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. 2021 Jun 14;72(Suppl 3):S210-S216.
doi: 10.1093/cid/ciab211.

Sustainable Surveillance of Neglected Tropical Diseases for the Post-Elimination Era

Hollie-Ann Hatherell  1 , Hope Simpson  1 , Rebecca F Baggaley  2 , T Déirdre Hollingsworth  3 , Rachel L Pullan  1
Affiliations

Sustainable Surveillance of Neglected Tropical Diseases for the Post-Elimination Era

Hollie-Ann Hatherell et al. Clin Infect Dis. .

Abstract

The World Health Organization's (WHO's) 2030 road map for neglected tropical diseases (NTDs) emphasizes the importance of strengthened, institutionalized "post-elimination" surveillance. The required shift from disease-siloed, campaign-based programming to routine, integrated surveillance and response activities presents epidemiological, logistical, and financial challenges, yet practical guidance on implementation is lacking. Nationally representative survey programs, such as demographic and health surveys (DHS), may offer a platform for the integration of NTD surveillance within national health systems and health information systems. Here, we describe characteristics of DHS and other surveys conducted within the WHO Africa region in terms of frequency, target populations, and sample types and discuss applicability for post-validation and post-elimination surveillance. Maximizing utility depends not only on the availability of improved diagnostics but also on better understanding of the spatial and temporal dynamics of transmission at low prevalence. To this end, we outline priorities for obtaining additional data to better characterize optimal post-elimination surveillance platforms.

Keywords: Africa; neglected tropical diseases; post-elimination; surveillance; survey.

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Figures

Figure 1.
Figure 1.
Frequency of DHS by country in the WHO Africa region. Dots indicate years in which a DHS was conducted. The size of each dot reflects the number of years out of the previous 10 in which a DHS took place. The number of surveys conducted in 2008–2018 is shown in brackets. Countries with more than 3 surveys in 2008–2018 (ie, surveys at least roughly every 3 years) are highlighted in bold. African countries are colored according to the number of DHS surveys conducted in 2008–2018. Survey frequency is compared with status of LF control in each country, as defined by surveillance and MDA status using data from the Expanded Special Project for Elimination of Neglected Tropical Diseases. Abbreviations: CAR, Central African Republic; DHS, demographic and health survey; DRC, Democratic Republic of Congo; LF, lymphatic filariasis; MDA, mass drug administration; STP, Sao Tome and Principe; WHO, World Health Organization.
Figure 2.
Figure 2.
Representation of males and females by age in surveys that collected blood samples conducted in the African region.
Figure 3.
Figure 3.
Number of large-scale surveys ever conducted by country for the WHO Africa region. Left side shows the number of all surveys that collected blood samples by sample type. Right side shows all demographic and health surveys ever conducted, whether they collected blood samples and sample type, where relevant. Where multiple samples were taken, surveys using WBS were categorized as WBS, those using a mixture of DBS and RDT were categorized as DBS, and those using RDT and other types of tests were categorized as RDT. Abbreviations: CAR, Central African Republic; DBS, dry blood spot; DRC, Democratic Republic of Congo; NS, not stated; RDT, rapid diagnostic test; STP, Sao Tome and Principe; WBS, whole blood sample.
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References

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