Background Great progress is being made toward the goal of elimination as a public health problem for neglected tropical diseases such as leprosy, human African trypanosomiasis, Buruli ulcer, and visceral leishmaniasis, which relies on intensified disease management and case finding. However, strategies for maintaining this goal are still under discussion. Passive surveillance is a core pillar of a long-term, sustainable surveillance program. Methods We use a generic model of disease transmission with slow epidemic growth rates and cases detected through severe symptoms and passive detection to evaluate under what circumstances passive detection alone can keep transmission under control. Results Reducing the period of infectiousness due to decreasing time to treatment has a small effect on reducing transmission. Therefore, to prevent resurgence, passive surveillance needs to be very efficient. For some diseases, the treatment time and level of passive detection needed to prevent resurgence is unlikely to be obtainable. Conclusions The success of a passive surveillance program crucially depends on what proportion of cases are detected, how much of their infectious period is reduced, and the underlying reproduction number of the disease. Modeling suggests that relying on passive detection alone is unlikely to be enough to maintain elimination goals.

中文翻译：

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利用被动监测来维持消除被忽视的热带病这一公共卫生问题：基于模型的探索

背景 在消除麻风病、非洲人类锥虫病、布鲁里溃疡和内脏利什曼病等被忽视的热带疾病这一公共卫生问题的目标方面，正在取得巨大进展，这依赖于加强疾病管理和病例发现。然而，维持这一目标的策略仍在讨论中。被动监视是长期、可持续监视计划的核心支柱。方法 我们使用流行病增长率缓慢的疾病传播通用模型以及通过严重症状和被动检测发现的病例来评估在什么情况下仅被动检测可以控制传播。结果 通过减少治疗时间来缩短传染期对减少传播的影响很小。因此，为了防止死灰复燃，被动监测需要非常有效。对于某些疾病，防止复发所需的治疗时间和被动检测水平不太可能实现。结论 被动监测计划的成功关键取决于发现的病例比例、感染期缩短的程度以及疾病的潜在繁殖数量。建模表明，仅依靠被动检测不太可能足以维持消除目标。