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首页> 外文期刊>The American Journal of Tropical Medicine and Hygiene >Ecological and Socioeconomic Predictors of Transmission Assessment Survey Failure for Lymphatic Filariasis
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Ecological and Socioeconomic Predictors of Transmission Assessment Survey Failure for Lymphatic Filariasis

机译：淋巴丝虫病传输评估调查失败的生态和社会经济预测因子

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The transmission assessment survey (TAS) is recommended to determine whether cessation of mass drug administration (MDA) for lymphatic filariasis (LF) is warranted. Ministries of health typically implement TASs in evaluation units (EUs) that have had more than five rounds of annual MDA. Under TAS guidelines, sample size calculations determine a decision value: if the number of individuals testing positive exceeds this threshold, then MDA continues in the EU. The objective of this study was to determine whether fine scale geospatial covariates could be used to identify predictors of TAS failure. We geo-referenced 746 TAS EUs, of which 65 failed and extracted geospatial covariates using R to estimate odds of failure. We implemented stepwise backward elimination to select covariates for inclusion in a logistic regression to estimate the odds of TAS failure. Covariates included environmental predictors (aridity, distance to fresh water, elevation, and enhanced vegetation index), cumulative rounds of MDA, measures of urbanicity and access, LF species, and baseline prevalence. Presence of Brugia was significantly associated with TAS failure (odds ratio [OR]: 4.79,95% CI: 2.52-9.07), as was population density (OR: 2.91, 95% CI: 1.06-7.98). The presence of nighttime lights was highly protective against failure (OR: 0.22, 95% CI: 0.10-0.50), as was an increase in elevation (OR: 0.36, 95% CI: 0.18-0.732). This work identifies predictors associated with TAS failure at the EU areal level, given the data presently available, and also identifies the need for more granular data to conduct a more robust assessment of these predictors.
机译：建议判断传输评估调查（TAS）以确定是否有必要对淋巴丝体（LF）进行溃疡药物施用（MDA）的停止。卫生部部通常在有超过五轮MDA的评估单位（EUS）中实施TASS。在TAS指南下，样本大小计算确定决策值：如果检测正面的个人数量超过此阈值，则MDA在欧盟继续。本研究的目的是确定尺度的地理空间协变量是否可用于识别TAS故障的预测因子。我们地理引用了746个TAS EU，其中65个失败，并使用R提取地理空间协变量，以估计失败的几率。我们逐步向后消除，以选择协变量以包含在逻辑回归中以估计TA失败的几率。协变量包括环境预测因素（干旱，与淡水距离，高等植被指数），累积的MDA，城市性措施和访问，LF物种和基线患病率。 Brugia的存在显着与TAS失败有关（差距[或]：4.79,95％CI：2.52-9.07），群体密度（或：2.91,95％CI：1.06-7.98）。夜间灯的存在对失败具有高度保护性（或：0.22,95％CI：0.10-0.50），升高增加（或：0.36,95％CI：0.18-0.732）。考虑到目前可用的数据，这项工作识别与欧盟区域级别的TAS故障相关的预测器，并且还确定需要更多粒度数据来对这些预测器进行更强大的评估。

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