{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T04:12:29Z","timestamp":1790741549020,"version":"4.1.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2020,12,8]],"date-time":"2020-12-08T00:00:00Z","timestamp":1607385600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1033740"],"award-info":[{"award-number":["OPP1033740"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NTD Modelling Consortium","award":["OPP1184344"],"award-info":[{"award-number":["OPP1184344"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,6,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Mass drug administration (MDA) with ivermectin is the main strategy for onchocerciasis elimination. Ivermectin is generally safe, but is associated with serious adverse events in individuals with high Loa loa microfilarial densities (MFD). Therefore, ivermectin MDA is not recommended in areas where onchocerciasis is hypo-endemic and L loa is co-endemic. To eliminate onchocerciasis in those areas, a test-and-not-treat (TaNT) strategy has been proposed. We investigated whether onchocerciasis elimination can be achieved using TaNT and the required duration.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We used the individual-based model ONCHOSIM to predict the impact of TaNT on onchocerciasis microfilarial (mf) prevalence. We simulated precontrol mf prevalence levels from 2% to 40%. The impact of TaNT was simulated under varying levels of participation, systematic nonparticipation, and exclusion from ivermectin resulting from high L loa MFD. For each scenario, we assessed the time to elimination, defined as bringing onchocerciasis mf prevalence below 1.4%.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In areas with 30% to 40% precontrol mf prevalence, the model predicted that it would take between 14 and 16 years to bring the mf prevalence below 1.4% using conventional MDA, assuming 65% participation. TaNT would increase the time to elimination by up to 1.5 years, depending on the level of systematic nonparticipation and the exclusion rate. At lower exclusion rates (\u22642.5%), the delay would be less than 6 months.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our model predicts that onchocerciasis can be eliminated using TaNT in L loa co-endemic areas. The required treatment duration using TaNT would be only slightly longer than in areas with conventional MDA, provided that participation is good.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciaa1829","type":"journal-article","created":{"date-parts":[[2020,12,8]],"date-time":"2020-12-08T03:20:15Z","timestamp":1607397615000},"page":"e1047-e1055","source":"Crossref","is-referenced-by-count":15,"title":["Feasibility of Onchocerciasis Elimination Using a \u201cTest-and-not-treat\u201d Strategy in <i>Loa loa<\/i> Co-endemic Areas"],"prefix":"10.1093","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8919-1063","authenticated-orcid":false,"given":"David J","family":"Blok","sequence":"first","affiliation":[{"name":"Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Kamgno","sequence":"additional","affiliation":[{"name":"Centre for Research on Filariasis and other Tropical Diseases (CRFilMT), Yaound\u00e9, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastien D","family":"Pion","sequence":"additional","affiliation":[{"name":"IRD UMI 233-INSERM U1175-Montpellier University, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugues C","family":"Nana-Djeunga","sequence":"additional","affiliation":[{"name":"Centre for Research on Filariasis and other Tropical Diseases (CRFilMT), Yaound\u00e9, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yannick","family":"Niamsi-Emalio","sequence":"additional","affiliation":[{"name":"Centre for Research on Filariasis and other Tropical Diseases (CRFilMT), Yaound\u00e9, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cedric B","family":"Chesnais","sequence":"additional","affiliation":[{"name":"IRD UMI 233-INSERM U1175-Montpellier University, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles D","family":"Mackenzie","sequence":"additional","affiliation":[{"name":"Task force for Global Health, Decatur, Georgia, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy D","family":"Klion","sequence":"additional","affiliation":[{"name":"Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel A","family":"Fletcher","sequence":"additional","affiliation":[{"name":"Department of Bioengineering and the Biophysics Program, University of California, Berkeley, California, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas B","family":"Nutman","sequence":"additional","affiliation":[{"name":"Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sake J","family":"de Vlas","sequence":"additional","affiliation":[{"name":"Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Boussinesq","sequence":"additional","affiliation":[{"name":"IRD UMI 233-INSERM U1175-Montpellier University, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilma A","family":"Stolk","sequence":"additional","affiliation":[{"name":"Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,12,8]]},"reference":[{"key":"2021061513444591600_CIT0001","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/S0140-6736(96)11094-1","article-title":"Serious reactions after mass treatment 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