Strengthening the collection, interpretation and use of data to target expansion and integration of case detection and management interventions against neglected tropical diseases.

Neglected tropical diseases (NTDs) cause a large burden of morbidity, primarily affecting disadvantaged communities. They are variously targeted for control, elimination, and eradication, which will require primary health system strengthening and public health interventions. Certain NTDs are controlled through mass drug administration (MDA) to reduce transmission and limit progression of infections to morbidity; others (grouped as ‘case management NTDs’) by early identification and treatment of individual cases, which can be enhanced through active case searches. To maximise efficiency, interventions should be targeted to high prevalence or incidence areas, and integrated across co-endemic NTDs. Targeting and integration of case detection and management interventions are challenging, however, as existing data on case management NTDs originate mainly from routine health facility notifications, which are both under-representative and biased due to uneven service coverage and accessibility. This portfolio comprises five research papers exploring these issues, and approaches to strengthen surveillance for NTDs. The first used remote georeferencing to map routinely detected cases of NTD morbidity in Ghana, and investigated epidemiological indicators by health facility accessibility. The second is a systematic literature review of the global distribution of Buruli ulcer. The third used environmental niche modelling to predict suitability for Buruli ulcer in Africa. The fourth integrated multiple decision criteria to target a survey for podoconiosis in India. The fifth describes a prevalence survey for lymphatic filariasis morbidity to evaluate a community-based screening method. This work advocates for a broader perspective on the targeting of NTD case detection and management interventions, specifically acknowledging potential biases in routine surveillance data, and for further integration of interventions across diseases and within primary health systems. Financial support, development of information and surveillance systems, and further engagement and support of community health staff are critical. This is intended to support more equitable programmes and progress towards universal health coverage.