Sustainable surveillance of neglected tropical diseases for the post-elimination era.
Hatherell HA., Simpson H., Baggaley RF., Hollingsworth TD., Pullan R.
The World Health Organisation 2030 Roadmap for neglected tropical diseases (NTDs) emphasises the importance of strengthened, institutionalised "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 programmes, 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. Maximising utility depends not only on the availability of improved diagnostics but also better understanding of the spatial and temporal dynamics of transmission at low prevalence. To this end, we outline priorities for obtaining further data to better characterise optimal post-elimination surveillance platforms.