COR NTD Integrated strategies for hotspots: beyond ecology and towards cross-cutting programmatic challenges

Together with the STH Coalition and the Global Schistosomiasis Alliance, the COR-NTD Secretariat held a pre-meeting session called, "Integrated strategies for hotspots: beyond ecology and towards cross-cutting programmatic challenges."

The annual meeting of the Coalition for Operational Research on Neglected Tropical Diseases (COR-NTD) is taking place virtually this year. Ahead of the COR-NTD meeting, individual sessions will take place to inform synthesized sessions of a broader topic at COR-NTD in November.

Research Challenge to be addressed
How can hotspots be addressed with strategies that are integrated across NTDs? We focus on the challenge of developing generalizable, streamlined methods/toolkits to identify and to resolve hotspots. We address this challenge by examining causes and programmatic challenges common to multiple NTDs.

Aim of the Session
By bringing in the perspectives of programme managers, implementing partners, and researchers, the overall aim of this session is to provide a cross-cutting framework for addressing persistent hotspots. There is no single agreed, operational protocol for identifying hotspots that remain despite repeated mass drug administration (MDA). MDA and mapping already are ongoing in many countries. As such, national programmes require innovative approaches for hotspots that do not focus on infection-specific ecologies or strict prevalence/intensity cutoffs used for setting up MDA. Persistent hotspots exist due to sub-optimal interventions. Hence, a promising way forward is to use common programmatic challenges with MDA to identify hotspots. A meeting convened by the NTD-SC in April 2019 concluded that “a hotspot is an area that requires programmatic action.” Yet, there still remains a need for methods to classify and address hotspots based on their shared programmatic challenges. In this session, we will advance the hotspot research agenda by building on the NTD-SC 2019 meeting and a previous COR-NTD session (3C in 2018). Operational research questions will be identified that must be answered in order to formulate a general toolkit or ‘checklist’ for standardizing the identification of persistent hotspots by their causes and potential solutions.

The issues to be discussed in the talks include:

• addressing low treatment rates across multiple rounds of MDA, persistent morbidity clusters, and other implementation-specific challenges concentrated within hotspots,
• co-sampling for MDA across implementation units, diseases, and WASH risk factors to identify hotspots,
• identifying hotspots based on their responsiveness to MDA and adopting flexible approaches for national programme actions for hotspots, and
• testing the use of performance-based checklists within national programmes for identifying and resolving hotspots.

Speakers and moderators

• Prof Daniel G. Colley
• Prof Peter Diggle
• Dr Rubina Imtiaz
• Dr Narcis Kabatereine
• Dr Goylette Chami
• Mr Cosmas Ndellejong