Modeling the effectiveness of One Health interventions against the zoonotic hookworm Ancylostoma ceylanicum

Abstract

Hookworm disease is a major global public health concern, annually affecting 500–700 million of the world's poorest people. The World Health Organization is targeting the elimination of hookworm as a public health problem by 2030 using a strategy of mass drug administration (MDA) to at-risk human populations. However, in Southeast Asia and the Pacific the zoonotic hookworm species, Ancylostoma ceylanicum, is endemic in dogs and commonly infects people. This presents a potential impediment to the effectiveness of MDA that targets only humans. Here, we develop a novel multi-host (dog and human) transmission model of A. ceylanicum and compare the effectiveness of human-only and “One Health” (human plus dog) MDA strategies under a range of eco-epidemiological assumptions. We show that One Health interventions—targeting both dogs and humans—could suppress prevalence in humans to ≤ 1% by the end of 2030, even with only modest coverage (25–50%) of the animal reservoir. With increasing coverage, One Health interventions may even interrupt transmission. We discuss key unresolved questions on the eco-epidemiology of A. ceylanicum, the challenges of delivering MDA to animal reservoirs, and the growing importance of One Health interventions to human public health.

Zoonotic helminths of dogs and risk factors associated with polyparasitism in Grenada, West Indies

“…Such a strategy would reduce the imperative for owners to have their puppies treated within the first 2 weeks postpartum to prevent egg shedding in this highly infected population (Gates and Nolan, 2009 ). Emphasizing the importance of public education to reduce roaming behaviour in dogs, remove and dispose of canine feces and wash hands regularly are also important means of controlling transmission (Macpherson et al ., 2022 ; Massetti et al ., 2022 ; Walker et al ., 2023 ). The presence of A. ceylanicum requires that further behavioural changes be adopted as well, such as wearing shoes outdoors and proper disposal of human and animal feces (Baker et al ., 2018 ; Nery et al ., 2019 ; Colella et al ., 2021 ; Walker et al ., 2023 ).…”

“…Emphasizing the importance of public education to reduce roaming behaviour in dogs, remove and dispose of canine feces and wash hands regularly are also important means of controlling transmission (Macpherson et al, 2022;Massetti et al, 2022;Walker et al, 2023). The presence of A. ceylanicum requires that further behavioural changes be adopted as well, such as wearing shoes outdoors and proper disposal of human and animal feces (Baker et al, 2018;Nery et al, 2019;Colella et al, 2021;Walker et al, 2023). Further studies of Strongyloides spp.…”

“…There is a paucity of information on STHs in the Caribbean, including Grenada, which represents a major gap in the knowledge of the transmission and public health relevance of these parasites in this region. Thus, assessing factors involved in the transmission of these helminths should aid in developing targeted control programmes using a One Health approach (Walker et al ., 2023 ).…”

Ancylostoma ceylanicum and other zoonotic canine hookworms: neglected public and animal health risks in the Asia–Pacific region

“…This is of particular concern since companion animals from the tropics, where hookworms and other geohelminths are most likely to be endemic, are constantly exposed and thus at risk of acquiring infections even after treatment (Dantas-Torres et al 2020). A recent modeling study revealed that human MDA with animal deworming of moderate coverage (20-50%) may reduce the human A. ceylanicum prevalence to less than 1% by 2030; increasing animal treatment coverage to at least 75% may result in transmission interruption (Walker et al 2023). The results of Walker et al (2023) indicate the importance of including animal reservoir hosts in control and preventive measures aimed at reducing the public health threat of zoonotic hookworms, such as A. ceylanicum.…”

“…A recent modeling study revealed that human MDA with animal deworming of moderate coverage (20-50%) may reduce the human A. ceylanicum prevalence to less than 1% by 2030; increasing animal treatment coverage to at least 75% may result in transmission interruption (Walker et al 2023). The results of Walker et al (2023) indicate the importance of including animal reservoir hosts in control and preventive measures aimed at reducing the public health threat of zoonotic hookworms, such as A. ceylanicum.…”