Stolk Wilma A, de Vlas Sake J, Borsboom Gerard J J M, Habbema J Dik F
Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O.Box 2040, 3000 CA Rotterdam, The Netherlands.
Parasitology. 2008 Nov;135(13):1583-98. doi: 10.1017/S0031182008000437.
LYMFASIM is a simulation model for lymphatic filariasis transmission and control. We quantified its parameters to simulate Wuchereria bancrofti transmission by Anopheles mosquitoes in African villages, using a wide variety of reported data. The developed model captures the general epidemiological patterns, but also the differences between communities. It was calibrated to represent the relationship between mosquito biting rate and the prevalence of microfilariae (mf) in the human population, the age-pattern in mf prevalence, and the relation between mf prevalence and geometric mean mf intensity. Explorative simulations suggest that the impact of mass treatment depends strongly on the mosquito biting rate and on the assumed coverage, compliance and efficacy. Our sensitivity analysis showed that some biological parameters strongly influence the predicted equilibrium pre-treatment mf prevalence (e.g. the lifespan of adult worms and mf). Other parameters primarily affect the post-treatment trends (e.g. severity of density dependence in the mosquito uptake of infection from the human blood, between-person variability in exposure to mosquito bites). The longitudinal data, which are being collected for evaluation of ongoing elimination programmes, can help to further validate the model. The model can help to assess when ongoing elimination activities in African populations can be stopped and to design surveillance schemes. It can be a valuable tool for decision making in the Global Programme to Eliminate Lymphatic Filariasis.
LYMFASIM是一种用于淋巴丝虫病传播与控制的模拟模型。我们利用各种已报道的数据对其参数进行量化，以模拟非洲村庄中华按蚊传播班氏吴策线虫的情况。所开发的模型不仅捕捉到了一般的流行病学模式，还体现了不同社区之间的差异。该模型经过校准，以反映蚊虫叮咬率与人群中微丝蚴（mf）患病率之间的关系、mf患病率的年龄模式，以及mf患病率与几何平均mf强度之间的关系。探索性模拟表明，群体治疗的影响在很大程度上取决于蚊虫叮咬率以及假定的覆盖率、依从性和疗效。我们的敏感性分析表明，一些生物学参数对预测的治疗前mf患病率有强烈影响（例如成虫和mf的寿命）。其他参数主要影响治疗后的趋势（例如蚊虫从人体血液中摄取感染时密度依赖性的严重程度、人群中接触蚊虫叮咬的个体差异）。正在收集的用于评估现行消除计划的纵向数据，有助于进一步验证该模型。该模型有助于评估非洲人群中现行的消除活动何时可以停止，并有助于设计监测方案。它可以成为全球消除淋巴丝虫病计划决策中的一个有价值的工具。
