Elimination of tropical disease through surveillance and response

Abstract

Surveillance and response represent the final crucial steps in achieving effective control and particularly elimination of communicable diseases as recognized in the area of neglected tropical diseases (NTDs), applied in increasing numbers in endemic countries with ongoing control and elimination programmers. More and more national NTD elimination initiatives are scheduled based on the innovative and effective One world-One health perspective to detect pockets of transmission and disease reintroduction. Resource-constrained countries, which carry the heaviest NTD burdens, face various challenges how to strengthen the health system as well as developing effective and novel tools for surveillance and response tailored to local settings. Surveillance-response approaches take place in two different stages corralling the basic components of the surveillance-response system for NTD elimination. Six different research priorities have been identified:1)dynamic mapping of transmission, 2) near real-time capture of population dynamics, 3) modelling based on a minimum essential database/dataset, 4) implementation of mobile health (m-health) and sensitive diagnostics, 5) design of effective response packages tailored to different transmission settings and levels, and 6) validation of approaches and responses packages.

Figure 1

The major components of a surveillance-response system. Four components are crucial: (i) a minimum database/dataset for data collection and management, (ii) data modelling by either statistical or mathematical models to forecast the future tendency of disease transmission, thereby providing the guidance for intervention, (iii) novel tools to sensitively detect or respond to low-transmission patterns and (re-)emerging pathogens, and (iv) evaluation of the chosen elimination programme. The overall goal will depend on additional indices to provide the threshold of zero transmission and specific parameters depending on specific scenarios (MED = Minimum Essential Database/set, M&E = Monitoring and Evaluation). (This figure was contributed by Dr. Guo-Jing Yang, and Dr. Jing-Fan Xu).