Predicting the environmental suitability for onchocerciasis in Africa as an aid to elimination planning

Author:

Cromwell Elizabeth A.ORCID,Osborne Joshua C. P.,Unnasch Thomas R.ORCID,Basáñez Maria-GloriaORCID,Gass Katherine M.ORCID,Barbre Kira A.ORCID,Hill ElexORCID,Johnson Kimberly B.ORCID,Donkers Katie M.,Shirude Shreya,Schmidt Chris A.ORCID,Adekanmbi VictorORCID,Adetokunboh Olatunji O.ORCID,Afarideh Mohsen,Ahmadpour EhsanORCID,Ahmed Muktar BeshirORCID,Akalu Temesgen Yihunie,Al-Aly ZiyadORCID,Alanezi Fahad MashhourORCID,Alanzi Turki M.ORCID,Alipour VahidORCID,Andrei Catalina LilianaORCID,Ansari FereshtehORCID,Ansha Mustafa GeletoORCID,Anvari DavoodORCID,Appiah Seth Christopher YawORCID,Arabloo JalalORCID,Arnold Benjamin F.ORCID,Ausloos MarcelORCID,Ayanore Martin AmogreORCID,Baig Atif Amin,Banach MaciejORCID,Barac Aleksandra,Bärnighausen Till Winfried,Bayati MohsenORCID,Bhattacharyya KrittikaORCID,Bhutta Zulfiqar A.ORCID,Bibi Sadia,Bijani AliORCID,Bohlouli SomayehORCID,Bohluli MahdiORCID,Brady Oliver J.ORCID,Bragazzi Nicola LuigiORCID,Butt Zahid A.ORCID,Carvalho Felix,Chatterjee SouranshuORCID,Chattu Vijay KumarORCID,Chattu Soosanna Kumary,Cormier Natalie MariaORCID,Dahlawi Saad M. A.ORCID,Damiani GiovanniORCID,Daoud FarahORCID,Darwesh Aso MohammadORCID,Daryani AhmadORCID,Deribe KebedeORCID,Dharmaratne Samath DhammindaORCID,Diaz DanielORCID,Do Hoa Thi,El Sayed Zaki Maysaa,El Tantawi MahaORCID,Elemineh Demelash Abewa,Faraj Anwar,Fasihi Harandi MajidORCID,Fatahi YousefORCID,Feigin Valery L.ORCID,Fernandes Eduarda,Foigt Nataliya A.ORCID,Foroutan MasoudORCID,Franklin Richard CharlesORCID,Gubari Mohammed Ibrahim MohialdeenORCID,Guido Davide,Guo YumingORCID,Haj-Mirzaian Arvin,Hamagharib Abdullah KanaanORCID,Hamidi Samer,Herteliu ClaudiuORCID,Hidru Hagos Degefa de,Higazi Tarig B.,Hossain NazninORCID,Hosseinzadeh MehdiORCID,Househ Mowafa,Ilesanmi Olayinka StephenORCID,Ilic Milena D.ORCID,Ilic Irena M.ORCID,Iqbal UsmanORCID,Irvani Seyed Sina NaghibiORCID,Jha Ravi PrakashORCID,Joukar Farahnaz,Jozwiak Jacek JerzyORCID,Kabir Zubair,Kalankesh Leila R.,Kalhor RohollahORCID,Karami Matin BehzadORCID,Karimi Salah EddinORCID,Kasaeian AmirORCID,Kavetskyy Taras,Kayode Gbenga A.ORCID,Kazemi Karyani AliORCID,Kelbore Abraham GetachewORCID,Keramati Maryam,Khalilov Rovshan,Khan Ejaz AhmadORCID,Khan Md Nuruzzaman NuruzzamanORCID,Khatab KhaledORCID,Khater Mona M.ORCID,Kianipour Neda,Kibret Kelemu Tilahun,Kim Yun JinORCID,Kosen SoewartaORCID,Krohn Kris J.,Kusuma Dian,La Vecchia CarloORCID,Lansingh Van CharlesORCID,Lee Paul H.ORCID,LeGrand Kate E.ORCID,Li Shanshan,Longbottom JoshuaORCID,Magdy Abd El Razek Hassan,Magdy Abd El Razek Muhammed,Maleki AfshinORCID,Mamun Abdullah A.ORCID,Manafi Ali,Manafi NavidORCID,Mansournia Mohammad Ali,Martins-Melo Francisco RogerlândioORCID,Mazidi MohsenORCID,McAlinden ColmORCID,Meharie Birhanu GetaORCID,Mendoza Walter,Mengesha Endalkachew WorkuORCID,Mengistu Desalegn TadeseORCID,Mereta Seid Tiku,Mestrovic TomislavORCID,Miller Ted R.ORCID,Miri Mohammad,Moghadaszadeh Masoud,Mohammadian-Hafshejani Abdollah,Mohammadpourhodki RezaORCID,Mohammed ShafiuORCID,Mohammed SalahuddinORCID,Moradi Masoud,Moradzadeh Rahmatollah,Moraga PaulaORCID,Mosser Jonathan F.ORCID,Naderi MehdiORCID,Nagarajan Ahamarshan JayaramanORCID,Naik Gurudatta,Negoi IonutORCID,Nguyen Cuong Tat,Nguyen Huong Lan ThiORCID,Nguyen Trang Huyen,Nikbakhsh Rajan,Oancea BogdanORCID,Olagunju Tinuke O.ORCID,Olagunju Andrew T.ORCID,Omar Bali AhmedORCID,Onwujekwe Obinna E.ORCID,Pana AdrianORCID,Pourjafar HadiORCID,Rahim FakherORCID,Rahman Mohammad Hifz UrORCID,Rathi PriyaORCID,Rawaf SalmanORCID,Rawaf David LaithORCID,Rawassizadeh RezaORCID,Resnikoff SergeORCID,Reta Melese AbateORCID,Rezapour AzizORCID,Rubagotti EnricoORCID,Rubino Salvatore,Sadeghi EhsanORCID,Saghafipour AbedinORCID,Sajadi S. MohammadORCID,Samy Abdallah M.ORCID,Sarmiento-Suárez Rodrigo,Sawhney Monika,Schipp Megan F.ORCID,Shaheen Amira A.ORCID,Shaikh Masood Ali,Shamsizadeh MortezaORCID,Sharafi KiomarsORCID,Sheikh Aziz,Shetty B. Suresh KumarORCID,Shin Jae IlORCID,Shivakumar K. M.ORCID,Simonetti BiagioORCID,Singh Jasvinder A.ORCID,Skiadaresi Eirini,Soheili AminORCID,Soltani ShahinORCID,Spurlock Emma ElizabethORCID,Sufiyan Mu’awiyyah BabaleORCID,Tabuchi TakahiroORCID,Tapak Leili,Thompson Robert L.,Thomson Alan J.,Traini EugenioORCID,Tran Bach Xuan,Ullah Irfan,Ullah SaifORCID,Uneke Chigozie JesseORCID,Unnikrishnan BhaskaranORCID,Uthman Olalekan A.,Vinkeles Melchers Natalie V. S.ORCID,Violante Francesco S.ORCID,Wolde Haileab Fekadu,Wonde Tewodros EsheteORCID,Yamada Tomohide,Yaya SanniORCID,Yazdi-Feyzabadi VahidORCID,Yip Paul,Yonemoto NaohiroORCID,Yousof Hebat-Allah Salah A.,Yu Chuanhua,Yu Yong,Yusefzadeh Hasan,Zaki Leila,Zaman Sojib BinORCID,Zamanian MaryamORCID,Zhang Zhi-JiangORCID,Zhang Yunquan,Ziapour ArashORCID,Hay Simon I.ORCID,Pigott David M.

