@article{fdi:010090619,
  title = {{H}eterogeneity in elimination efforts could increase the risk of resurgence of lymphatic filariasis in {M}adagascar},
  author = {{R}ajaonarifara, {E}. and {R}oche, {B}enjamin and {C}hesnais, {C}{\'e}dric and {R}abenantoandro, {H}. and {E}vans, {M}. and {G}architorena, {A}ndres},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {P}rogress in lymphatic filariasis ({LF}) elimination is spatially heterogeneous in many endemic countries, which may lead to resurgence in areas that have achieved elimination. {U}nderstanding the drivers and consequences of such heterogeneity could help inform strategies to reach global {LF} elimination goals by 2030. {T}his study assesses whether differences in age -specific compliance with mass drug administration ({MDA}) could explain {LF} prevalence patterns in southeastern {M}adagascar and explores how spatial heterogeneity in prevalence and age -specific {MDA} compliance may affect the risk of {LF} resurgence after transmission interruption. {M}ethodology: {W}e used {LYMFASIM} model with parameters in line with the context of southeastern {M}adagascar and explored a wide range of scenarios with different {MDA} compliance for adults and children (40 - 100%) to estimate the proportion of elimination, non -elimination and resurgence events associated with each scenario. {F}inally, we evaluated the risk of resurgence associated with different levels of migration (2 - 6%) from surrounding districts combined with varying levels of {LF} microfilaria (mf) prevalence (0 - 24%) during that same study period. {R}esults: {D}ifferences in {MDA} compliance between adults and children better explained the observed heterogeneity in {LF} prevalence for these age groups than differences in exposure alone. {T}he risk of resurgence associated with differences in {MDA} compliance scenarios ranged from 0 to 19% and was highest when compliance was high for children (e.g. 90%) and low for adults (e.g. 50%). {T}he risk of resurgence associated with migration was generally higher, exceeding 60% risk for all the migration levels explored (2 - 6% per year) when mf prevalence in the source districts was between 9% and 20%. {C}onclusion: {G}aps in the implementation of {LF} elimination programme can increase the risk of resurgence and undermine elimination efforts. {I}n {M}adagascar, districts that have not attained elimination pose a significant risk for those that have achieved it. {M}ore research is needed to help guide {LF} elimination programme on the optimal strategies for surveillance and control that maximize the chances to sustain elimination and avoid resurgence.},
  keywords = {{MADAGASCAR}},
  booktitle = {},
  journal = {{I}nfection {G}enetics and {E}volution},
  volume = {120},
  numero = {},
  pages = {105589 [11 ]},
  ISSN = {1567-1348},
  year = {2024},
  DOI = {10.1016/j.meegid.2024.105589},
  URL = {https://www.documentation.ird.fr/hor/fdi:010090619},
}