Potential Impact of a Diagnostic Test for Detecting Prepatent Guinea Worm Infections in Dogs

Hannah Smalley H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, Georgia;

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Pinar Keskinocak H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, Georgia;

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Julie Swann H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, Georgia;
Edward P. Fitts Department of Industrial and Systems Engineering, North Carolina State University, Raleigh, North Carolina;

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Christopher Hanna Global Project Partners, LLC, Elmhurst, Illinois;

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Adam Weiss Guinea Worm Eradication Program, The Carter Center, Atlanta, Georgia

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ABSTRACT.

Chad has seen a considerable reduction in cases of Guinea worm disease (or dracunculiasis) in domestic dogs in recent years. Tethering of dogs and application of Abate® larvicide to water sources appear to have contributed to this progress, but with 767 reported dog cases in 2021, accelerating elimination of the disease in Chad may require additional tools. We investigate the potential benefits of a hypothetical diagnostic test that could be capable of detecting prepatent infections in dogs. We adapt an agent-based simulation model for forecasting the impact of interventions on guinea worm disease in dogs to examine the interaction of multiple test factors including test accuracy, when the test can detect infection, dog selection, and dog-owner compliance with tethering recommendations. We find that a diagnostic test could be successful if used in conjunction with existing interventions, and elimination can be achieved within 2 years with 80% or higher test sensitivity, 90% or higher specificity, systematic testing of each dog twice per year, and more than 90% long-term tethering compliance when a dog tests positive or a worm is emerging. Because of the long incubation period of Guinea worm disease (10–14 months) and the fact that no treatment exists, the benefits of the test rely on the testing rollout and response of dog owners. If the test could estimate the timing of worm emergence, long-term tethering could be eliminated and infected dogs could be tethered only when the worms are expected, minimizing the related resources (human and financial) to support the intervention.

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Author Notes

Financial support: This study was supported by a grant from the Carter Center; the Global Campaign to Eradicate Dracunculiasis receives financial support from a large coalition of organizations and agencies. Please refer to https://www.cartercenter.org/donate/corporate-government-foundation-partners/index.html. This research was also supported in part by the Center for Health and Humanitarian Systems and the following Georgia Tech benefactors: William W. George, Andrea Laliberte, Joseph C. Mello, Richard “Rick” E. and Charlene Zalesky.

Authors’ addresses: Hannah Smalley and Pinar Keskinocak, H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, GA, E-mails: hannahsmalley@gatech.edu and, pinar@isye.gatech.edu. Julie Swann, H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, GA, and Edward P. Fitts Department of Industrial and Systems Engineering, North Carolina State University, Raleigh, NC, E-mail: jlswann@ncsu.edu. Christopher Hanna, Global Project Partners, LLC, Elmhurst, IL, E-mail: channa@gpppm.com. Adam Weiss, Guinea Worm Eradication Program, The Carter Center, Atlanta, GA, E-mail: adam.weiss@cartercenter.org.

Address correspondence to Pinar Keskinocak, H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, North Ave., Atlanta, GA 30318. E-mail: pinar@isye.gatech.edu
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