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

Author

Cromwell E.A., Osborne J.C.P., Unnasch T.R., Basanez M., Gass K.M., Barbre K.A., Hill E., Johnson K.B., Donkers K.M., Shirude S., Schmidt C.A., Adekanmbi V., Adetokunboh O.O., Afarideh M., Ahmadpour E., Beshir Ahmed M., Yihunie Akalu T., Al-Aly Z., Alanezi F.M., Alanzi T.M., Alipour V., Andrei C.L., Ansari F., Ansha M.G., Anvari D., Yaw Appiah S.C., Arabloo J., Arnold B.F., Ausloos M., Ayanore M.A., Amin Baig A., Banach M., Barac A., Barnighausen T.W., Bayati M., Bhattacharyya K., Bhutta Z.A., Bibi S., Bijani A., Bohlouli S., Bohluli M., Brady O.J., Bragazzi N.L., Butt Z.A., Carvalho F., Chatterjee S., Chattu V.K., Chattu S.K., Cormier N.M., Dahlawi S.M.A., Damiani G., Daoud F., Darwesh A.M., Daryani A., Deribe K., Dharmaratne S.D., Diaz D., Do H.T., El Sayed Zak M., El Tantawi M., Elemineh D.A., Faraj A., Harandi M.F., Fatahi Y., Feigin V.L., Fernandes E., Foigt N.A., Foroutan M., Franklin R.C., Mohialdeen Gubari M.I., Guido D., Guo Y., Haj-Mirzaian A., Abdullah K.H., Hamidi S., Herteliu C., De Hidru H.D., Higazi T.B., Hossain N., Hosseinzadeh M., Househ M., Ilesanmi O.S., Ilic M.D., Ilic I.M., Iqbal U., Naghibi Irvani S.S., Jha R.P., Joukar F., Jozwiak J.J., Kabir Z., Kalankesh L.R., Kalhor R., Matin B.K., Karimi S.E., Kasaeian A., Kavetskyy T., Kayode G.A., Karyani A.K., Kelbore A.G., Keramati M., Khalilov R., Khan E.A., Nuruzzaman Khan M.N., Khatab K., Khater M.M., Kianipour N., Kibret K.T., Kim Y.J., Kosen S., Krohn K.J., Kusuma D., Vecchia C.L., Lansingh V.C., Lee P.H., Legrand K.E., Li S., Longbottom J., Abd El Razek H.M., Abd El Razek M.M., Maleki A., Mamun A.A., Manafi A., Manafi N., Mansournia M.A., Martins-Melo F.R., Mazidi M., McAlinden C., Meharie B.G., Mendoza W., Mengesha E.W., Mengistu D.T., Mereta S.T., Mestrovic T., Miller T.R., Miri M., Moghadaszadeh M., Hafshejani A.M., Mohammadpourhodki R., Mohammed S., Moradi M., Moradzadeh R., Moraga P., Mosser J.F., Naderi M., Nagarajan A.J., Naik G., Negoi I., Nguyen C.T., Nguyen H.L.T., Nguyen T.H., Nikbakhsh R., Oancea B., Olagunju T.O., Olagunju A.T., Bali A.O., Onwujekwe O.E., Pana A., Pourjafar H., Rahim F., Ur Rahman M.H., Rathi P., Rawaf S., Rawaf D.L., Rawassizadeh R., Resnikoff S., Reta M.A., Rezapour A., Rubagotti E., Rubino S., Sadeghi E., Saghafipour A., Sajadi S.M., Samy A.M., Sarmiento-Suarez R., Sawhney M., Schipp M.F., Shaheen A.A., Shaikh M.A., Shamsizadeh M., Sharafi K., Sheikh A., Kumar Shetty B.S., Shin J.I., Shivakumar K.M., Simonetti B., Singh J.A., Skiadaresi E., Soheili A., Soltani S., Spurlock E.E., Sufiyan M.B., Tabuchi T., Tapak L., Thompson R.L., Thomson A.J., Traini E., Tran B.X., Ullah I., Ullah S., Uneke C.J., Unnikrishnan B., Uthman O.A., Melchers N.V.S.V., Violante F.S., Wolde H.F., Wonde T.E., Yamada T., Yaya S., Yazdi Feyzabadi V., Yip P., Yonemoto N., Yousof H.-A.S.A., Yu C., Yu Y., Yusefzadeh H., Zaki L., Zaman S.B., Zamanian M., Zhang Z.