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Title: Mathematical modelling of neglected tropical disease control with particular reference to schistosomiasis in sub-Saharan Africa
Author: French, Michael Duncan
Awarding Body: Imperial College London
Current Institution: Imperial College London
Date of Award: 2011
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Abstract:
The overarching aim of the thesis is the use of mathematical models to provide policy-relevant guidance to neglected tropical disease (NTD) control programmes, particularly those against schistosomiasis, identified following discussions with Schistosomiasis Control Initiative (SCI) staff, and utilising the SCl's extensive datasets from sub-Saharan Africa. Firstly, changes are estimated in the force of infection (Fa/) of schistosomes following annual control in Uganda, relative to baseline, expressed as the number of mature parasites acquired per host per year. It is known that praziquantel treatment results in significant reductions in infection intensity in treated individuals; however, the thesis shows that Fal reductions also result in benefits for untreated individuals. Models are developed, parameterized and fitted to Schistosoma mansoni (intestinal schistosomiasis) data from areas with differing initial endemicity, and results indicate significant and substantial reductions following treatment. Models are developed further to estimate reductions in the Fal of S. haematobium (urogenital schistosomiasis) and used in other SCI locations (Uganda, Tanzania, Burkina Faso, Niger, Mali, Zambia). Secondly, the thesis investigates changes in schistosome population genetic structure following chemotherapy to gain insights into the transmission and clinical processes of the disease. Large-scale chemotherapy-based control likely exerts strong selective pressure on parasite populations. Recently developed microsatellite markers have demonstrated significant reductions in S. mansoni genetic diversity following one round of treatment. This may have implications for the parasite's evolutionary potential and the future success of such campaigns. Stochastic re-sampling approaches are used to estimate the magnitude of changes, the robustness of the microsatellite markers used, and to identify optimum sampling frameworks in terms of numbers of hosts, and numbers of parasites per host required, in order to detect changes in parasite population structure. Finally, results are discussed in terms of the role that models can play in the implementation, monitoring and evaluation of programmes for NTD control, and current research gaps are high lighted.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID: uk.bl.ethos.550985  DOI: Not available
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