Impact of key assumptions about the population biology of soil-transmitted helminths on the sustainable control of morbidity.

2021 
The design and evaluation of control programmes for soil-transmitted helminths (STHs) is based on surveillance data recording measurements of egg counts in the stool of infected individuals which underpin estimates of the prevalence and average intensity of infection. There is considerable uncertainty around these measurements and their interpretation. The uncertainty is composed of several sources of measurement error and the limit of detection of faecal smear tests on the one hand, and key assumptions on STH biology on the other hand, including assumptions on the aggregation of worms within hosts and on the impact of density-dependent influences on worm reproduction. Using two independently developed models of STH transmission we show how different aspects of STH biology and human behaviour impact on STH surveillance and control programmes and how accounting for uncertainty can help to develop optimal and sustainable control strategies to meet the WHO morbidity target for STHs.
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