-J., Zhang Y., Ziapour A., Hay S.I., Pigott D.M., Cromwell E.A., Osborne J.C.P., Unnasch T.R., Basanez M., Gass K.M., Barbre K.A., Hill E., Johnson K.B., Donkers K.M., Shirude S., Schmidt C.A., Adekanmbi V., Adetokunboh O.O., Afarideh M., Ahmadpour E., Beshir Ahmed M., Yihunie Akalu T., Al-Aly Z., Alanezi F.M., Alanzi T.M., Alipour V., Andrei C.L., Ansari F., Ansha M.G., Anvari D., Yaw Appiah S.C., Arabloo J., Arnold B.F., Ausloos M., Ayanore M.A., Amin Baig A., Banach M., Barac A., Barnighausen T.W., Bayati M., Bhattacharyya K., Bhutta Z.A., Bibi S., Bijani A., Bohlouli S., Bohluli M., Brady O.J., Bragazzi N.L., Butt Z.A., Carvalho F., Chatterjee S., Chattu V.K., Chattu S.K., Cormier N.M., Dahlawi S.M.A., Damiani G., Daoud F., Darwesh A.M., Daryani A., Deribe K., Dharmaratne S.D., Diaz D., Do H.T., El Sayed Zak M., El Tantawi M., Elemineh D.A., Faraj A., Harandi M.F., Fatahi Y., Feigin V.L., Fernandes E., Foigt N.A., Foroutan M., Franklin R.C., Mohialdeen Gubari M.I., Guido D., Guo Y., Haj-Mirzaian A., Abdullah K.H., Hamidi S., Herteliu C., De Hidru H.D., Higazi T.B., Hossain N., Hosseinzadeh M., Househ M., Ilesanmi O.S., Ilic M.D., Ilic I.M., Iqbal U., Naghibi Irvani S.S., Jha R.P., Joukar F., Jozwiak J.J., Kabir Z., Kalankesh L.R., Kalhor R., Matin B.K., Karimi S.E., Kasaeian A., Kavetskyy T., Kayode G.A., Karyani A.K., Kelbore A.G., Keramati M., Khalilov R., Khan E.A., Nuruzzaman Khan M.N., Khatab K., Khater M.M., Kianipour N., Kibret K.T., Kim Y.J., Kosen S., Krohn K.J., Kusuma D., Vecchia C.L., Lansingh V.C., Lee P.H., Legrand K.E., Li S., Longbottom J., Abd El Razek H.M., Abd El Razek M.M., Maleki A., Mamun A.A., Manafi A., Manafi N., Mansournia M.A., Martins-Melo F.R., Mazidi M., McAlinden C., Meharie B.G., Mendoza W., Mengesha E.W., Mengistu D.T., Mereta S.T., Mestrovic T., Miller T.R., Miri M., Moghadaszadeh M., Hafshejani A.M., Mohammadpourhodki R., Mohammed S., Moradi M., Moradzadeh R., Moraga P., Mosser J.F., Naderi M., Nagarajan A.J., Naik G., Negoi I., Nguyen C.T., Nguyen H.L.T., Nguyen T.H., Nikbakhsh R., Oancea B., Olagunju T.O., Olagunju A.T., Bali A.O., Onwujekwe O.E., Pana A., Pourjafar H., Rahim F., Ur Rahman M.H., Rathi P., Rawaf S., Rawaf D.L., Rawassizadeh R., Resnikoff S., Reta M.A., Rezapour A., Rubagotti E., Rubino S., Sadeghi E., Saghafipour A., Sajadi S.M., Samy A.M., Sarmiento-Suarez R., Sawhney M., Schipp M.F., Shaheen A.A., Shaikh M.A., Shamsizadeh M., Sharafi K., Sheikh A., Kumar Shetty B.S., Shin J.I., Shivakumar K.M., Simonetti B., Singh J.A., Skiadaresi E., Soheili A., Soltani S., Spurlock E.E., Sufiyan M.B., Tabuchi T., Tapak L., Thompson R.L., Thomson A.J., Traini E., Tran B.X., Ullah I., Ullah S., Uneke C.J., Unnikrishnan B., Uthman O.A., Melchers N.V.S.V., Violante F.S., Wolde H.F., Wonde T.E., Yamada T., Yaya S., Yazdi Feyzabadi V., Yip P., Yonemoto N., Yousof H.-A.S.A., Yu C., Yu Y., Yusefzadeh H., Zaki L., Zaman S.B., Zamanian M., Zhang Z.-J., Zhang Y., Ziapour A., Hay S.I., and Pigott D.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 x 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 5x5-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 ult

Published
2021

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

Author

