{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T19:29:18Z","timestamp":1774380558708,"version":"3.50.1"},"reference-count":29,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2017,6,26]],"date-time":"2017-06-26T00:00:00Z","timestamp":1498435200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["U01GM110744"],"award-info":[{"award-number":["U01GM110744"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Welcomme Trust","award":["095066"],"award-info":[{"award-number":["095066"]}]},{"DOI":"10.13039\/100000865","name":"Bill &amp; Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1119467"],"award-info":[{"award-number":["OPP1119467"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill &amp; Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1093011"],"award-info":[{"award-number":["OPP1093011"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill &amp; Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1106023"],"award-info":[{"award-number":["OPP1106023"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill &amp; Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1132415"],"award-info":[{"award-number":["OPP1132415"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>During the endgame of elimination programs, parasite populations may exhibit dynamical phenomena not typical of endemic disease. Particularly, monitoring programs for tracking infection prevalence may be hampered by overall rarity, the sporadic and unpredictable timing and location of outbreaks, and under-reporting. A particularly important problem for monitoring is determining the distance that must be covered to achieve the elimination threshold at an effective reproduction number less than one. In this perspective, we suggest that this problem may be overcome by measuring critical slowing down. Critical slowing down is a phenomenon exhibited by nonlinear dynamical systems in the vicinity of a critical threshold. In infectious disease dynamics, critical slowing down is expressed as an increase in the coefficient of variation and other properties of the fluctuations in the number of cases. In simulations, we show the coefficient of variation to be insensitive to under-reporting error and therefore a robust measurement of the approach to elimination. Additionally, we show that there is an inevitable delay between the time at which the effective reproduction number is reduced to below one and complete elimination is achieved. We urge that monitoring programs include dynamical properties such as critical slowing down in their metrics for measuring achievement and avoid withdrawing control activities prematurely.<\/jats:p>","DOI":"10.3390\/tropicalmed2030020","type":"journal-article","created":{"date-parts":[[2017,6,27]],"date-time":"2017-06-27T02:58:05Z","timestamp":1498532285000},"page":"20","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Monitoring the Path to the Elimination of Infectious Diseases"],"prefix":"10.3390","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4646-1235","authenticated-orcid":false,"given":"John M.","family":"Drake","sequence":"first","affiliation":[{"name":"Odum School of Ecology, University of Georgia, Athens, GA 30602-2202, USA"},{"name":"Center for the Ecology of Infectious Diseases, University of Georgia, Athens, GA 30602-2202, USA"},{"name":"Department of Zoology, University of Oxford, Oxford OX2, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon I.","family":"Hay","sequence":"additional","affiliation":[{"name":"Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98121, USA"},{"name":"Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford OX3 7LF, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2017,6,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1056\/NEJMra1200391","article-title":"Disease eradication","volume":"368","author":"Hopkins","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref_2","unstructured":"Fenner, F., Henderson, D.A., Arita, I., Jecek, Z., and Ladnyi, I.D. (1998). Smallpox and Its Eradication. History of International Public Health, World Health Organization."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"20120140","DOI":"10.1098\/rstb.2012.0140","article-title":"The final stages of the global eradication of poliomyelitis","volume":"368","author":"Grassly","year":"2013","journal-title":"Philos. Trans. R. Soc. B"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"20120146","DOI":"10.1098\/rstb.2012.0146","article-title":"Dracunculiasis (guinea worm disease): Eradication without a drug or a vaccine","volume":"368","author":"Biswas","year":"2013","journal-title":"Philos. Trans. R. Soc. B"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Rinaldi, A. (2012). Yaws eradication: Facing old problems, raising new hopes. PLoS Negl. Trop. Dis., 6.","DOI":"10.1371\/journal.pntd.0001837"},{"key":"ref_6","unstructured":"Global Health Group, and Malaria Atlas Project (2011). Atlas of Malaria Eliminating Countries, The Global Health Group, Global Health Sciences, University of California."},{"key":"ref_7","unstructured":"World Health Organization (2012). Global programme to eliminate lymphatic filariasis: Progress report, 2011. Wkly. Epidemiol. Rec., 37, 345\u2013356."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1186\/1756-3305-7-46","article-title":"Global Alliance to Eliminate Lymphatic Filariasis. Seventh meeting of the Global Alliance to Eliminate Lymphatic Filariasis: Reaching the vision by scaling up, scaling down, and reaching out","volume":"7","author":"Brady","year":"2014","journal-title":"Parasites Vectors"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"20120141","DOI":"10.1098\/rstb.2012.0141","article-title":"Think globally, act locally: The role of local demographics and vaccination coverage in the dynamic response of measles infection to control","volume":"368","author":"Ferrari","year":"2013","journal-title":"Philos. Trans. R. Soc. B"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1001\/jamapediatrics.2013.4342","article-title":"Elimination of endemic measles, rubella, and congenital rubella syndrome from the Western hemisphere: The US experience","volume":"168","author":"Papania","year":"2014","journal-title":"JAMA Pediatr."