Predicting the environmental suitability for onchocerciasis in Africa as an aid to elimination planning

CROMWELL, Elizabeth A., OSBORNE, Joshua C. P., UNNASCH, Thomas R., BASÁÑEZ, Maria-Gloria, GASS, Katherine M., BARBRE, Kira A., HILL, Elex, JOHNSON, Kimberly B., DONKERS, Katie M., SHIRUDE, Shreya, SCHMIDT, Chris A., ADEKANMBI, Victor, ADETOKUNBOH, Olatunji O., AFARIDEH, Mohsen, AHMADPOUR, Ehsan, AHMED, Muktar Beshir, AKALU, Temesgen Yihunie, AL-ALY, Ziyad, ALANEZI, Fahad Mashhour, ALANZI, Turki M., ALIPOUR, Vahid, ANDREI, Catalina Liliana, ANSARI, Fereshteh, ANSHA, Mustafa Geleto, ANVARI, Davood, APPIAH, Seth Christopher Yaw, ARABLOO, Jalal, ARNOLD, Benjamin F., AUSLOOS, Marcel, AYANORE, Martin Amogre, BAIG, Atif Amin, BANACH, Maciej, BARAC, Aleksandra, BÄRNIGHAUSEN, Till Winfried, BAYATI, Mohsen, BHATTACHARYYA, Krittika, BHUTTA, Zulfiqar A., BIBI, Sadia, BIJANI, Ali, BOHLOULI, Somayeh, BOHLULI, Mahdi, BRADY, Oliver J., BRAGAZZI, Nicola Luigi, BUTT, Zahid A., CARVALHO, Felix, CHATTERJEE, Souranshu, CHATTU, Vijay Kumar, CHATTU, Soosanna Kumary, CORMIER, Natalie Maria, DAHLAWI, Saad M. A., DAMIANI, Giovanni, DAOUD, Farah, DARWESH, Aso Mohammad, DARYANI, Ahmad, DERIBE, Kebede, DHARMARATNE, Samath Dhamminda, DIAZ, Daniel, DO, Hoa Thi, EL SAYED ZAKI, Maysaa, EL TANTAWI, Maha, ELEMINEH, Demelash Abewa, FARAJ, Anwar, FASIHI HARANDI, Majid, FATAHI, Yousef, FEIGIN, Valery L., FERNANDES, Eduarda, FOIGT, Nataliya A., FOROUTAN, Masoud, FRANKLIN, Richard Charles, GUBARI, Mohammed Ibrahim Mohialdeen, GUIDO, Davide, GUO, Yuming, HAJ-MIRZAIAN, Arvin, HAMAGHARIB ABDULLAH, Kanaan, HAMIDI, Samer, HERTELIU, Claudiu, HIDRU, Hagos Degefa de, HIGAZI, Tarig B., HOSSAIN, Naznin, HOSSEINZADEH, Mehdi, HOUSEH, Mowafa, ILESANMI, Olayinka Stephen, ILIC, Milena D., ILIC, Irena M., IQBAL, Usman, IRVANI, Seyed Sina Naghibi, JHA, Ravi Prakash, JOUKAR, Farahnaz, JOZWIAK, Jacek Jerzy, KABIR, Zubair, KALANKESH, Leila R., KALHOR, Rohollah, KARAMI MATIN, Behzad, KARIMI, Salah Eddin, KASAEIAN, Amir, KAVETSKYY, Taras, KAYODE, Gbenga A., KAZEMI KARYANI, Ali, KELBORE, Abraham Getachew, KERAMATI, Maryam, KHALILOV, Rovshan, KHAN, Ejaz Ahmad, KHAN, Md Nuruzzaman Nuruzzaman, KHATAB, Khaled, KHATER, Mona M., KIANIPOUR, Neda, KIBRET, Kelemu Tilahun, KIM, Yun Jin, KOSEN, Soewarta, KROHN, Kris J., KUSUMA, Dian, LA VECCHIA, Carlo, LANSINGH, Van Charles, LEE, Paul H., LEGRAND, Kate E., LI, Shanshan, LONGBOTTOM, Joshua, MAGDY ABD EL RAZEK, Hassan, MAGDY ABD EL RAZEK, Muhammed, MALEKI, Afshin, MAMUN, Abdullah A., MANAFI, Ali, MANAFI, Navid, MANSOURNIA, Mohammad Ali, MARTINS-MELO, Francisco Rogerlândio, MAZIDI, Mohsen, MCALINDEN, Colm, MEHARIE, Birhanu Geta, MENDOZA, Walter, MENGESHA, Endalkachew Worku, MENGISTU, Desalegn Tadese, MERETA, Seid Tiku, MESTROVIC, Tomislav, MILLER, Ted R., MIRI, Mohammad, MOGHADASZADEH, Masoud, MOHAMMADIAN-HAFSHEJANI, Abdollah, MOHAMMADPOURHODKI, Reza, MOHAMMED, Shafiu, MOHAMMED, Salahuddin, MORADI, Masoud, MORADZADEH, Rahmatollah, MORAGA, Paula, MOSSER, Jonathan F., NADERI, Mehdi, NAGARAJAN, Ahamarshan Jayaraman, NAIK, Gurudatta, NEGOI, Ionut, NGUYEN, Cuong Tat, NGUYEN, Huong Lan Thi, NGUYEN, Trang Huyen, NIKBAKHSH, Rajan, OANCEA, Bogdan, OLAGUNJU, Tinuke O., OLAGUNJU, Andrew T., OMAR BALI, Ahmed, ONWUJEKWE, Obinna E., PANA, Adrian, POURJAFAR, Hadi, RAHIM, Fakher, RAHMAN, Mohammad Hifz Ur, RATHI, Priya, RAWAF, Salman, RAWAF, David Laith, RAWASSIZADEH, Reza, RESNIKOFF, Serge, RETA, Melese