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The 2021–2030 Neglected Tropical Diseases road map calls for intensified cross-cutting approaches. By moving away from vertical programming, the integration of platforms and intervention delivery aims to improve efficiency, cost-effectiveness and programme coverage. Drawing on the direct experiences of the authors, this article outlines key elements for successful integrated surveys, the challenges encountered, as well as future opportunities and threats to such surveys. There are multiple advantages. Careful planning should ensure that integration does not result in a process that is less efficient, more expensive or that generates data driving less reliable decisions than conducting multiple disease-specific surveys.

Helminth infections caused by schistosomes and soil-transmitted helminths (STHs) are among the most prevalent afflictions of humans who live in areas of poverty in the developing world. The level of morbidity and mortality caused by these helminthes requires urgent intervention. This study reports on the epidemiological mapping and intervention strategies for the control of schistosomiasis and STH in Nigeria. Epidemiological survey on the prevalence of schistosomiasis and STH was conducted in Nigeria between November 2013 and May 2015 in 19 States of the Federation and the Federal Capital Territory (FCT), covering 2,160 schools /communities in 433 LGAs. Urine and faecal samples were collected from 108,472 pupils comprising 57,670 (53.2%) males and 50,802 (46.8%) females of age range 5 to 16 years. The samples were analysed using urine filtration and KatoKatz techniques. The target population for intervention was determined using the World Health Organization Guidelines for intervention strategies. Prevalence of 9.5% and 27% were recorded for schistosomiasis and soil transmitted helminthiasis respectively from the pupils sampled. Highest prevalence of 26.1% was recorded in Niger State for schistosomiasis while the lowest was in Rivers State (0.1%). STH had highest prevalence in Akwa Ibom State (58.4%) and lowest in Yobe State (1.4%). Niger State also had the highest prevalence for co-infection (8.96%). Based on the prevalence of schistosomiasis observed, a total of 202 LGAs fall within the low risk category, 153 moderate and four LGAs were high risk category. The high risk LGAs were located in Niger and Kebbi States. Case-based management is required for STH in 191 LGAs while 177 LGAs fall within the low-risk and 60 LGAs were in the high risk categories. The findings of this study highlighted the treatment interventions required to facilitate scale up of appropriate mass administration of medicine, water, sanitation and hygiene intervention in the 19 States of the Federation and the FCT. Keywords: Schistosomiasis; soil-transmitted helminthiasis; prevalence; intervention strategy; risk; control; treatment.

Purpose: To determine the local government area (LGA)-level prevalence of trachoma in all 34 LGAs of Katsina State. Methods: A population-based prevalence survey was conducted in each LGA of Katsina State, using the Global Trachoma Mapping Project methodology. We used a 3-stage cluster random sampling strategy to select 25 households from each of 25 clusters. We examined all residents of selected households aged 1 year and older for the clinical signs of trachomatous inflammation–follicular (TF), trachomatous inflammation–intense and trichiasis, using the World Health Organization (WHO) simplified grading scheme. Results: We examined 129,281 persons. Six LGAs had a TF prevalence ≥10%, and another six LGAs had a TF prevalence between 5% and 9.9%; all 12 require mass drug administration with azithromycin plus other interventions. The prevalence of trichiasis was ≥1.0% in 13 LGAs, and there is a need to perform trichiasis surgery in over 26,000 persons to reach targets set by the WHO for elimination of trichiasis. Conclusion: The prevalence of TF is generally low in Katsina state, but urgent steps must be taken to implement the full SAFE strategy (surgery, antibiotics, facial cleanliness, environmental improvement) in at least 12 LGAs while also stepping up efforts to provide community-based trichiasis surgery throughout the whole state, in order to make trachoma elimination by 2020 a reality.

