Achieving the endgame: Integrated NTD case searches

Buyon, Lucas E.; Slaven, Randall; Emerson, Paul M.; King, Jonathan D.; Debrah, Oscar; Aboe, Agatha; Ruiz‐Tiben, Ernesto; Callahan, E. Kelly

doi:10.1371/journal.pntd.0006623

Cited by 5 publications

(5 citation statements)

References 7 publications

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“…Our costs are similar to those from a study conducted in Ghana that employed house-to-house screening to identify TT and guinea worm disease simultaneously ($19.97–$20.85). 5 However, a study conducted in Nigeria found costs per TT case identified using house-to-house comparable to our community mobilization costs ($5.40–$6.30). 8 Importantly, our analysis focused exclusively on Orbis’ programmatic costs.…”

Section: Discussionsupporting

confidence: 64%

“…In our study, PPV for TT case identification ranged from 4% to 45%, whereas others have reported PPV ranging from 12% to 75%. 5,[7][8][9] False-positive case identification can adversely impact individuals who took time away from other responsibilities to travel for surgery. Incorrectly identified individuals with other eye problems may be disappointed to learn their problem will not be addressed immediately.…”

Section: Discussionmentioning

confidence: 99%

“…In other programs, community health workers (CHWs) travel house-to-house to identify suspected cases and refer them for examination by a TT surgeon. [5][6][7][8][9][10] In this study, we evaluated the effectiveness of both approaches in Ethiopia.…”

mentioning

confidence: 99%

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Effectiveness of Trachomatous Trichiasis Case-identification Approaches in Ethiopia

Diallo,

Bayissasse,

Sisay

et al. 2023

Epidemiology

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Background: Trachoma control programs use multiple approaches to identify individuals with trachomatous trichiasis (TT). Evidence is limited regarding which approaches are most effective and cost-efficient. Methods: We evaluated the effectiveness of two TT case-identification approaches in Ethiopia: community mobilization to encourage self-referral for centralized screening and house-to-house screenings conducted by case finders. We compared the number of true cases found per 1000 population and costs associated with case identification under each approach, stratified by villages that received one or multiple screening visits. Results: We conducted screenings in 396 villages. In villages receiving one house-to-house visit, case finders identified 14,229 suspected cases, of whom 10,513 (73.9%) presented for TT confirmation. A median of 17.2% (interquartile range [IQR]: 9.1%–27.8%) of those presenting truly had TT (positive predictive value). In single-visit villages, the community mobilization approach yielded higher rates of confirmed cases than the house-to-house approach (1.5 [IQR: 1.1, 2.6] vs. 1.1 [IQR: 0.5, 1.9] cases per 1000 population), and the median cost of identifying a TT case was less ($5.59 vs. $31.18) using community mobilization than house-to-house. In multiple-visit villages, additional screening visits increased the median rate of confirmed cases to 2.5 per 1000 population in community mobilization villages, but the rate remained unchanged in house-to-house villages. Conclusions: Community mobilization-based TT case finding had a higher yield than house-to-house, at a substantially lower cost. Future research should examine whether additional tools to aid case finders in their diagnosis increases case-finding efficiency and accuracy and whether TT prevalence and surgical program duration impact case-finding success.

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Section: Discussionsupporting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effectiveness of Trachomatous Trichiasis Case-identification Approaches in Ethiopia

Diallo,

Bayissasse,

Sisay

et al. 2023

Epidemiology

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“…Several studies have been conducted on the integrated case management of NTDs strategy in Liberia, focusing on patient perception, the outcome of care, and case detection [ 22 , 25 , 26 ]. There have been findings on the effectiveness of active case search in increasing the number of cases compared to reliance on passive surveillance at the health facility for specific diseases [ 27 , 28 ]. However, the findings from this study support improved access to care for affected persons through early case detection.…”

Section: Discussionmentioning

confidence: 99%

The development, implementation, and evaluation of an optimal model for the case detection, referral, and case management of Neglected Tropical Diseases

Godwin-Akpan

Chowdhury

Rogers³

et al. 2023

PLoS ONE

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Background People affected by Neglected Tropical Diseases (NTDs), specifically leprosy, Buruli ulcer (BU), yaws, and lymphatic filariasis, experience significant delays in accessing health services, often leading to catastrophic physical, psychosocial, and economic consequences. Global health actors have recognized that Sustainable Development Goal 3:3 is only achievable through an integrated inter and intra-sectoral response. This study evaluated existing case detection and referral approaches in Liberia, utilizing the findings to develop and test an Optimal Model for integrated community-based case detection, referral, and confirmation. We evaluate the efficacy of implementing the Optimal Model in improving the early diagnosis of NTDs, thus minimizing access delays and reducing disease burden. Methods We used a participatory action research approach to develop, implement, and evaluate an Optimal Model for the case detection, referral, and management of case management NTDs in Liberia. We utilized qualitative and quantitative methods throughout the cycle and implemented the model for 12 months. Results During the implementation of our optimal model, the annual number of cases detected increased compared to the previous year. Cases were detected at an earlier stage of disease progression, however; gendered dynamics in communities shape the case identification process for some individuals. Qualitative data showed increased knowledge of the transmission, signs, symptoms, and management options among community health workers (CHW). Conclusion The results provide evidence of the benefits of an integrated approach and the programmatic challenges to improve access to health services for persons affected by NTDs. The effectiveness of an integrated approach depends on a high level of collaboration, joint planning, and implementation embedded within existing health systems infrastructure.

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“…While daunting, as mentioned earlier, this is necessary because humans and animals are infected by shared populations of Guinea worms, and as a result, humans be at risk for infections so long as the parasite continues to infect animals. This makes disease surveillance, case finding, and case containment a priority [ 58 ]. In Chad, a consistent pattern has been the discovery of dog infections with the expansion of active surveillance following identified human cases in new areas.…”

Section: Discussionmentioning

confidence: 99%

A One Health Approach for Guinea Worm Disease Control: Scope and Opportunities

et al. 2020

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Guinea worm disease (GWD) is a neglected tropical disease that was targeted for eradication several decades ago because of its limited geographical distribution, predictable seasonality, straightforward diagnosis, and exclusive infection of humans. However, a growing body of evidence challenges this last attribute and suggests that GWD can affect both humans and animal populations. The One Health approach emphasizes the relatedness of human, animal, and environmental health. We reviewed epidemiological evidence that could support the utility of a One Health approach for GWD control in the six countries that have reported human GWD cases since 2015—Angola, Cameroon, Chad, Ethiopia, Mali, and South Sudan. Human GWD cases have dramatically declined, but recent years have seen a gradual increase in human case counts, cases in new geographies, and a rapidly growing number of animal infections. Taken together, these suggest a need for an adjusted approach for eradicating GWD using a framework rooted in One Health, dedicated to improving disease surveillance and in animals; pinpointing the dominant routes of infection in animals; elucidating the disease burden in animals; determining transmission risk factors among animals and from animals to humans; and identifying practical ways to foster horizontal and multidisciplinary approaches.

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Achieving the endgame: Integrated NTD case searches

Cited by 5 publications

References 7 publications

Effectiveness of Trachomatous Trichiasis Case-identification Approaches in Ethiopia

Effectiveness of Trachomatous Trichiasis Case-identification Approaches in Ethiopia

The development, implementation, and evaluation of an optimal model for the case detection, referral, and case management of Neglected Tropical Diseases

A One Health Approach for Guinea Worm Disease Control: Scope and Opportunities

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