01956nas a2200193   4500000000100000008004100001260001200042100001400054700001300068700002100081700001400102700001600116245021100132856009900343300001300442490000700455520128600462022001401748       2020                            d  c10/20201 aCollyer B1 aIrvine M1 aHollingsworth DT1 aBradley M1 aAnderson RM00aDefining a prevalence level to describe the elimination of Lymphatic Filariasis (LF) transmission and designing monitoring & evaluating (M&E) programmes post the cessation of mass drug administration (MDA).  uhttps://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0008644&type=printable  ae00086440 v143 a<p>The global decline in prevalence of lymphatic filariasis has been one of the major successes of the WHO's NTD programme. The recommended strategy of intensive, community-wide mass drug administration, aims to break localised transmission by either reducing the prevalence of microfilaria positive infections to below 1%, or antigen positive infections to below 2%. After the threshold is reached, and mass drug administration is stopped, geographically defined evaluation units must pass Transmission Assessment Surveys to demonstrate that transmission has been interrupted. In this study, we use an empirically parameterised stochastic transmission model to investigate the appropriateness of 1% microfilaria-positive prevalence as a stopping threshold, and statistically evaluate how well various monitoring prevalence-thresholds predict elimination or disease resurgence in the future by calculating their predictive value. Our results support the 1% filaremia prevalence target as appropriate stopping criteria. However, because at low prevalence-levels random events dominate the transmission dynamics, we find single prevalence measurements have poor predictive power for predicting resurgence, which suggests alternative criteria for restarting MDA may be beneficial.</p>  a1935-2735