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Achieving the endgame: Integrated NTD case searches.

Lucas Buyon1, Randall Slaven2, Paul M Emerson3

  • 1Harvard T.H. Chan School of Public Health, Department of Immunology and Infectious Diseases, Boston, Massachusetts, United States of America.

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|December 21, 2018
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Summary

Integrated case searches for neglected tropical diseases (NTDs) like trachoma and Guinea Worm Disease (GWD) are crucial for elimination. Point of Care (POC) delivery of services proved more cost-effective and achieved higher surgical uptake for trachomatous trichiasis (TT).

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Area of Science:

  • Public Health
  • Tropical Medicine
  • Epidemiology

Background:

  • Trachoma and Guinea Worm Disease (GWD) are neglected tropical diseases (NTDs) targeted for elimination and eradication by the WHO.
  • As elimination programs progress, identifying and treating the final cases of Trachomatous Trichiasis (TT) and GWD is a public health priority.

Purpose of the Study:

  • To evaluate the feasibility and effectiveness of integrated house-to-house case searches for GWD and TT in Ghana.
  • To compare two case management strategies: centralized referral versus Point of Care (POC) service delivery for TT treatment.

Main Methods:

  • Integrated case searches for GWD and TT were conducted using a house-to-house approach.
  • Two TT case management strategies were compared: centralized referral and POC service delivery.
  • Surgical uptake and cost per case examined were analyzed for both strategies.

Main Results:

  • The POC method identified 482 suspected TT cases with 100% surgical acceptance.
  • The centralized method identified 835 suspected TT cases with 72.4% surgical acceptance.
  • The cost per TT case examined was lower in the POC searches ($19.97) compared to centralized searches ($20.85).

Conclusions:

  • House-to-house case searches offering services at the Point of Care (POC) are a feasible and effective strategy for NTD elimination programs.
  • The POC approach demonstrated higher surgical uptake and lower costs, making it a valuable tool for reaching elimination and eradication targets.