Fereshteh Ansari, Richard C. Franklin, Naznin Hossain, Rodrigo Sarmiento-Suárez, Mahdi Bohluli, Irena Ilic, Anwar Faraj, Soosanna Kumary Chattu, Sanni Yaya, Hagos Degefa Hidru, Morteza Shamsizadeh, Ehsan Sadeghi, Bach Xuan Tran, Leila Zaki, Mohammad Miri, Maha El Tantawi, Maciej Banach, Hasan Yusefzadeh, Kira A Barbre, Chigozie Jesse Uneke, Mehdi Naderi, Behzad Karami Matin, Yunquan Zhang, Vahid Yazdi-Feyzabadi, Emma Elizabeth Spurlock, Zahid A Butt, Nuruzzaman Khan, Robert L. Thompson, Mehdi Hosseinzadeh, Rovshan Khalilov, Usman Iqbal, K M Shivakumar, Leili Tapak, Chris A Schmidt, Priya Rathi, Shanshan Li, Bhaskaran Unnikrishnan, Chuanhua Yu, Elizabeth A. Cromwell, Davood Anvari, Hoa Thi Do, Abdullah Al Mamun, Obinna Onwujekwe, Serge Resnikoff, Majid Fasihi Harandi, Joshua C. P. Osborne, Farahnaz Joukar, Aso Mohammad Darwesh, Rohollah Kalhor, Turki Alanzi, Katie M Donkers, Amir Kasaeian, Eirini Skiadaresi, Aleksandra Barac, Simon I. Hay, Paul S. F. Yip, Tomislav Mestrovic, Zhi-Jiang Zhang, Katherine Gass, Cuong Tat Nguyen, Gurudatta Naik, Joshua Longbottom, Somayeh Bohlouli, Aziz Rezapour, Huong Lan Thi Nguyen, Khaled Khatab, Mohammed Ibrahim Mohialdeen Gubari, Ahmed Omar Bali, Temesgen Yihunie Akalu, Paul H. Lee, Vahid Alipour, Kebede Deribe, Megan F. Schipp, Ziyad Al-Aly, Biagio Simonetti, Masoud Moradi, Jalal Arabloo, Reza Rawassizadeh, Saif Ullah, Seth Christopher Yaw Appiah, Demelash Abewa Elemineh, Abedin Saghafipour, Fakher Rahim, Tinuke O Olagunju, Kimberly B. Johnson, Souranshu Chatterjee, Salvatore Rubino, Nataliya Foigt, Olayinka Stephen Ilesanmi, Taras Kavetskyy, Carlo La Vecchia, Eduarda Fernandes, Mohsen Mazidi, Claudiu Herteliu, Sojib Bin Zaman, Aziz Sheikh, Yong Yu, David Laith Rawaf, Hassan Magdy Abd El Razek, Natalie V S Vinkeles Melchers, Samath D Dharmaratne, Enrico Rubagotti, Fahad Alanezi, Masood Ali Shaikh, Masoud Foroutan, B. Suresh Kumar Shetty, Milena Ilic, Melese Abate Reta, Dian Kusuma, Ali Manafi, Krittika Bhattacharyya, Giovanni Damiani, Kanaan Hamagharib Abdullah, Desalegn Tadese Mengistu, Van C. Lansingh, Till Bärnighausen, Benjamin F. Arnold, Natalie Maria Cormier, Zulfiqar A Bhutta, Ahmad Daryani, Ali Bijani, Jae Il Shin, Samer Hamidi, Jasvinder A. Singh, Mohsen Bayati, Tomohide Yamada, Zubair Kabir, Muhammed Magdy Abd El Razek, Jonathan F. Mosser, Gbenga A. Kayode, Martin Amogre Ayanore, Shahin Soltani, Arvin Haj-Mirzaian, Mohammad Ali Mansournia, Salah Eddin Karimi, Alan J Thomson, Daniel Diaz, Ahamarshan Jayaraman Nagarajan, Adrian Pana, Salman Rawaf, Oliver J. Brady, Birhanu Geta Meharie, Yousef Fatahi, Sadia Bibi, Bogdan Oancea, Masoud Moghadaszadeh, Kelemu Tilahun Kibret, Valery L. Feigin, Saad M.A. Dahlawi, Ted R. Miller, Nicola Luigi Bragazzi, Atif Amin Baig, Maryam Zamanian, Kate E. LeGrand, Salahuddin Mohammed, Yuming Guo, Irfan Ullah, Hebat Allah Salah A. Yousof, Mowafa Househ, Ionut Negoi, Naohiro Yonemoto, Reza Mohammadpourhodki, Hadi Pourjafar, Navid Manafi, Neda Kianipour, Abraham Getachew Kelbore, Victor Adekanmbi, Seid Tiku Mereta, Olalekan A. Uthman, Arash Ziapour, Olatunji O. Adetokunboh, Trang Huyen Nguyen, Seyed Sina Naghibi Irvani, Francesco Saverio Violante, Monika Sawhney, Paula Moraga, Rahmatollah Moradzadeh, Mu'awiyyah Babale Sufiyan, Mohammad Hifz Ur Rahman, María-Gloria Basáñez, Vijay Kumar Chattu, Mustafa Geleto Ansha, Mona M. Khater, Andrew T Olagunju, Ejaz Ahmad Khan, Davide Guido, Kiomars Sharafi, S. Mohammad Sajadi, Francisco Rogerlândio Martins-Melo, Tarig B. Higazi, Afshin Maleki, Abdollah Mohammadian-Hafshejani, Soewarta Kosen, Amin Soheili, Félix Carvalho, Yun Jin Kim, Catalina Liliana Andrei, Ali Kazemi Karyani, Ehsan Ahmadpour, Thomas R. Unnasch, Mohsen Afarideh, Takahiro Tabuchi, Shreya