{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:16:16Z","timestamp":1792790176528,"version":"4.5.0"},"reference-count":29,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:00:00Z","timestamp":1771804800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The University of Queensland\u2019s Health Research Accelerator (HERA) initiative"},{"name":"NHMRC Investigator Grant","award":["1193826"],"award-info":[{"award-number":["1193826"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Lymphatic filariasis (LF) is a mosquito-borne neglected tropical disease that causes substantial morbidity and social exclusion. Global efforts under the World Health Organization\u2019s Global Programme to Eliminate Lymphatic Filariasis have markedly reduced prevalence, and several Pacific Island Countries and Territories (PICTs) have achieved elimination of the disease as a public health problem. However, post-validation surveillance (PVS), essential for detecting resurgence and enabling early response, has rarely been implemented, and barriers to its delivery remain poorly understood. We used two complementary qualitative approaches to identify systemic barriers and enablers to LF PVS in PICTs. First, we conducted a Nominal Group Technique followed by a structured expert elicitation involving program managers and technical staff. Data were analysed thematically and triangulated across sources. Participants identified 70 challenges which were consolidated into ten thematic domains. Pertinent barriers relate to limited leadership understanding of LF and surveillance options, inconsistent technical and financial support, and a lack of context-appropriate operational guidance. Additional challenges included limited field-ready diagnostics, procurement delays, the absence of formal mandates, and low community engagement. Enablers included embedding PVS within existing health services, leveraging trusted community networks, strengthening regional frameworks, and co-developing practical tools with countries. Sustaining LF elimination in the Pacific will require political commitment, regional collaboration, and integrated, programmatic approaches informed by recent PVS experience.<\/jats:p>","DOI":"10.3390\/tropicalmed11020062","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T11:39:10Z","timestamp":1771846750000},"page":"62","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Enablers of Post-Validation Surveillance for Lymphatic Filariasis in the Pacific Islands: A Nominal Group Technique and Expert Elicitation"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9287-8755","authenticated-orcid":false,"given":"Adam T.","family":"Craig","sequence":"first","affiliation":[{"name":"Operational Research and Decision Support for Infectious Diseases (ODeSI) Program, Centre for Clinical Research, The University of Queensland, Royal Brisbane Hospital, Herston, QLD 4029, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clement","family":"Couteaux","sequence":"additional","affiliation":[{"name":"Agence de Sant\u00e9 of Wallis and Futuna, Sia Hospital, Hahake District, Wallis 98600, Wallis and Futuna"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Jetton","sequence":"additional","affiliation":[{"name":"Republic of the Marshall Islands Ministry of Health and Human Services, P.O. Box 16, Majuro 96960, Marshall Islands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Nehemia","sequence":"additional","affiliation":[{"name":"Te Marae Ora Cook Islands Ministry of Health, Avarua P.O. Box 109, Rarotonga, Cook Islands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Sokana","sequence":"additional","affiliation":[{"name":"Solomon Islands Ministry of Health and Medical Services, Honiara P.O. Box 349, Solomon Islands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanebu","family":"Tong","sequence":"additional","affiliation":[{"name":"Kiribati Ministry of Health and Medical Services, Tarawa P.O. Box 268, Kiribati"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Temea","family":"Bauro","sequence":"additional","affiliation":[{"name":"Kiribati Ministry of Health and Medical Services, Tarawa P.O. Box 268, Kiribati"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taulanga","family":"Baratio","sequence":"additional","affiliation":[{"name":"Kiribati Ministry of Health and Medical Services, Tarawa P.O. Box 268, Kiribati"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ofa","family":"Tukai","sequence":"additional","affiliation":[{"name":"Tonga Ministry of Health, Nuku\u2019alofa P.O. Box 59, Tonga"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joe","family":"Takai","sequence":"additional","affiliation":[{"name":"Tonga Ministry of Health, Nuku\u2019alofa P.O. Box 59, Tonga"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satupaitea","family":"Viali","sequence":"additional","affiliation":[{"name":"Oceania University of Medicine, Apia P.O. Box 232, Samoa"},{"name":"School of Medicine, Faculty of Health Sciences, National University of Samoa, Toomatagi, Apia P.O. Box 1622, Samoa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noel Gama","family":"Soares","sequence":"additional","affiliation":[{"name":"Timor-Leste Ministry of Health, Palaco do Governo, Dili TL10001, Timor-Leste"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Ome-Kaius","sequence":"additional","affiliation":[{"name":"Papua New Guinea Institute of Medical Research, Goroka P.O. Box 60, Papua New Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Yohogu","sequence":"additional","affiliation":[{"name":"Papua New Guinea Ministry of Health, Waigani 121, Port Moresby P.O. Box 807, Papua New Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Litiana","family":"Volavola","sequence":"additional","affiliation":[{"name":"Fiji Ministry of Health and Medical Services, Dinem House, 88 Amy Street, Toorak, Suva P.O. Box 2223, Fiji"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Tatui","sequence":"additional","affiliation":[{"name":"Niue Department of Health, Niue Foou Hospital, Alofi P.O. Box 40, Niue"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fasihah","family":"Taleo","sequence":"additional","affiliation":[{"name":"World Health Organization Vanuatu Country Office, Port Vila P.O. Box 177, Vanuatu"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salanieta","family":"Saketa","sequence":"additional","affiliation":[{"name":"Public Health Division, Pacific Community, Suva P.O. Box 2223, Fiji"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andie","family":"Tucker","sequence":"additional","affiliation":[{"name":"Global Alliance to Eliminate Lymphatic Filariasis, Decatur, GA 30030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4628-8188","authenticated-orcid":false,"given":"Charles","family":"Mackenzie","sequence":"additional","affiliation":[{"name":"Global Alliance to Eliminate Lymphatic Filariasis, Decatur, GA 30030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2084-8039","authenticated-orcid":false,"given":"Katherine","family":"Gass","sequence":"additional","affiliation":[{"name":"Task Force for Global Health, Decatur, GA 30030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3559-3055","authenticated-orcid":false,"given":"Holly","family":"Jian","sequence":"additional","affiliation":[{"name":"Operational Research and Decision Support for Infectious Diseases (ODeSI) Program, Centre for Clinical Research, The University of Queensland, Royal Brisbane Hospital, Herston, QLD 4029, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8288-4169","authenticated-orcid":false,"given":"Colleen L.","family":"Lau","sequence":"additional","affiliation":[{"name":"Operational Research and Decision Support for Infectious Diseases (ODeSI) Program, Centre for Clinical Research, The University of Queensland, Royal Brisbane Hospital, Herston, QLD 4029, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9699-8201","authenticated-orcid":false,"given":"Harriet L. S.","family":"Lawford","sequence":"additional","affiliation":[{"name":"Operational Research and Decision Support for Infectious Diseases (ODeSI) Program, Centre for Clinical Research, The University of Queensland, Royal Brisbane Hospital, Herston, QLD 4029, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"de Souza, D.K., and Bockarie, M.J. (2025). Current perspectives in the epidemiology and control of lymphatic filariasis. Clin. Microbiol. Rev., 38.","DOI":"10.1128\/cmr.00126-23"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Gordon, C.A., Jones, M.K., and McManus, D.P. (2018). The History of Bancroftian Lymphatic Filariasis in Australasia and Oceania: Is There a Threat of Re-Occurrence in Mainland Australia?. Trop. Med. Infect. 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