Abstract
BACKGROUND: Dirofilaria immitis is a mosquito-transmitted filarial parasite causing heartworm disease in dogs. The parasite may cause a significant disease burden to the dog population in high prevalence areas and is mainly managed through prophylactic treatments. METHODS: In this modelling study, the effect of a prophylactic treatment with moxidectin and sarolaner on heartworm disease dynamics was investigated in dogs. A compartmental model was developed to investigate different epidemiological settings considering different values for prevalence and host preference. RESULTS: When the mosquito host preference to dogs is low, a treatment compliance of only 40% decreases the proportion of infectious dogs. When the host preference of the mosquitoes however increases, an exponential increase in infectious dogs was observed, and a higher treatment compliance is required. In high transmission environments, with a high prevalence and a high mosquito host preference, a high treatment compliance (up to 100%) is required to have an impact on the number of infected animals. Notably, in scenarios with higher host preference towards dogs, more mosquitoes are exposed to sarolaner through the blood meal, leading to higher mortality of these mosquitoes and resulting in fewer infected and infectious dogs. CONCLUSIONS: The preventive efficacy, as measured by the number of non-infected dogs, increases with increasing treatment compliance, but the extent of the treatment effect differs with the epidemiological setting. Adding sarolaner to a heartworm prevention has a complimentary impact on mosquito survival and heartworm disease transmission, although this effect depends on the epidemiological settings, emphasizing the true complexity of disease dynamics of a vector-borne disease.