{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T05:11:35Z","timestamp":1793423495884,"version":"4.5.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"Supplement_3","license":[{"start":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T00:00:00Z","timestamp":1619568000000},"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":["OPP1184344"],"award-info":[{"award-number":["OPP1184344"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000265","name":"UK Medical Research Council","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000278","name":"Department for International Development, UK Government","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000278","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,6,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Due to spatial heterogeneity in onchocerciasis transmission, the duration of ivermectin mass drug administration (MDA) required for eliminating onchocerciasis will vary within endemic areas and the occurrence of transmission \u201chotspots\u201d is inevitable. The geographical scale at which stop-MDA decisions are made will be a key driver in how rapidly national programs can scale down active intervention upon achieving the epidemiological targets for elimination.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We used 2 onchocerciasis models (EPIONCHO-IBM and ONCHOSIM) to predict the likelihood of achieving elimination by 2030 in Africa, accounting for variation in preintervention endemicity levels and histories of ivermectin treatment. We explore how decision making at contrasting geographical scales (community vs larger scale \u201cproject\u201d) changes projections on populations still requiring MDA or transitioning to post-treatment surveillance.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The total population considered grows from 118 million people in 2020 to 136 million in 2030. If stop-MDA decisions are made at project level, the number of people requiring treatment declines from 69\u2013118 million in 2020 to 59\u2013118 million in 2030. If stop-MDA decisions are made at community level, the numbers decline from 23\u201381 million in 2020 to 15\u201363 million in 2030. The lower estimates in these prediction intervals are based on ONCHOSIM, the upper limits on EPIONCHO-IBM.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The geographical scale at which stop-MDA decisions are made strongly determines how rapidly national onchocerciasis programs can scale down MDA programs. Stopping in portions of project areas or transmission zones would free up human and economic resources.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciab238","type":"journal-article","created":{"date-parts":[[2021,3,22]],"date-time":"2021-03-22T20:13:01Z","timestamp":1616443981000},"page":"S165-S171","source":"Crossref","is-referenced-by-count":15,"title":["Scaling-Down Mass Ivermectin Treatment for Onchocerciasis Elimination: Modeling the Impact of the Geographical Unit for Decision Making"],"prefix":"10.1093","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9509-1328","authenticated-orcid":false,"given":"Wilma A","family":"Stolk","sequence":"first","affiliation":[{"name":"Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J","family":"Blok","sequence":"additional","affiliation":[{"name":"Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan I D","family":"Hamley","sequence":"additional","affiliation":[{"name":"London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine (St Mary\u2019s Campus), Imperial College London, London, United Kingdom"},{"name":"MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine (St Mary\u2019s Campus), Imperial College London, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul T","family":"Cantey","sequence":"additional","affiliation":[{"name":"Division of Parasitic Diseases and Malaria, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"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, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Walker","sequence":"additional","affiliation":[{"name":"London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine (St Mary\u2019s Campus), Imperial College London, London, United Kingdom"},{"name":"London Centre for Neglected Tropical Disease Research, Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, Hatfield, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda-Gloria","family":"Bas\u00e1\u00f1ez","sequence":"additional","affiliation":[{"name":"London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine (St Mary\u2019s Campus), Imperial College London, London, United Kingdom"},{"name":"MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine (St Mary\u2019s Campus), Imperial College London, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,6,14]]},"reference":[{"key":"2021070813552519200_CIT0001","first-page":"61","article-title":"The population dynamics of Onchocerca volvulus in the human host","volume":"44","author":"Duke","year":"1993","journal-title":"Trop Med Parasitol"},{"key":"2021070813552519200_CIT0002","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/0001-706X(91)90015-C","article-title":"The reproductive lifespan of Onchocerca volvulus in West African savanna","volume":"48","author":"Plaisier","year":"1991","journal-title":"Acta Trop"},{"key":"2021070813552519200_CIT0003","doi-asserted-by":"crossref","DOI":"10.1002\/9781118148594.ch11","article-title":"Onchocerciasis.","volume-title":"Water and sanitation-related diseases and the environment: challenges, interventions, and preventive measures","author":"Hopkins","year":"2011","edition":"1"},{"key":"2021070813552519200_CIT0004","first-page":"545","article-title":"World Health Organization. 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