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Surveillance of Eliminated and Near-Eliminated Infectious Disease in the Western Pacific Region

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A special issue of Tropical Medicine and Infectious Disease (ISSN 2414-6366). This special issue belongs to the section "Infectious Diseases".

Deadline for manuscript submissions: closed (25 May 2026) | Viewed by 9657

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Special Issue Editors

Dr. Harriet Lawford

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Guest Editor

UQ Centre for Clinical Research, Faculty of Health, Medicine, and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia
Interests: infectious diseases surveillance; operational research; Pacific islands; lymphatic filariasis; neglected tropical diseases

Dr. Adam Craig

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Guest Editor

UQ Centre for Clinical Research, Faculty of Health, Medicine, and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia
Interests: infectious diseases surveillance; integrated surveillance; Pacific islands; health systems; operational research; health policy research; public health

Special Issue Information

Dear Colleagues,

The Western Pacific Region (WPR) has achieved substantial progress in the elimination and erradication of vaccine-preventable and neglected tropical infectious diseases, with several countries successfully eliminating lymphatic filariasis (LF), trachoma, hepatitis B, and yaws; others are well on the way to meeting their targets. However, elimination or erradication is not the end of the public health road for these diseases in these countires. Robust post-validation/elimination surveillance is essential to ensure resugence of disases does not occur and that the hard won gains made through years of public health effort lost.

Complex geographies, limited human and financial resources, fragile supply chains, and competing health priorities continue to challenges infectious disease programmes in the WPR, necessitating novel, bold thinking and integrated approaches. By integrating surveillance across disease progams and service delivery systems, countries can find efficiencies extending the reach and impact of their efforts. Strong community engagement, culturally tailored communication, and prudent health system integration are critical to supporting elimination targets.

This Special Issue aims to showcase novel approaches to the surveillance of eliminated and near-eliminated vaccine-preventable and neglected tropical infectious diseases in the WPR. Consolidating evidence in this issue will create a platform for cross-country and interdisciplinary learning, ensuring that efforts to reach elimination goals are targeted, supporting resilient health security across the region.

Dr. Harriet Lawford
Dr. Adam Craig
Guest Editors

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Keywords

infectious diseases
neglected tropical diseases
vaccine preventable diseases
lymphatic filariasis
yaws
trachoma
measles
rubella
Asia-Pacific
surveillance

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Published Papers (7 papers)

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Research

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17 pages, 1159 KB

Open AccessArticle

Challenges to ‘Last Mile’ Surveillance: Result of Programmatic Review of Integrated Skin NTDs Surveillance in Three Indonesian Districts

by Agrin Zauyani Putri, Ajib Diptyanusa, Regina Tiolina Sidjabat, Yatinawati Yatinawati, Yety Intarti, Irma Surya Kusuma, Khadijah Qurrata Ayun, Trijoko Yudopuspito, Muhammad Anwar Simanullang, Dwi Martanti, Achmad Naufal Azhari, Herdiana Herdiana and Yullita Evarini Yuzwar

Trop. Med. Infect. Dis. 2026, 11(5), 123; https://doi.org/10.3390/tropicalmed11050123 - 6 May 2026

Viewed by 679

Abstract

Indonesia is approaching the ‘last mile’ of elimination for several skin-related neglected tropical diseases (skin NTDs): notably, leprosy, yaws and lymphatic filariasis (LF). However, persistent transmission in selected districts highlights systemic weaknesses in surveillance. This paper aimed to analyse the health system, operational and sociocultural barriers to integrated skin NTDs surveillance in Indonesia. A descriptive analysis of the national programmatic review of integrated skin NTDs was conducted in 2024, using a mixed-methods descriptive evaluation based on routine data and thematic analysis. Comparative case studies of the Belitung, Mimika and Sorong Selatan Districts were conducted using routine data, programme reports, and structured observations at primary health centres, district health offices and laboratories. Qualitative insights from programme managers, health workers and communities were thematically analysed. Integrated surveillance was constrained by fragmented governance, inflexible financing, and uneven workforce capacity, alongside operational challenges like delayed detection and geographic inaccessibility. Furthermore, sociocultural factors such as stigma and population mobility, combined with zoonotic LF transmission in Belitung, significantly undermine effectiveness and long-term programmatic sustainability. Despite strong national policy commitment and substantial progress in disease elimination, significant gaps remain between integration frameworks and operational realities at the district level. Accelerating skin NTDs elimination in Indonesia requires context-adapted integration, strengthened digital surveillance, sustained subnational financing, workforce capacity building and, in zoonotic settings, a One Health approach. Addressing these factors is essential for achieving and sustaining elimination in the last mile. Indonesia has achieved substantial progress across major skin NTDs, while also revealing persistent gaps that threaten the sustainability of elimination gains. Full article

