Discussion
In this paper, we present new evidence-based recommendations for cost-efficient monitoring of therapeutic drug efficacy against STH, using a simulation framework that captures important interactions between STH epidemiology (variability in egg counts due to various sources), diagnostic test performance (species- and method-dependent egg recovery and count variability), survey design (bias and accuracy that change with endemicity) and operational costs (which change with endemicity, diagnostic method and survey design). With this framework, we address the challenge of minimizing operational costs of STH monitoring in resource-limited settings without jeopardizing the quality of the decision-making. We performed an in-depth analysis of the operational costs to process one sample for three FEC methods (KK, Mini-FLOTAC and FECPAK