2023.1092030

Modeling the effectiveness of One Health interventions against the zoonotic hookworm Ancylostoma ceylanicum

Front Med (Lausanne). 2023 Mar 7:10:1092030. doi: 10.3389/fmed.2023.1092030. eCollection 2023.

Authors

Martin Walker^{1

2}, Sébastien Lambert^{1

2

3}, M Inês Neves^{1

2}, Andrew D Worsley⁴, Rebecca Traub⁴, Vito Colella⁴

Affiliations

¹ Department of Pathobiology and Populations Sciences, Royal Veterinary College, Hatfield, United Kingdom.
² Department of Infectious Disease Epidemiology, London Centre for Neglected Tropical Disease Research, Imperial College London, London, United Kingdom.
³ IHAP, INRAE, ENVT, Université de Toulouse, Toulouse, France.
⁴ Department of Veterinary Biosciences, The University of Melbourne, Melbourne, VIC, Australia.

Abstract

Hookworm disease is a major global public health concern, annually affecting 500-700 million of the world's poorest people. The World Health Organization is targeting the elimination of hookworm as a public health problem by 2030 using a strategy of mass drug administration (MDA) to at-risk human populations. However, in Southeast Asia and the Pacific the zoonotic hookworm species, Ancylostoma ceylanicum, is endemic in dogs and commonly infects people. This presents a potential impediment to the effectiveness of MDA that targets only humans. Here, we develop a novel multi-host (dog and human) transmission model of A. ceylanicum and compare the effectiveness of human-only and "One Health" (human plus dog) MDA strategies under a range of eco-epidemiological assumptions. We show that One Health interventions-targeting both dogs and humans-could suppress prevalence in humans to ≤ 1% by the end of 2030, even with only modest coverage (25-50%) of the animal reservoir. With increasing coverage, One Health interventions may even interrupt transmission. We discuss key unresolved questions on the eco-epidemiology of A. ceylanicum, the challenges of delivering MDA to animal reservoirs, and the growing importance of One Health interventions to human public health.

Keywords: Ancylostoma ceylanicum; One Health; effectiveness; elimination; hookworm; intervention; modeling; zoonosis.