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Community control of helminth infections of man by mass and selective chemotherapy

  • R. M. Anderson (a1) and G. F. Medley (a1)

The design of mass and targetted community-based chemotherapy programmes for the control of the major helminth infections of man is discussed in relation to the population and transmission dynamics of the parasites. Rapid reinfection following a single mass or targetted anthelmintic application is shown to be a universal feature of helminth transmission, as a consequence of the regulatory or feed-back mechanisms controlling population abundance within both individuals and the community as a whole. Control of reinfection requires repeated community treatment where the intensity of application and the interval between treatments are dependent on the reproductive life-expectancy of the adult worm, the net force of transmission prior to control (the basic reproductive rate) and the factors which create aggregation in the distribution of parasite loads within the population. Selective or targetted treatment is shown to be most effective for the control of morbidity as opposed to the control of transmission. The impact of targetted treatment depends critically on the factors that generate heterogeneity in parasite burdens and on whether or not selectivity is based on a single or repeated identification of the ‘wormy’ fraction of the community. Monte Carlo simulation studies are employed to assess the likely impacts of different control strategies on average parasite abundance/person and the distributions of parasite loads within populations. Future epidemiological research needs are discussed in relation to theoretical work and recent field studies of predisposition to heavy infection.

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R. M. Anderson , (1980). The dynamics and control of direct life cycle helminth parasites. Lecture Notes in Biomathematics 39, 278322.

R. M. Anderson , (1982). Population dynamics and control of hookworm and roundworm infections. In Population Dynamics of Infectious Diseases: Theory and Applications (ed. R. M. Anderson ), pp. 67108. London: Chapman and Hall.

R. M. Anderson , & D. M. Gordon , (1982). Processes influencing the distribution of parasite numbers within host populations with special emphasis on parasite-induced host mortalities. Parasitology 85, 373–98.

R. M. Anderson , & R. M. May , (1982). Population dynamics of human helminth infections: control by chemotherapy. Nature, London297, 557–63.

R. M. Anderson , & R. M. May , (1985 a). Helminth infections of humans: mathematical models. population dynamics and control. Advances in Parasitology (in the Press).

R. M. Anderson , & R. M. May , (1985 b). Herd immunity to helminth infection: implications for parasite control. Nature, London (in the Press).

R. M. Anderson , & G. A. Schad , (1985). Hookworm burdens and faecal egg counts: an analysis of the biological basis of variation. Transactions of the Royal Society of Tropical Medicine and Hygiene (in the Press).

D. J. Bradley , & F. S. McCullough , (1973). Egg output and stability and the epidemiology of Schistosoma haematobium Part II. An analysis of the epidemiology of endemic S. haematobium. Transactions of the Royal Society of Tropical Medicine and Hygiene 67, 491500.

A. E. Butterworth , M. Capron , P. R. Dalton , Q. W. Dunne , H. C. Kariuki , D. Koech , M. Mugambi , J. H. Ouma , M. A. Prentice , B. A. Richardson , T. K. Arap Siongok , R. F. Sturrock , & D. W. Taylor , (1985). Immunity after treatment of schistosomiasis mansoni. II. Identification of resistant individuals and analysis of their immune responses. Transactions of the Royal Society of Tropical Medicine and Hygiene (in Press).

A. E. Butterworth , P. R. Dalton , Q. W. Dunne , M. Mugambi , J. H. Ouma , B. A. Richardson , T. K. Arap Siongok , & R. F. Sturrock , (1984). Immunity after treatment of human schistosomiasis mansoni. I. Study design, pretreatment observations and the results of treatment. Transactions of the Royal Society of Tropical Medicine and Hygiene 78, 108–23.

N. S. Croll , R. M. Anderson , T. W. Gyorkos , & E. Ghadirian , (1982). The population biology and control of Ascaris lumbricoides in a rural community in Iran. Transactions of the Royal Society of Tropical Medicine and Hygiene 76, 187–97.

K. Dietz , (1982). The population dynamics of onchocerciasis. In Population Dynamics of Infectious Diseases: Theory and Applications, (ed. R. M. Anderson ), pp. 209241. London: Chapman and Hall.

M. J. Goddard , & P. Jordan , (1980). On the longevity of Schistosoma mansoni in man on St. Lucia, West Indies. Transactions of the Royal Society for Tropical Medicine and Hygiene 74, 185–91.

B. Kirkwood , P. Smith , T. Marshall , & A. Prost , (1983). Relationship between mortality, visual activity and microfilial load in the area of the Onchocerciasis Control Programme. Transactions of the Royal Society of Tropical Medicine and Hygiene 77, 862–8.

G. Macdonald , (1965). The dynamics of helminth infections, with special reference to schistosomes. Transactions of the Royal Society of Tropical Medicine and Hygiene 59, 498506.

R. M. May , (1977). Togetherness among schistosomes: its effects on the dynamics of infection. Mathematical Biosciences 35, 301–43.

G. A. Schad , & L. E. Rozenbaum , (1976). Integrated control of helminths in human populations. Annual Review of Ecology and Systematics 7, 393420.

B. Y. Seo , & J. Y. Chai , (1980). Effect of two-month interval mass chemotherapy on the reinfection of Ascaris lumbricoides in Korea. Korean Journal of Parasitology 18, 153–63.

R. F. Sturrock , B. J. Cottrell , & R. Kimani , (1984). Observations on the ability of repeated, light exposures to Schistosoma mansoni cercariae to induce resistance to reinfection in Kenyan baboons (Papio anubis). Parasitology 88, 505–14.

D. Wakelin , (1984 b). Evasion of the immune response: survival within low responder individuals of the host population. Parasitology 88, 639–58.

K. S. Warren , (1973). Regulation of the prevalence and intensity of schistosomiasis in man: immunoloy or ecology. Journal of Infectious Diseases 127, 595609.

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  • ISSN: 0031-1820
  • EISSN: 1469-8161
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