Additional file 2: of Progress towards onchocerciasis elimination in the participating countries of the African Programme for Onchocerciasis Control: epidemiological evaluation results

ONCHOSIM simulations: brief model description, input assumptions and simulations that were done (DOCX 64 kb

Additional file 1: of Progress towards onchocerciasis elimination in the participating countries of the African Programme for Onchocerciasis Control: epidemiological evaluation results

Multilingual abstracts in the six official working languages of the United Nations. (PDF 732 kb

Sensitivity analysis for the impact of assumed parameter values on the total averted burden.

<p>For each parameter (y-axis), the figure between brackets indicates the relative amount by which it was varied in the sensitivity analysis.</p

Burden of off-target infections averted by annual ivermectin mass treatment with ivermectin in Africa.

<p>^a These figures are the product of the potential disease burden due to off-target infections in people treated with ivermectin and the assumed effect of ivermectin treatment on the disease burden (see <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0004051#pntd.0004051.box001" target="_blank">Box 1</a>).</p><p>^b Estimates for Sudan and South Sudan are merged, as information on the burden per capita was reported for the two together [<a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0004051#pntd.0004051.ref014" target="_blank">14</a>].</p><p>Figures represent the cumulative burden averted between 1995 and 2010 in areas covered by the African Programme for Onchocerciasis Control.</p

Onchocerciasis-endemic countries in Africa, showing countries covered by the OCP and initially by APOC.

<p>Map from 2010. Note that South Sudan gained independence in 2011, becoming the 20th APOC country.</p

Possible evolution of APOC structures and mechanisms.

<p>Possible evolution of APOC structures and mechanisms.</p

Disability-adjusted life years (DALYs) lost due to onchocerciasis from 1995 to 2015.

<p>The total height of the bars (colored plus blank) represents the estimated number of DALYs lost in a counterfactual scenario without ivermectin mass treatment (increasing trend due to population growth). The colored part of each bar represents the estimated actual number of DALYs lost (declining trend due to ivermectin mass treatment). The blank part of each bar therefore represents the annual number of DALYs averted by ivermectin mass treatment in the total APOC population.</p

Population at risk and treated in areas covered by the African Programme for Onchocerciasis Control.

<p>Dots represent time points for which data were available; projections for 2011–2015 (shaded area) are based on the assumptions that populations continue to grow according to the latest known growth rates and that all projects scale up therapeutic coverage by 10 percentage points per year (up to a maximum coverage of 75%).</p

Health impact and cost of ivermectin mass treatment, 1995–2015.

<p>The health impact is expressed as the annual number of DALYs averted. Costs include those taken on by the African Programme for Onchocerciasis Control (APOC) and national onchocerciasis task forces (including beneficiary governments and non-governmental development organizations). All costs are expressed in nominal US$(i.e., uncorrected for inflation and undiscounted), and do not include cost of donated drugs or government salaries.</p>*<p>National onchocerciasis task force expenditures for the years 1995–2003 and 2010 were unknown; they were assumed to be equal to 47$0.52).</p

Predicted prevalence of onchocercal infection and morbidity in APOC areas from 1995 to 2015.

<p>Please note the different scales for the y-axes in the four panels. Shaded areas represent projections for 2011–2015. A) Prevalence of infection is defined as infestation with at least one adult female worm, or alternatively, presence of detectable microfilariae in the skin. B) Prevalence of troublesome itch, caused by onchocerciasis. C) Prevalence of onchocercal visual impairment, defined as corrected visual acuity (i.e. measured with glasses on or through pinhole) of <18/60 and ≥3/60 in the better eye. D) Prevalence of onchocercal blindness, defined as corrected visual acuity (i.e. measured with glasses on or through pinhole) of <3/60 or restriction of visual field to less than 10° in the better eye.</p