1. Development of spatio-temporal models and associated statistical methods to enable forward projections of the geographical distribution of prevalence, and hence the risk of resurgence, by combining model-based geostatistical analysis with mechanistic predictive modelling of disease transmission dynamics, using the most recent available data on disease prevalence and environmental risk-factors.
2. To use the results from aim 1 to derive statistically efficient and affordable designs for networks of sentinel sites to enable continued monitoring of prevalence in areas at high risk of resurgence."
Can geostatistical tools be used to develop a stop IDA strategy for LF that can measure <1% Mf prevalence in adults?
Utility of screening easy to access population sub groups as a surveillance tool in monitoring interruption of LF transmission
The question of how to conduct post-elimination surveillance is a high priority for the NTD community, given that most NTD programs scale back or shut down completely once elimination as a public health problem is achieved. Few solutions exist and this proposal provides an interesting and useful case study for surveillance moving forward. The study team plans to target 1708 pregnant women as a proxy for measuring LF resurgence in a post-elimination context. As a comparison group, they plan to conduct a prevalence survey of 427 households (1708 participants) in the same community to compare LF prevalence found in each methodology. Each participant at the health facility’s residence will be geo-referenced to understand the coverage area. They also plan to conduct interviews with patients and health workers, a time-motion study, and a cost analysis to assess the additional burden on health care workers and the health system. The study will occur in 14 facilities in one district of Malawi where LF was highly endemic prior to the launch of the program.
Can geospatial algorithms be used by disease programs to help identify hotspots at community and Implementation Unit level?
Improving outcome of future transmission assessment surveys and community compliance for MDA in 14 LF endemic districts of Uttar Pradesh.
The success of MDA programs requires effective planning, community engagement, and delivery by community drug distributors. This proposal seeks to assess barriers and facilitators of effective coverage. Using in depth interviews, focus group discussions, and surveys, they will investigate factors related to acceptance, availability, and accessibility of MDA from the perspectives of drug distributors, healthcare workers, community leaders, the NTD program, and community members. Using the findings from the formative phase, an intervention package will be developed and implemented during MDA, followed by an evaluation of the impact of the intervention on coverage.
This project is part of a larger series of four studies that use a mixed methods approach to understand why particular districts that have undergone 5+ years of MDA are failing or are likely to fail transmission assessment surveys (TAS). Other studies include 169.1D Ghana, 169.2U Burkina Faso, and 177U Nepal. This study in Uttar Pradesh also provides a second opportunity to deploy the rapid ethnographic approach that will be first tested in Nepal. Team members from HERD Nepal will be traveling to India to train their team on the technique and assist with roll out.
Developing a surveillance framework for the post-elimination phase of the lymphatic filariasis programme in Bangladesh
- Can the micro-stratification of lymphatic filariasis (LF) transmission assessment surveys positive case and clinical case data be used to identify, map and monitor transmission hotspots as part of an enhanced endgame surveillance strategy?
- Can targeted molecular xenomonitoring detect ongoing transmission [to the same extent as human surveillance] in defined LF transmission hotspots?
Is there still LF transmission after successful TAS 3?
Post-validation survey for the elimination of blinding trachoma to evaluate the effectiveness of a serological surveillance strategy in two provinces of Morocco
Conduct district-wide field trials of the Pgp3 lateral flow assay to measure the seroprevalence of antibodies against the Chlamydia trachomatis antigen Pgp3 in low-prevalence settings.
Investigation of communities at increased risk of trachoma recrudescence & a model post-elimination surveillance strategy
Primary research question
Is there evidence of on-going or recent ocular Ct transmission in communities of northern Ghana felt to be at increased risk of recrudescence, at least two years since they were identified with Ct infection and or high anti-Pgp3 seroprevalence during pre-validation trachoma surveillance surveys?
Secondary research questions
What is the geographical extent of the boundaries of any persistent Ct infection and on-going transmission in the post-elimination setting?
What is the community-level (anti-Pgp3) prevalence of seropositivity for the multiplex bead array (MBA) (and possibly ELISA) as compared to the lateral flow assay (LFA)?
Mapping the Potential Risk of Mycetoma Infection in Sudan and South Sudan Using Ecological Niche Modeling
What is the potential distribution of mycetoma in Sudan and South Sudan? What are the most important factors associated with the spatial distriutional patterns of disease cases in Both countries.