(This article belongs to the Special Issue Surveillance of Eliminated and Near-Eliminated Infectious Disease in the Western Pacific Region)

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19 pages, 1023 KB

Open AccessArticle

Schistosomiasis japonicum in Indonesia: Progress and Surveillance Needs in Verge-of-Elimination Settings

by Achmad Naufal Azhari, Agrin Zauyani Putri, Ajib Diptyanusa, Sunardi Sunardi, Yayuk Agustin Hapsari, Regina Tiolina Sidjabat, Dauries Ariyanti, Zainal Khoirudin, Rezavitawanti Rezavitawanti, Herdiana Herdiana, Yullita Evarini Yuzwar and Farida Alhosani

Trop. Med. Infect. Dis. 2026, 11(4), 86; https://doi.org/10.3390/tropicalmed11040086 - 24 Mar 2026

Viewed by 1056

Abstract

Schistosomiasis japonicum transmission in Indonesia has declined substantially over recent decades, placing it in the last miles of elimination in the Western Pacific Region. As programmes transition from control to interruption of transmission, surveillance systems must be capable of detecting residual transmission. This study synthesised routine epidemiological data from 2015 to 2025 to assess Indonesia’s readiness for elimination and to identify key surveillance gaps in near-elimination settings. Descriptive quantitative analysis was conducted using national surveillance data from two endemic districts in Central Sulawesi, complemented by programme reports on mass drug administration, human diagnosis, animal reservoir surveillance, and snail surveys. Results showed that while prevalence in humans has remained low and responsive to mass drug administration, transmission persists through infected animal reservoirs and intermediate snail hosts. Surveillance performance is constrained by limited diagnostic capacity, inconsistent snail survey coverage, fragmented paper-based reporting systems, and weak integration across human, animal, and environmental sectors. These findings indicated that low prevalence in humans alone is insufficient to demonstrate interruption of transmission, particularly in zoonotic schistosomiasis. In conclusion, Indonesia’s experience highlights the need to strengthen near-elimination surveillance through sensitive diagnostics, integrated One Health approaches, and digitally enabled data systems to sustain elimination and support future verification of schistosomiasis transmission interruption. Full article

(This article belongs to the Special Issue Surveillance of Eliminated and Near-Eliminated Infectious Disease in the Western Pacific Region)

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12 pages, 597 KB

Open AccessCommunication

Locally Acquired Dengue in Townsville, Australia, 2024–2025: An Outbreak Report in a Non-Endemic Region with wMel Wolbachia-Infected Aedes aegypti

by Kyra Thompson, Scott Lyons, Katherine Malone, Jesse Fryk, Alyssa Pyke and Kate Murton

Trop. Med. Infect. Dis. 2026, 11(3), 66; https://doi.org/10.3390/tropicalmed11030066 - 26 Feb 2026

Viewed by 1513

Abstract

During the 2024/2025 wet season, Townsville had its first sustained autochthonous outbreak of dengue disease caused by dengue virus type 2 (DENV-2), the second locally transmitted outbreak of dengue since 2014 following the introduction of wMel strain Wolbachia-infected mosquitoes, a control strategy for dengue virus (DENV) and other Aedes-transmitted arboviruses. In comparison to two recorded locally acquired cases of dengue in 2020, the 2024/2025 outbreak resulted in sixteen cases in two inner-city suburbs of Townsville during the wet season associated with higher-than-average rainfall. This second dengue outbreak since 2014 highlights that Townsville and other north Queensland communities where Wolbachia mosquito programs have been deployed remain vulnerable to DENV incursions and local disease outbreaks despite the apparent high coverage of Wolbachia-infected mosquitoes. Whilst these control strategies have likely contributed to a reduction in the number and frequency of autochthonous DENV outbreaks in north Queensland, ongoing maintenance and monitoring of Wolbachia-infected mosquito coverage is necessary, together with timely review and improvement in dengue awareness and prevention health promotion activities in the community. Full article