Shirude, Marcel Ausloos, Maysaa El Sayed Zaki, Haileab Fekadu Wolde, Amira Shaheen, Shafiu Mohammed, Rajan Nikbakhsh, Tewodros Eshete Wonde, Endalkachew Worku Mengesha, Jacek Jerzy Jozwiak, Muktar Beshir Ahmed, Eugenio Traini, Leila R Kalankesh, Kris J. Krohn, Colm McAlinden, Walter Mendoza, Maryam Keramati, Ravi Prakash Jha, David M. Pigott, Elex Hill, Abdallah M. Samy, Farah Daoud, Wanji, Samuel, Public Health, Bill & Melinda Gates Foundation, Medical Research Council (Reino Unido), Department for International Development (Reino Unido), Unión Europea, Cromwell E.A., Osborne J.C.P., Unnasch T.R., Basanez M., Gass K.M., Barbre K.A., Hill E., Johnson K.B., Donkers K.M., Shirude S., Schmidt C.A., Adekanmbi V., Adetokunboh O.O., Afarideh M., Ahmadpour E., Beshir Ahmed M., Yihunie Akalu T., Al-Aly Z., Alanezi F.M., Alanzi T.M., Alipour V., Andrei C.L., Ansari F., Ansha M.G., Anvari D., Yaw Appiah S.C., Arabloo J., Arnold B.F., Ausloos M., Ayanore M.A., Amin Baig A., Banach M., Barac A., Barnighausen T.W., Bayati M., Bhattacharyya K., Bhutta Z.A., Bibi S., Bijani A., Bohlouli S., Bohluli M., Brady O.J., Bragazzi N.L., Butt Z.A., Carvalho F., Chatterjee S., Chattu V.K., Chattu S.K., Cormier N.M., Dahlawi S.M.A., Damiani G., Daoud F., Darwesh A.M., Daryani A., Deribe K., Dharmaratne S.D., Diaz D., Do H.T., El Sayed Zak M., El Tantawi M., Elemineh D.A., Faraj A., Harandi M.F., Fatahi Y., Feigin V.L., Fernandes E., Foigt N.A., Foroutan M., Franklin R.C., Mohialdeen Gubari M.I., Guido D., Guo Y., Haj-Mirzaian A., Abdullah K.H., Hamidi S., Herteliu C., De Hidru H.D., Higazi T.B., Hossain N., Hosseinzadeh M., Househ M., Ilesanmi O.S., Ilic M.D., Ilic I.M., Iqbal U., Naghibi Irvani S.S., Jha R.P., Joukar F., Jozwiak J.J., Kabir Z., Kalankesh L.R., Kalhor R., Matin B.K., Karimi S.E., Kasaeian A., Kavetskyy T., Kayode G.A., Karyani A.K., Kelbore A.G., Keramati M., Khalilov R., Khan E.A., Nuruzzaman Khan M.N., Khatab K., Khater M.M., Kianipour N., Kibret K.T., Kim Y.J., Kosen S., Krohn K.J., Kusuma D., Vecchia C.L., Lansingh Van C., Lee P.H., Legrand K.E., Li S., Longbottom J., Abd El Razek H.M., Abd El Razek M.M., Maleki A., Mamun A.A., Manafi A., Manafi N., Mansournia M.A., Martins-Melo F.R., Mazidi M., McAlinden C., Meharie B.G., Mendoza W., Mengesha E.W., Mengistu D.T., Mereta S.T., Mestrovic T., Miller T.R., Miri M., Moghadaszadeh M., Hafshejani A.M., Mohammadpourhodki R., Mohammed S., Moradi M., Moradzadeh R., Moraga P., Mosser J.F., Naderi M., Nagarajan A.J., Naik G., Negoi I., Nguyen C.T., Nguyen H.L.T., Nguyen T.H., Nikbakhsh R., Oancea B., Olagunju T.O., Olagunju A.T., Bali A.O., Onwujekwe O.E., Pana A., Pourjafar H., Rahim F., Ur Rahman M.H., Rathi P., Rawaf S., Rawaf D.L., Rawassizadeh R., Resnikoff S., Reta M.A., Rezapour A., Rubagotti E., Rubino S., Sadeghi E., Saghafipour A., Sajadi S.M., Samy A.M., Sarmiento-Suarez R., Sawhney M., Schipp M.F., Shaheen A.A., Shaikh M.A., Shamsizadeh M., Sharafi K., Sheikh A., Kumar Shetty B.S., Shin J.I., Shivakumar K.M., Simonetti B., Singh J.A., Skiadaresi E., Soheili A., Soltani S., Spurlock E.E., Sufiyan M.B., Tabuchi T., Tapak L., Thompson R.L., Thomson A.J., Traini E., Tran B.X., Ullah I., Ullah S., Uneke C.J., Unnikrishnan B., Uthman O.A., Melchers N.V.S.V., Violante F.S., Wolde H.F., Wonde T.E., Yamada T., Yaya S., Yazdi Feyzabadi V., Yip P., Yonemoto N., Yousof H.-A.S.A., Yu C., Yu Y., Yusefzadeh H., Zaki L., Zaman S.B., Zamanian M., Zhang Z.-J., Zhang Y., Ziapour A., Hay S.I., Pigott D.M., and Cuidado de la Salud y Desarrollo Sostenible

