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Fig. 7 | BMC Medicine

Fig. 7

From: Heterogeneous dynamics, robustness/fragility trade-offs, and the eradication of the macroparasitic disease, lymphatic filariasis

Fig. 7

Site-specific versus macroscopic superensemble predictions of the impact of LF interventions. The results from combining site-specific best-fit model parameters to develop and use vector-specific superensemble models for simulating the impact of LF intervention at 80 % MDA and VC coverages for the MDA alone and MDA + VC strategies are shown in (a, c) and (b, d), respectively. The solid curves represent the superensemble medians of annual MDA rounds required to reduce community-level mf prevalences below their respective infection breakpoint thresholds for achieving a 95 % probability of elimination, and are stratified as a function of community ABR (annual biting rate) values. Note that the x-axis is on a logarithmic scale. The dark and light grey regions, respectively, represent the 50 % (between the 25th and 75th percentiles) and 95 % (between the 2.5th and 97.5th percentiles) credible intervals (CIs) of the number of years of interventions predicted by the ensemble model to cross the respective 95 % elimination thresholds in each site. Circles (open, anopheline sites; filled, culicine sites) denote the median number of years of each intervention (at 80 % coverages) predicted by the respective best-fitting site-specific models to break LF transmission. The lower dashed line drawn at 6 years (i.e. the time period representing six annual MDA rounds) is to contrast the model-predicted MDA rounds required to achieve LF elimination with the WHO recommendation of applying six annual MDAs to achieve elimination of LF from all endemic settings in the world. The upper solid line drawn at 20 annual MDA cycles represents the target deadline for meeting the call for eliminating LF worldwide by 2020. The results for each site represent simulations of the impact of interventions mimicking a start year of 2000 (i.e. the year of WHO announcement of GPELF) and maintenance of MDA and VC coverages at 80 % throughout

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