02145nas a2200253   4500000000100000008004100001653003900042653001300081653003000094100001300124700001300137700001400150700001100164700001300175700001100188700001700199700001500216245005700231856009900288300001300387490000700400520147000407022001401877       2018                            d10aNeglected tropical diseases (NTDs)10aTrachoma10aGuinea Worm Disease (GWD)1 aBuyon LE1 aSlaven R1 aEmerson P1 aKing J1 aDebrah O1 aAboe A1 aRuiz-Tiben E1 aCallahan K00aAchieving the endgame: Integrated NTD case searches.  uhttps://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0006623&type=printable  ae00066230 v123 a<p>Trachoma and Guinea Worm Disease (GWD) are neglected tropical diseases (NTD) slated for elimination as a public health problem and eradication respectively by the World Health Organization. As these programs wind down, uncovering the last cases becomes an urgent priority. In 2010, Ghana Health Services, along with The Carter Center, Sightsavers, and other partners, conducted integrated case searches for both GWD and the last stage of trachoma disease, trachomatous trichiasis (TT), as well as providing surgical treatment for TT to meet elimination (and eradication targets). House to house case searches for both diseases were conducted and two case management strategies were explored: a centralized referral to services method and a Point of Care (POC) delivery method. 835 suspected TT cases were discovered in the centralized method, of which 554 accepted surgery. 482 suspected TT cases were discovered in the POC method and all TT cases accepted surgery. The cost per TT case examined was lower in the POC searches compared to the centralized searches ($19.97 in the POC searches and $20.85 in the centralized searches). Both strategies resulted in high surgical uptake for TT surgery, with average uptakes of 72.4% and 83.9% for the centralized and POC searches respectively. We present here that house to house case searches offering services at POC are feasible and a potential tool for elimination and eradication programs nearing their end.</p>
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