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Am. J. Trop. Med. Hyg., 75(5), 2006, pp. 921-927
Copyright © 2006 by The American Society of Tropical Medicine and Hygiene

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MODELING TARGETED IVERMECTIN TREATMENT FOR CONTROLLING RIVER BLINDNESS

ERIC M. POOLMAN* AND ALISON P. GALVANI
Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut

There is considerable host heterogeneity in exposure to onchocerciasis. We incorporate this heterogeneity into a model of onchocerciasis transmission that we use to evaluate intervention strategies targeting specific portions of the human population for treatment with ivermectin. Our model predicts that targeted allocation of ivermectin in a highly heterogeneous population will reduce the public health burden of onchocerciasis using 20–25% of the doses of untargeted allocation. Targeted allocation therefore poses significantly lower risk of adverse effects, while potentially delaying the emergence and spread of ivermectin resistance, relative to untargeted allocation.

Received January 12, 2006. Accepted for publication May 8, 2006.

Acknowledgments: We are grateful to Michael Cappello, Thomas Nutman, Edward Kaplan, Timothy Reluga, Jan Medlock, and Howard Pearson for discussion and comments; and Robert Stephenson-Padron for editorial assistance.

Financial support: Research supported by the Wilbur Downs Fellowship, the Office of Student Research at the Yale University School of Medicine, by a MacMillan Center award, by an award from the Notsew Orm Sands Foundation, and by the National Institute on Drug Abuse Grant R01DA015612.

* Address correspondence to Eric M. Poolman, Department of Epidemiology and Public Health, Yale School of Medicine, 60 College Street, Room 147, New Haven, CT 06520-8034. E-mail: eric.poolman{at}yale.edu

Authors’ addresses: Eric M. Poolman, Department of Epidemiology and Public Health, Yale School of Medicine, 60 College Street, Room 147, New Haven, CT 06520-8034, Telephone: 203-589-8925, Fax: 203-785-3260, E-mail: eric.poolman{at}yale.edu. Alison P. Galvani, Department of Epidemiology and Public Health, Yale School of Medicine, 60 College Street, New Haven, CT 06520-8034, Telephone: 203-785-2642, Fax: 203-785-3260, E-mail: alison.galvani{at}yale.edu.

Reprint requests: Eric M. Poolman, Department of Epidemiology and Public Health, Yale School of Medicine, 60 College Street, Room 147, New Haven, CT 06520-8034.






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Copyright © 2006 by the American Society of Tropical Medicine and Hygiene.