(This article belongs to the Special Issue Surveillance of Eliminated and Near-Eliminated Infectious Disease in the Western Pacific Region)

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14 pages, 2459 KB

Open AccessArticle

Finding the Gaps: Integrated Serosurveillance and Spatial Clustering of Vaccine Preventable Diseases in Samoa, 2018–2019

by Selina Ward, Harriet L. S. Lawford, Benn Sartorius, Helen J. Mayfield, Filipina Amosa-Lei Sam, Sarah Louise Sheridan, Robert Thomsen, Satupaitea Viali and Colleen L. Lau

Trop. Med. Infect. Dis. 2026, 11(1), 9; https://doi.org/10.3390/tropicalmed11010009 - 28 Dec 2025

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Abstract

Introduction: Seroprevalence of antibodies for vaccine-preventable diseases (VPDs), due to vaccination or previous infection, can provide a more accurate estimate of immunity compared to vaccination coverage data alone. This study aimed to examine the seroepidemiology and spatial distribution of VPD seroprevalence in Samoa in 2018 and 2019. Methods: Dried blood spot (DBS) samples were collected from two nationally representative community-based surveys of participants aged ≥5 years from the Surveillance and Monitoring to Eliminate Lymphatic Filariasis and Scabies from Samoa (SaMELFS) project. DBSs were tested using multiplex bead assays (MBAs) to detect antibodies against measles, rubella, diphtheria, and tetanus. Seroprevalence was estimated at the national and primary sampling unit (PSU) levels, and cluster analysis was completed using SaTScan. Results: Overall, 8394 valid MBA results were analysed across 35 PSUs. The highest overall seroprevalence was observed for tetanus (91.0%; 95% CI: 90.2–91.7), followed by diphtheria (83.7%; 95% CI: 82.7–84.7), rubella (79.3%; 95% CI: 78.2–80.3), and measles (45.8%; 95% CI: 44.8–46.9) with substantial heterogeneity across PSUs. Clusters of seronegativity to measles (relative risk [RR]: 1.16, p < 0.001) and diphtheria (RR: 1.16, p < 0.001) were also identified. Conclusions: These findings demonstrate significant variation in seroprevalence and pockets of low population immunity to multiple VPDs, highlighting the key advantage of an integrated rather than siloed approach. The relatively high seroprevalence to rubella suggests potential community transmission, emphasising the need to strengthen congenital rubella surveillance and improve vaccination coverage. Identifying low immunity to VPDs can provide an early warning to potential outbreak risk and support the Ministry of Health to target public health interventions in higher-risk areas. Full article

(This article belongs to the Special Issue Surveillance of Eliminated and Near-Eliminated Infectious Disease in the Western Pacific Region)

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Review

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25 pages, 2436 KB

Open AccessReview

Neglected Tropical Diseases Elimination in the Philippines: Challenges and Gaps

by Josephine Abrazaldo, Patrick de Vera, Sheila Grace Martin, John Leo Dayrit, Daryl Christian Mejos and Ferdinand Mortel

Trop. Med. Infect. Dis. 2026, 11(4), 106; https://doi.org/10.3390/tropicalmed11040106 - 17 Apr 2026

Viewed by 1581

Abstract

Neglected tropical diseases (NTDs) such as soil-transmitted helminthiasis, lymphatic filariasis, schistosomiasis, leprosy, rabies, and food-borne trematodiasis are endemic in the Philippines. Despite global and national elimination efforts, these six NTDs remain a persistent burden to the poor, those living in Geographically Isolated and Disadvantaged Areas (GIDAs), and other vulnerable groups. This narrative review synthesized data from Field Health Services Information System (FHSIS) reports of the Philippine Department of Health (DOH) from 2020 to 2024, the available literature from electronic databases, and DOH and WHO reports focusing on the challenges, barriers, and gaps in NTD control and elimination in the country. Core challenges include complex epidemiological landscapes, lapses in disease surveillance, infrastructure, and fragmented health care systems. Gaps include access to diagnostics, insufficient funding and human resource training, and scarcity of local studies focusing on endemic NTDs. With these challenges and gaps, this review highlights the need for a real-time feedback loop system in surveillance strategy, community-based interventions, full integration of NTDs in primary health care, and collaboration between government, NGOs and private entities. Addressing these challenges and gaps is key to shifting from control to elimination. Full article

