Once control has been implemented, a key question is: how do we best track changes in infection levels over time?
Any identified surveillance approach will need to take into account the spatial heterogeneity of infection as this will influence the sampling design but also the costs of conducting the surveillance and the administrative unit for which decisions are required. A further consideration is the choice of diagnostic method used to detect infection and how the appropriate method varies according to transmission setting.
We have previously used a combination of computer simulation, geostatistics and cost analysis to evaluate the cost-effectiveness of alternative mapping survey designs for STH and schistosomiasis, and have contributed to the practical targeting of control efforts.
Building on this work, we are currently evaluating the cost-effectiveness of alterative diagnostic and sampling methods for the surveillance of NTDs in differing transmission settings. In this work we use a combination of computer-based simulation, fieldwork, statistical analysis and cost-effectiveness analysis.
We are also interested in evaluating the use of schools in malaria surveillance in East Africa.
Main areas of recent and current research include:
- Estimating the cost-effectiveness of alternative diagnostic methods for detection of NTDs.
- Evaluating the cost-effectiveness of alternative survey and surveillance strategies for NTDs.
- Evaluating the usefulness of the LF transmission assessment survey (TAS) used for assessing STH infection levels.
- Quantifying the performance of common diagnostic tests for STH and influencing factors, using Bayesian latent class analysis