RESEARCH ARTICLE Detecting infection hotspots: Modeling the surveillance challenge for elimination of lymphatic filariasis Julie R. Harris1,2¤*, Ryan E. Wiegand2 1 Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America, 2 Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America ¤ Current address: Century Center, Atlanta, Georgia, United States of America *
[email protected] a1111111111 a1111111111 Abstract a1111111111 a1111111111 a1111111111 Background During the past 20 years, enormous efforts have been expended globally to eliminate lym- OPEN ACCESS phatic filariasis (LF) through mass drug administration (MDA). However, small endemic foci Citation: Harris JR, Wiegand RE (2017) Detecting (microfoci) of LF may threaten the presumed inevitable decline of infections after MDA ces- infection hotspots: Modeling the surveillance sation. We conducted microsimulation modeling to assess the ability of different types of challenge for elimination of lymphatic filariasis. surveillance to identify microfoci in these settings. PLoS Negl Trop Dis 11(5): e0005610. https://doi. org/10.1371/journal.pntd.0005610 Editor: MarõÂa-Gloria BasaÂñez, Imperial College London, Faculty of Medicine, School of Public Methods Health, UNITED KINGDOM Five or ten microfoci of radius 1, 2, or 3 km with infection marker prevalence (intensity) of 3, Received: September 6, 2016 6, or 10 times background prevalence were placed in spatial simulations, run in R Version Accepted: April 28, 2017 3.2. Diagnostic tests included microfilaremia, immunochromatographic test (ICT), and Published: May 19, 2017 Wb123 ELISA. Population size was fixed at 360,000 in a 60 x 60 km area; demographics Copyright: This is an open access article, free of all were based on literature for Sub-Saharan African populations.