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As the numbers of cases decline, costs of treatment and control diminish but those for surveillance remain high even after the \u2018last\u2019 case. Reducing surveillance may risk missing persistent or (re-)emerging foci of disease. Here, we use a simulation-based approach to determine the minimal number of passive surveillance sites required to ensure maximum coverage of a population at-risk (PAR) of an infectious disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methodology and principal findings<\/jats:title>\n                    <jats:p>For this study, we use Gambian human African trypanosomiasis (g-HAT) in north-western Uganda, a neglected tropical disease (NTD) which has been reduced to historically low levels (&lt;1000 cases\/year globally), as an example. To quantify travel time to diagnostic facilities, a proxy for surveillance coverage, we produced a high spatial-resolution resistance surface and performed cost-distance analyses. We simulated travel time for the PAR with different numbers (1\u2013170) and locations (170,000 total placement combinations) of diagnostic facilities, quantifying the percentage of the PAR within 1h and 5h travel of the facilities, as per in-country targets. Our simulations indicate that a 70% reduction (51\/170) in diagnostic centres still exceeded minimal targets of coverage even for remote populations, with &gt;95% of a total PAR of ~3million individuals living \u22641h from a diagnostic centre, and we demonstrate an approach to best place these facilities, informing a minimal impact scale back.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our results highlight that surveillance of g-HAT in north-western Uganda can be scaled back without substantially reducing coverage of the PAR. The methodology described can contribute to cost-effective and equable strategies for the surveillance of NTDs and other infectious diseases approaching elimination or (re-)emergence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pntd.0008599","type":"journal-article","created":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T13:49:50Z","timestamp":1614692990000},"page":"e0008599","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":14,"title":["Optimising passive surveillance of a neglected tropical disease in the era of elimination: A modelling study"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4151-9031","authenticated-orcid":true,"given":"Joshua","family":"Longbottom","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Wamboga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7901-969X","authenticated-orcid":true,"given":"Paul R.","family":"Bessell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9550-4030","authenticated-orcid":true,"given":"Steve J.","family":"Torr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1754-4894","authenticated-orcid":true,"given":"Michelle C.","family":"Stanton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,3,2]]},"reference":[{"issue":"1","key":"pntd.0008599.ref001","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1146\/annurev-publhealth-031816-044348","article-title":"Public Health Surveillance Systems: Recent Advances in Their Use and Evaluation","volume":"38","author":"SL Groseclose","year":"2017","journal-title":"Annual Review of Public Health"},{"key":"pntd.0008599.ref002","article-title":"Updated guidelines for evaluating public health surveillance systems; recommendations from the Guidelines Working Group","author":"RR German","year":"2001"},{"key":"pntd.0008599.ref003","first-page":"875253","article-title":"The past, present, and future of public health surveillance","volume":"2012","author":"BC Choi","year":"2012","journal-title":"Scientifica"},{"issue":"9","key":"pntd.0008599.ref004","doi-asserted-by":"crossref","first-page":"e0204335","DOI":"10.1371\/journal.pone.0204335","article-title":"Cost-effectiveness of using a rapid diagnostic test to screen for human African trypanosomiasis in the Democratic Republic of the Congo","volume":"13","author":"PR Bessell","year":"2018","journal-title":"PLoS One"},{"issue":"1","key":"pntd.0008599.ref005","doi-asserted-by":"crossref","first-page":"19","DOI":"10.2105\/AJPH.92.1.19","article-title":"Impact of targeted programs on health systems: a case study of the polio eradication initiative","volume":"92","author":"B Loevinsohn","year":"2002","journal-title":"American journal of public health"},{"issue":"1","key":"pntd.0008599.ref006","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1093\/ije\/5.1.19","volume":"5","author":"DA Henderson","year":"1976","journal-title":"Surveillance of Smallpox. 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