Conclusion
We confirm that Kato-Katz is the FEC method of choice for assessing drug efficacy, but that the current WHO-recommended screen and select survey design should be replaced by a no-screen survey design. Our detailed analysis of laboratory time and material costs allows for a cost-efficiency assessment of other FEC-based programmatic decisions as well, like decisions regarding stopping and scaling down of preventive chemotherapy. In addition, the flexible and holistic design of our simulation framework allows further study of alternative diagnostic techniques that aim to further decrease operational costs while maintaining or improving the quality of decision-making, like automated egg counting.