Abstract

Recent evidence suggests that, in some foci, elimination of onchocerciasis from Africa may be feasible with mass drug administration (MDA) of ivermectin. To achieve continental elimination of transmission, mapping surveys will need to be conducted across all implementation units (IUs) for which endemicity status is currently unknown. Using boosted regression tree models with optimised hyperparameter selection, we estimated environmental suitability for onchocerciasis at the 5 × 5-km resolution across Africa. In order to classify IUs that include locations that are environmentally suitable, we used receiver operating characteristic (ROC) analysis to identify an optimal threshold for suitability concordant with locations where onchocerciasis has been previously detected. This threshold value was then used to classify IUs (more suitable or less suitable) based on the location within the IU with the largest mean prediction. Mean estimates of environmental suitability suggest large areas across West and Central Africa, as well as focal areas of East Africa, are suitable for onchocerciasis transmission, consistent with the presence of current control and elimination of transmission efforts. The ROC analysis identified a mean environmental suitability index of 0·71 as a threshold to classify based on the location with the largest mean prediction within the IU. Of the IUs considered for mapping surveys, 50·2% exceed this threshold for suitability in at least one 5 × 5-km location. The formidable scale of data collection required to map onchocerciasis endemicity across the African continent presents an opportunity to use spatial data to identify areas likely to be suitable for onchocerciasis transmission. National onchocerciasis elimination programmes may wish to consider prioritising these IUs for mapping surveys as human resources, laboratory capacity, and programmatic schedules may constrain survey implementation, and possibly delaying MDA initiation in areas that would ultimately qualify.

Funder

Bill & Melinda Gates Foundation

UK Medical Research Council / UK Department for International Development

Publisher

Public Library of Science (PLoS)

Subject

Infectious Diseases,Public Health, Environmental and Occupational Health

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