AUTHOR=Walker Martin , Lambert Sébastien , Neves M. Inês , Worsley Andrew D. , Traub Rebecca , Colella Vito 

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

JOURNAL=Frontiers in Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1092030

DOI=10.3389/fmed.2023.1092030

ISSN=2296-858X

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, \textit{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 \textit{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 $\le 1 \%$ 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 \textit{A. ceylanicum}, the challenges of delivering MDA to animal reservoirs and the growing importance of One Health interventions to human public health.