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.pt.2011.10.003","article-title":"Elimination of onchocerciasis from Africa: Possible?","volume":"28","author":"Mackenzie","year":"2012","journal-title":"Trends Parasitol."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Traore, M.O., Sarr, M.D., Badji, A., Bissan, Y., Diawara, L., Doumbia, K., Goita, S.F., Konate, L., Mounkoro, K., and Seck, A.F. (2012). Proof-of-principle of onchocerciasis elimination with ivermectin treatment in endemic foci in Africa: Final results of a study in Mali and Senegal. PLoS Negl. Trop. Dis., 6.","DOI":"10.1371\/journal.pntd.0001825"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1016\/j.actatropica.2012.04.013","article-title":"Time to set the agenda for schistosomiasis elimination","volume":"128","author":"Rollinson","year":"2013","journal-title":"Acta Trop."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1017\/S0031182013002102","article-title":"The journey towards elimination of gambiense human African trypanosomiasis: Not far, nor easy","volume":"141","author":"Franco","year":"2014","journal-title":"Parasitology"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"20120137","DOI":"10.1098\/rstb.2012.0137","article-title":"Towards the endgame and beyond: Complexities and challenges for the elimination of infectious diseases","volume":"368","author":"Klepac","year":"2013","journal-title":"Philos. Trans. R. Soc. B"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Bousema, T., Griffin, J.T., Sauerwein, R.W., Smith, D.L., Churcher, T.S., Takken, W., Ghani, A., Drakeley, C., and Gosling, R. (2012). Hitting hotspots: Spatial targeting of malaria for control and elimination. PLoS Med., 9.","DOI":"10.1371\/journal.pmed.1001165"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1186\/1475-2875-11-122","article-title":"Malaria resurgence: A systematic review and assessment of its causes","volume":"11","author":"Cohen","year":"2012","journal-title":"Malar. J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1093\/infdis\/jir727","article-title":"The final phase of polio eradication: New vaccines and complex choices","volume":"205","author":"Cochi","year":"2012","journal-title":"J. Infect. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1016\/j.coviro.2012.02.006","article-title":"Reaching the last one per cent: Progress and challenges in global polio eradication","volume":"2","author":"Kew","year":"2012","journal-title":"Curr. Opin. Virol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1374","DOI":"10.1056\/NEJMp1300765","article-title":"Go big and go fast\u2014Vaccine refusal and disease eradication","volume":"368","author":"Omer","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1126\/science.1225244","article-title":"Anticipating critical transitions","volume":"338","author":"Scheffer","year":"2012","journal-title":"Science"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1007\/s12080-013-0185-5","article-title":"Theory of early warning signals of disease emergence and leading indicators of elimination","volume":"6","author":"Drake","year":"2013","journal-title":"Theor. Ecol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1007\/s12080-013-0192-6","article-title":"Early warning signals: The charted and uncharted territories","volume":"6","author":"Boettiger","year":"2013","journal-title":"Theor. Ecol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1007\/s12080-015-0285-5","article-title":"Leading indicators of mosquito-borne disease elimination","volume":"9","author":"Lillie","year":"2016","journal-title":"Theor. Ecol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"044109","DOI":"10.1063\/1.2159468","article-title":"Efficient step size selection for the tau-leaping simulation method","volume":"124","author":"Cao","year":"2006","journal-title":"J. Chem. Phys."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1038\/nature02007","article-title":"Planning for smallpox outbreaks","volume":"426","author":"Ferguson","year":"2003","journal-title":"Nature"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"20160540","DOI":"10.1098\/rsif.2016.0540","article-title":"Waiting time to infectious disease emergence","volume":"13","author":"Dibble","year":"2016","journal-title":"J. R. Soc. Interface"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Dakos, V., Carpenter, S.R., Brock, W.A., Ellison, A.M., Guttal, V., Ives, A.R., K\u00e9fi, S., Livina, V., Seekell, D., and van Nes, E.H. (2012). Methods for detecting early warnings of critical transitions in time series illustrated using simulated ecological data. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0041010"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s12080-008-0033-1","article-title":"Spatial variance and spatial skewness: Leading indicators of regime shifts in spatial ecological systems","volume":"2","author":"Guttal","year":"2009","journal-title":"Theor. Ecol."}],"container-title":["Tropical Medicine and Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2414-6366\/2\/3\/20\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T18:40:25Z","timestamp":1760208025000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2414-6366\/2\/3\/20"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,6,26]]},"references-count":29,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2017,9]]}},"alternative-id":["tropicalmed2030020"],"URL":"https:\/\/doi.org\/10.3390\/tropicalmed2030020","relation":{},"ISSN":["2414-6366"],"issn-type":[{"value":"2414-6366","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,6,26]]}}}