In collaboration with the health ministries that we serve and other partners, we set out to complete the multiple-country Global Trachoma Mapping Project. To maximize the accuracy and reliability of its outputs, we needed in-built, practical mechanisms for quality assurance and quality control. This article describes how those mechanisms were created and deployed. Using expert opinion, computer simulation, working groups, field trials, progressively accumulated in-project experience, and external evaluations, we developed 1) criteria for where and where not to undertake population-based prevalence surveys for trachoma; 2) three iterations of a standardized training and certification system for field teams; 3) a customized Android phone–based data collection app; 4) comprehensive support systems; and 5) a secure end-to-end pipeline for data upload, storage, cleaning by objective data managers, analysis, health ministry review and approval, and online display. We are now supporting peer-reviewed publication. Our experience shows that it is possible to quality control and quality assure prevalence surveys in such a way as to maximize comparability of prevalence estimates between countries and permit high-speed, high-fidelity data processing and storage, while protecting the interests of health ministries.

School surveys provide a convenient platform to obtain large child cohorts from multiple communities and are widely used as a proxy to determine community prevalence of neglected tropical diseases. The purpose of this study was to compare trachoma prevalence between preschool- and school-aged children and children who attend and do not attend school.; We analysed data from community-based trachoma surveys conducted from 2008-2011 in Ethiopia, Mali, Niger and Nigeria. The surveys utilised a cross-sectional, randomised cluster design. Individual-level data on school attendance was collected.; Overall, 75 864 children aged 1-15 years from 2100 communities were included in the analysis. The prevalence of trachomatous inflammation follicular (TF) among these children in surveyed districts was 19.1% (95% CI 17.9-20.2%) in Ethiopia, 6.2% (95% CI 5.4-6.9%) in Niger, 4.6% (95% CI 4.2-4.9%) in Mali and 4.2% (95% CI 3.5-4.9%) in Nigeria. Controlling for age, sex and clustering, the OR of TF for school-attendees compared to non-attendees was 0.64 (95% CI 0.56-0.73) in Ethiopia, 0.67 (95% CI 0.56-0.80) in Mali, 1.03 (95% CI 0.81-1.16) in Niger and 1.06, (95% CI 0.65-1.73) in Nigeria.; Estimating the prevalence of trachoma through examination of only school-going children risks underestimating the true prevalence.

Purpose: To determine the prevalence of trachoma in each of the 25 local government areas (LGAs) of Niger State, Nigeria. Methods: A population-based cross-sectional survey was conducted in each Niger State LGA between March and April 2014, as part of the Global Trachoma Mapping Project (GTMP). GTMP protocols were used in planning and conduct of the surveys. Using probability proportional to size, 25 clusters were selected; in each of these clusters, 25 households were enrolled for the survey. All residents aged 1 year and older were examined by GTMP-certified graders for trachomatous inflammation – follicular (TF) and trichiasis using the World Health Organization simplified grading scheme. Additionally, we collected data on household water and sanitation facilities. Results: Only one LGA (Kontagora) had TF prevalence in 1–9-year-olds above 10%; one other LGA (Rafi) had TF prevalence between 5.0 and 9.9%. Six LGAs need trichiasis surgical services provided to achieve a prevalence of

Purpose: To determine the prevalence of trachomatous inflammation – follicular (TF) and trichiasis in each of the 20 local government areas (LGAs) of Bauchi State, Nigeria. Methods: We undertook a population-based prevalence survey in each LGA in Bauchi State, employing the Global Trachoma Mapping Project methodology. We used a 2-stage, systematic and quasi-random sampling strategy. Using probability proportional to size, we selected 25 clusters, in each of which 25 households were selected by random walk. All residents of selected households 1 year and older were examined for TF, trachomatous inflammation – intense, and trichiasis, using the World Health Organization simplified grading scheme. Results: Only two LGAs in Bauchi State had TF prevalences in 1–9-year-olds over 5%, with none having TF prevalences of 10% or greater. Only one LGA had a trichiasis prevalence in adults below the elimination threshold; all the others had trichiasis at levels suggestive of public health significance. In all 20 LGAs, more than 60% of households were within 1 km of an improved source of water for hygiene. Conclusion: Efforts need to be made in Bauchi State to provide trichiasis surgery in order to avert trachomatous blindness. Water supplies needs to be sustained and good personal hygiene practices assured so that elimination of trachoma as a public health problem will be achieved and sustained.