02349nas a2200325   4500000000100000008004100001260001600042653002100058100002200079700001400101700001200115700001600127700001400143700001500157700001300172700001300185700001400198700001200212700001400224700001300238700001100251700001700262700001500279245013900294856015300433300001400586490000700600520140200607022001402009       2022                            d  bElsevier BV10aGeneral Medicine1 aWorsley-Tonks KEL1 aBender JB1 aDeem SL1 aFerguson AW1 aFèvre EM1 aMartins DJ1 aMuloi DM1 aMurray S1 aMutinda M1 aOgada D1 aOmondi GP1 aPrasad S1 aWild H1 aZimmerman DM1 aHassell JM00aStrengthening global health security by improving disease surveillance in remote rural areas of low-income and middle-income countries  uhttps://www.sciencedirect.com/science/article/pii/S2214109X22000316/pdfft?md5=3526322d7121512d99030e30bbe976cb&pid=1-s2.0-S2214109X22000316-main.pdf  ae579-e5840 v103 a<p>The COVID-19 pandemic has underscored the need to strengthen national surveillance systems to protect a globally connected world. In low-income and middle-income countries, zoonotic disease surveillance has advanced considerably in the past two decades. However, surveillance efforts often prioritise urban and adjacent rural communities. Communities in remote rural areas have had far less support despite having routine exposure to zoonotic diseases due to frequent contact with domestic and wild animals, and restricted access to health care. Limited disease surveillance in remote rural areas is a crucial gap in global health security. Although this point has been made in the past, practical solutions on how to implement surveillance efficiently in these resource-limited and logistically challenging settings have yet to be discussed. We highlight why investing in disease surveillance in remote rural areas of low-income and middle-income countries will benefit the global community and review current approaches. Using semi-arid regions in Kenya as a case study, we provide a practical approach by which surveillance in remote rural areas can be strengthened and integrated into existing systems. This Viewpoint represents a transition from simply highlighting the need for a more holistic approach to disease surveillance to a solid plan for how this outcome might be achieved.</p>
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