{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T05:52:47Z","timestamp":1770184367113,"version":"3.49.0"},"reference-count":54,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001711","name":"Schweizerischer Nationalfonds zur F\u00c3\u00b6rderung der Wissenschaftlichen Forschung","doi-asserted-by":"publisher","award":["PR00P3_179753"],"award-info":[{"award-number":["PR00P3_179753"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      The Zanzibar islands, Tanzania, have eliminated schistosomiasis as a public health problem since 2017 and need to rethink their intervention strategies to ensure that the progress made is sustained and advanced. We evaluated the performance of a novel surveillance-response approach for interrupting\n                      <jats:italic>Schistosoma<\/jats:italic>\n                      transmission on Pemba Island from 2020-2024.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>\n                      In low-prevalence implementation units (IUs), surveillance-response interventions were implemented, which consisted of active and reactive case finding, treatment of\n                      <jats:italic>S. haematobium<\/jats:italic>\n                      -positive individuals, and reactive snail control. The performance of the surveillance-response interventions was measured by sensitivity, timeliness and impact on prevalence. Annual cross-sectional surveys were conducted in schools and households to estimate the total number of individuals infected with\n                      <jats:italic>S. haematobium<\/jats:italic>\n                      in the area and the proportion identified by the surveillance-response approach. Urogenital schistosomiasis was diagnosed by egg microscopy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Principal Findings<\/jats:title>\n                    <jats:p>\n                      Among the 20 IUs in the study area, 15, 16, and 17 were considered low-prevalence IUs in the intervention periods in 2021, 2022, and 2023, respectively. Across the intervention periods, 4.6% (707\/15509) among the schoolchildren included in active surveillance were tested\n                      <jats:italic>S. haematobium<\/jats:italic>\n                      -positive and treated. During reactive surveillance, at water bodies 8.2% (10\/122) and in households 9.9% (45\/454) of individuals were found infected and treated. Moreover, 47 among the 262 waterbodies were treated with molluscicide. The overall sensitivity of the surveillance-response approach across 2 periods, where complete surveillance data were available, was 23.0%. The timeliness of reactive interventions was 2 weeks. In the low-prevalence IUs, the prevalence in schoolchildren changed from 0.5% (7\/1552) in 2021 to 0.4% (6\/1653) in 2022, from 0.6% (12\/2123) in 2022 to 0.7% (15\/2240) in 2023, and from 0.4% (8\/2287) in 2023 to 1.0% (27\/2755) in 2024 after surveillance-response implementation. The respective prevalence in community members was 0.5% (14\/2969) in 2021 and 0.7% (19\/2928) in 2022, 0.6% (18\/3175) in 2022 and 0.3% (10\/2979) in 2023, and 0.4% (12\/3257) in 2023 and 0.7% (22\/3106) in 2024.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Surveillance-response interventions maintained the low\n                      <jats:italic>S. haematobium<\/jats:italic>\n                      prevalence, but interruption of transmission was not achieved. The overall sensitivity of the approach was low. Timeliness was very good but required strong communication and collaboration between the surveillance-response teams. To work on a larger scale, with good coverage and improved sensitivity, elimination programs will need a large number of well-trained staff and adequate tools for surveillance and response activities, data management, and communication.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>ISRCTN, ISCRCTN91431493. Registered 11 February 2020, ISRCTN - ISRCTN91431493: Novel intervention strategies for schistosomiasis elimination in Zanzibar.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pntd.0013947","type":"journal-article","created":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T18:27:07Z","timestamp":1770143227000},"page":"e0013947","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of surveillance-response interventions for Schistosoma haematobium elimination on Pemba Island, Tanzania: A 4-year intervention study with repeated cross-sectional surveys"],"prefix":"10.1371","volume":"20","author":[{"given":"Lydia","family":"Trippler","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Hattendorf","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed Nassor","family":"Ali","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah Omar","family":"Najim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khamis Seif","family":"Khamis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khamis Rashid","family":"Suleiman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaali Makame","family":"Ame","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saleh","family":"Juma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fatma","family":"Kabole","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Said Mohammed","family":"Ali","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5707-7963","authenticated-orcid":true,"given":"Stefanie","family":"Knopp","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,2,3]]},"reference":[{"key":"pntd.0013947.ref001","unstructured":"World Health Organization. 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