(This article belongs to the Special Issue Surveillance of Eliminated and Near-Eliminated Infectious Disease in the Western Pacific Region)

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22 pages, 1243 KB

Open AccessReview

Global Lymphatic Filariasis Post-Validation Surveillance Activities in 2025: A Scoping Review

by Holly Jian, Harriet Lawford, Angus McLure, Colleen Lau and Adam Craig

Trop. Med. Infect. Dis. 2026, 11(1), 28; https://doi.org/10.3390/tropicalmed11010028 - 19 Jan 2026

Cited by 2 | Viewed by 1802

Abstract

Following World Health Organization (WHO) validation of lymphatic filariasis (LF) elimination as a public health problem, countries are required to implement post-validation surveillance (PVS) to detect potential resurgence and ensure sustained elimination. WHO’s guidelines released in 2025 recommend implementation of at least two of four PVS strategies—targeted surveys, integration into standardised surveys, health facility-based screening, and molecular xenomonitoring (MX) of mosquitoes. This review synthesised global evidence on PVS activities from 2007 to 2025 in the 23 countries and territories validated as having eliminated LF. Studies were identified through PubMed, Scopus, Embase, Web of Science, and the WHO Institutional Repository for Information Sharing (IRIS). Data on publication information, surveillance strategies, priority populations, and operational challenges and enablers were extracted. Narrative synthesis using deductive content analysis was applied. Thirty documents from 17 countries were included. Targeted surveillance and integration of PVS with other health programmes were the most common approaches noted (reported in ten and nine countries, respectively), followed by MX (seven countries) and health facility-based screening (four countries). Surveillance often focused on migrants and previous hotspots, with operational challenges linked to limited funding, workforce, and supply chains. Documents indicated that Sri Lanka, Thailand, China, and South Korea developed sustained PVS through national policies and domestic funding. Findings highlight the need for clear, contextualised guidance to operationalise sustainable PVS in different settings. Full article

(This article belongs to the Special Issue Surveillance of Eliminated and Near-Eliminated Infectious Disease in the Western Pacific Region)

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Other

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9 pages, 482 KB

Open AccessBrief Report

The Effect of Increased Temperature on Dengue Virus in the Vector Aedes aegypti from New Caledonia

by Méryl Delrieu, Olivia O’Connor, Nicolas Pocquet, Kenny Teraiharoa, Anne-Fleur Griffon, Christophe Menkes, Morgan Mangeas, Elvina Viennet, Valérie Burtet-Sarramegna, Myrielle Dupont-Rouzeyrol and Francesca D. Frentiu

Trop. Med. Infect. Dis. 2026, 11(2), 53; https://doi.org/10.3390/tropicalmed11020053 - 14 Feb 2026

Viewed by 969

Abstract

Dengue virus (DENV) is a major public health concern in tropical and subtropical regions, including the Pacific. Temperature is recognised as a major driver of transmission under climate change. Understanding how higher temperatures may alter DENV transmission is essential to anticipate future dengue risk. Therefore, we assessed the effect of temperature on DENV-1 in Aedes aegypti from New Caledonia. Mosquitoes were orally infected and maintained for 14 days at 26.6 °C (average temperatures during recent outbreaks) or 31.1 °C (SSP5-8.5 scenario projected temperatures). Mosquito bodies, heads, and saliva were analysed separately to determine infection, dissemination, and transmission rates as well as transmission efficiencies. Infectious virus was detected by using a fluorescent focus assay, and viral titres were quantified via TCID₅₀ assays. No significant differences were observed in infection, dissemination, and transmission rates or transmission efficiencies between the two temperatures. However, DENV titres in mosquito bodies and heads were significantly higher at 31.1 °C than 26.6 °C. Our results indicate that elevated temperature increases viral loads within the insect but not the proportion of infectious mosquitoes, highlighting the importance of considering temperature as a key parameter in assessing dengue risk under climate change. Further studies are needed to investigate the effects of temperature on virus–mosquito interactions. Full article

(This article belongs to the Special Issue Surveillance of Eliminated and Near-Eliminated Infectious Disease in the Western Pacific Region)

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