Evaluating the Effectiveness of Community-Based Surveillance for Schistosomiasis Control in Senegal: A Mixed-Methods Study

Community-based surveillance (CBS) is a cornerstone of neglected tropical disease (NTD) control in Africa, yet its operational effectiveness for schistosomiasis in Senegal requires contemporary evaluation. This mixed-methods study, conducted from 2023 to 2024, assessed the implementation and outcomes of the national schistosomiasis CBS programme in two endemic regions. We analysed longitudinal surveillance data (2021–2024) to quantify trends in suspected case reporting and treatment adherence. Concurrently, we conducted 35 semi-structured interviews and 12 focus group discussions with community health workers (CHWs), health district supervisors, and community members to identify implementation determinants. Quantitative results demonstrated a significant increase in suspected case reporting following enhanced CHW training in early 2023 (p<0.01), but persistent gaps were observed in the timely referral of severe cases. Qualitative findings identified critical barriers, including recurrent stockouts of rapid diagnostic tests and variable community trust, which were counterbalanced by facilitators such as strong local leadership and integrated health messaging. The study concludes that while CBS strengthens the surveillance cascade for schistosomiasis, its long-term effectiveness depends on predictable financing, reliable commodity supply chains, and formalised support structures for CHWs. These findings underscore the necessity of addressing systemic health system constraints to optimise this community-driven public health strategy in Senegal and similar endemic settings.