@article{fdi:010082546,
  title = {{F}easibility of {O}nchocerciasis elimination using a "{T}est-and-not-treat" strategy in {L}oa loa co-endemic areas},
  author = {{B}lok, {D}. {J}. and {K}amgno, {J}. and {P}ion, {S}{\'e}bastien and {N}ana-{D}jeunga, {H}. {C}. and {N}iamsi-{E}malio, {Y}. and {C}hesnais, {C}{\'e}dric and {M}ackenzie, {C}. {D}. and {K}lion, {A}. {D}. and {F}letcher, {D}. {A}. and {N}utman, {T}. {B}. and de {V}las, {S}. {J}. and {B}oussinesq, {M}ichel and {S}tolk, {W}. {A}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground. {M}ass drug administration ({MDA}) with ivermectin is the main strategy for onchocerciasis elimination. {I}vermectin is generally safe, but is associated with serious adverse events in individuals with high {L}oa loa microfilarial densities ({MFD}). {T}herefore, ivermectin {MDA} is not recommended in areas where onchocerciasis is hypo-endemic and {L} loa is co-endemic. {T}o eliminate onchocerciasis in those areas, a test-and-not-treat ({T}a{NT}) strategy has been proposed. {W}e investigated whether onchocerciasis elimination can be achieved using {T}a{NT} and the required duration. {M}ethods. {W}e used the individual-based model {ONCHOSIM} to predict the impact of {T}a{NT} on onchocerciasis microfilarial (mf) prevalence. {W}e simulated precontrol mf prevalence levels from 2% to 40%. {T}he impact of {T}a{NT} was simulated under varying levels of participation, systematic nonparticipation, and exclusion from ivermectin resulting from high {L} loa {MFD}. {F}or each scenario, we assessed the time to elimination, defined as bringing onchocerciasis mf prevalence below 1.4%. {R}esults. {I}n 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. {T}a{NT} would increase the time to elimination by up to 1.5 years, depending on the level of systematic nonparticipation and the exclusion rate. {A}t lower exclusion rates (<= 2.5%), the delay would be less than 6 months. {C}onclusions. {O}ur model predicts that onchocerciasis can be eliminated using {T}a{NT} in {L} loa co-endemic areas. {T}he required treatment duration using {T}a{NT} would be only slightly longer than in areas with conventional {MDA}, provided that participation is good.},
  keywords = {onchocerciasis ; {L}oa loa ; point-of-care testing ; elimination ; modeling ; {CAMEROUN}},
  booktitle = {},
  journal = {{C}linical {I}nfectious {D}iseases},
  volume = {72},
  numero = {12},
  pages = {{E}1047--{E}1055},
  ISSN = {1058-4838},
  year = {2021},
  DOI = {10.1093/cid/ciaa1829},
  URL = {https://www.documentation.ird.fr/hor/fdi:010082546},
}