Subjects
Oncocercosis, Decision Analysis, RC955-962, Onchocerciasis, law.invention, Geographical Locations, Medical Conditions, 0302 clinical medicine, law, Arctic medicine. Tropical medicine, Medicine and Health Sciences, 030212 general & internal medicine, Onchocerca, 11 Medical and Health Sciences, Data Management, biology, Pharmaceutics, wc_695, Enfermedades Parasitarias, Onchocerciasi, 3. Good health, Infectious Diseases, Geography, Transmission (mechanics), Helminth Infections, Engineering and Technology, Mass Drug Administration, Public aspects of medicine, RA1-1270, Management Engineering, Cartography, Human, Research Article, Neglected Tropical Diseases, Computer and Information Sciences, Drug Administration, 030231 tropical medicine, Decision tree, wa_395, Dermatology, wc_765, Environment, wc_885, Research and Analysis Methods, Skin Diseases, 03 medical and health sciences, Drug Therapy, SDG 3 - Good Health and Well-being, Diagnostic Medicine, Tropical Medicine, Parasitic Diseases, medicine, Humans, Disease Eradication, Spatial analysis, Ivermectin, Data collection, Receiver operating characteristic, Data Visualization, Decision Trees, Public Health, Environmental and Occupational Health, 06 Biological Sciences, Elimination planning, Africa, Implementation units, Public health, Tropical Diseases, medicine.disease, biology.organism_classification, Health Care, ROC Curve, People and Places, Health Statistics, Morbidity, Scale (map), Forecasting
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., Author summary As of 2018, it was unknown if onchocerciasis transmission occurred among approximately 2 400 implementation units (IUs; typically, second administrative-level units, such as districts) considered potentially endemic. These IUs have either never been surveyed for onchocerciasis or historical data are not sufficient to define contemporary endemicity status. Given the large number of IUs for which baseline data collection is likely required to achieve continental elimination, there is a need to prioritise areas for surveys to ensure that those suitable for endemic transmission, and therefore potentially eligible for mass drug administration, are able to initiate interventions as soon as possible. We used boosted regression trees to predict environmental suitability for onchocerciasis, with corresponding measures of uncertainty. We summarized the fine scale spatial predictions at the IU level by using receiver operating characteristic (ROC) curve analysis to identify a threshold that maximized agreement with the occurrence locations to identify IUs that may warrant prioritisation for mapping surveys. This analysis suggests that approximately half of the IUs considered for surveys could be classified as environmentally suitable for onchocerciasis. In order to develop an elimination strategy, many national onchocerciasis elimination programmes (NOEPs) need a mechanism to synthesise historical data to define priority areas for surveys.

Published
2021
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