11th Asian Congress on Tropical Medicine and Parasitology

Abstract

Soil-transmitted helminth (STH) infections remain a major public health burden worldwide despite available anthelmintic drugs usually deployed in mass deworming campaigns. The World Health Organization (WHO) aims to eliminate STH as a public health problem by 2030; however, the potential emergence of resistance to anthelmintic drugs threatens to undermine progress. While resistance is well documented in veterinary helminths, its population-level implications for human STH control remain poorly understood.

To address this gap, we are developing a stochastic agent-based model (ABM) to quantify the epidemiological and programmatic impact of anthelmintic resistance under realistic field conditions. The model captures individual-level heterogeneity in exposure, parasite burden, treatment uptake, and community structure, while explicitly representing stochastic processes governing transmission and the establishment of resistant parasite strains.

The model will be calibrated by field-collected data on community preferences, symptom burden, and health-related quality of life in the countries of Southeast Asia (Thailand, Malaysia, and the Philippines). Integrating these behavioural and community acceptability dimensions into transmission modelling will allow evaluation not only of epidemiological effectiveness but also of the feasibility and acceptability of alternative intervention strategies. Scenarios will explore varying degrees of drug efficacy decline, adaptive treatment strategies and complementary control approaches, estimating their probability of achieving EPHP targets under resistance emergence. The model can be expanded to other settings where these parasites co-exist in humans and animals, such as certain countries in Eastern Europe.

Ultimately, this modelling platform will function as a decision-support tool for policymakers, enabling proactive and evidence-based adaptation of STH control programmes within a One Health framework.