Abate, REZAPOUR, Aziz, RUBAGOTTI, Enrico, RUBINO, Salvatore, SADEGHI, Ehsan, SAGHAFIPOUR, Abedin, SAJADI, S. Mohammad, SAMY, Abdallah M., SARMIENTO-SUÁREZ, Rodrigo, SAWHNEY, Monika, SCHIPP, Megan F., SHAHEEN, Amira A., SHAIKH, Masood Ali, SHAMSIZADEH, Morteza, SHARAFI, Kiomars, SHEIKH, Aziz, SHETTY, B. Suresh Kumar, SHIN, Jae Il, SHIVAKUMAR, K. M., SIMONETTI, Biagio, SINGH, Jasvinder A., SKIADARESI, Eirini, SOHEILI, Amin, SOLTANI, Shahin, SPURLOCK, Emma Elizabeth, SUFIYAN, Mu’awiyyah Babale, TABUCHI, Takahiro, TAPAK, Leili, THOMPSON, Robert L., THOMSON, Alan J., TRAINI, Eugenio, TRAN, Bach Xuan, ULLAH, Irfan, ULLAH, Saif, UNEKE, Chigozie Jesse, UNNIKRISHNAN, Bhaskaran, UTHMAN, Olalekan A., VINKELES MELCHERS, Natalie V. S., VIOLANTE, Francesco S., WOLDE, Haileab Fekadu, WONDE, Tewodros Eshete, YAMADA, Tomohide, YAYA, Sanni, YAZDI-FEYZABADI, Vahid, YIP, Paul, YONEMOTO, Naohiro, YOUSOF, Hebat-Allah Salah A., YU, Chuanhua, YU, Yong, YUSEFZADEH, Hasan, ZAKI, Leila, ZAMAN, Sojib Bin, ZAMANIAN, Maryam, ZHANG, Zhi-Jiang, ZHANG, Yunquan, ZIAPOUR, Arash, HAY, Simon I. and PIGOTT, David M. (2021). Predicting the environmental suitability for onchocerciasis in Africa as an aid to elimination planning. PLOS Neglected Tropical Diseases, 15 (7). [Article]

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Abstract
Recent evidence suggests that, in some foci, elimination of onchocerciasis from Africa may be feasible with mass drug administration (MDA) of ivermectin. To achieve continental elimination of transmission, mapping surveys will need to be conducted across all implementation units (IUs) for which endemicity status is currently unknown. Using boosted regression tree models with optimised hyperparameter selection, we estimated environmental suitability for onchocerciasis at the 5 × 5-km resolution across Africa. In order to classify IUs that include locations that are environmentally suitable, we used receiver operating characteristic (ROC) analysis to identify an optimal threshold for suitability concordant with locations where onchocerciasis has been previously detected. This threshold value was then used to classify IUs (more suitable or less suitable) based on the location within the IU with the largest mean prediction. Mean estimates of environmental suitability suggest large areas across West and Central Africa, as well as focal areas of East Africa, are suitable for onchocerciasis transmission, consistent with the presence of current control and elimination of transmission efforts. The ROC analysis identified a mean environmental suitability index of 0·71 as a threshold to classify based on the location with the largest mean prediction within the IU. Of the IUs considered for mapping surveys, 50·2% exceed this threshold for suitability in at least one 5 × 5-km location. The formidable scale of data collection required to map onchocerciasis endemicity across the African continent presents an opportunity to use spatial data to identify areas likely to be suitable for onchocerciasis transmission. National onchocerciasis elimination programmes may wish to consider prioritising these IUs for mapping surveys as human resources, laboratory capacity, and programmatic schedules may constrain survey implementation, and possibly delaying MDA initiation in areas that would ultimately qualify.
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