Integrated Control and Management of Neglected Tropical Skin Diseases.

• Type of Material: Article
• Authors: Oriol Mitjà, University of Barcelona; Michael Marks, London School of Hygiene & Tropical Medicine; Laia Bertran, University of Barcelona; Karsor Kollie, Ministry of Health, Government of Liberia, Liberia; Daniel Argaw, World Health Organization; Ahmed H. Fahal, University of Khartoum; Christopher Fitzpatrick, World Health Organization; L. Claire Fuller, International Foundation for Dermatology; Bernardo Garcia Izquierdo, Anesvad Foundation; Roderick Hay, International Foundation for Dermatology; Norihisa Ishii, National Institute of Infectious Diseases, Japan; Christian Johnson, Fondation Raoul Follereau; Jeffrey V. Lazarus, University of Barcelona; Anthony Meka, German Leprosy and TB Relief Association; Michele Murdoch, Watford General Hospital; Sally-Ann Ohene, World Health Organization Country Office, Accra, Ghana.; Pam Small, University of Tennessee; Andrew Steer, Murdoch Children’s Research Institute; Earnest N. Tabah, Ministry of Public Health, Yaoundé, Cameroon; Alexandre Tiendrebeogo, World Health Organization Regional Office for Africa, Brazzaville, Congo; Lance Waller, Emory University; Rie Yotsu, National Center for Global Health and Medicine, Japan; Stephen L. Walker, London School of Hygiene & Tropical Medicine; Kingsley Asiedu, World Health Organization
• Language: English
• Date: 2017-01-19
• Publisher: Public Library of Science
• Publication Version: Final Published Version
• Copyright Statement: © 2017 Mitjà et al
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1371/journal.pntd.0005136
• Title of Journal or Parent Work: PLoS Neglected Tropical Diseases
• ISSN: 1935-2727
• Volume: 11
• Issue: 1
• Start Page: e0005136
• End Page: e0005136
• Grant/Funding Information: SLW is supported in part by the Leprosy Research Initiative and the Hospital and Homes of St. Giles.; MMa is supported by a Wellcome Trust Clinical Research Fellowship (102807).
• Keywords: Neglected tropical diseases; Diagnostic medicine; Skin diseases; Ulcers; Yaws; Mycetoma; Leprosy; Buruli ulcer
• Research Categories: Health Sciences, Epidemiology; Biology, Microbiology; Health Sciences, Public Health

Abstract

Neglected tropical diseases (NTDs) are communicable diseases that occur under conditions of poverty and are concentrated almost exclusively in impoverished populations in the developing world. NTDs affect more than 1000 million people in tropical and subtropical countries, costing developing economies billions of dollars every year. Effective control of NTDs can be achieved with the use of large-scale delivery of single-dose preventive chemotherapy (PC) or intensified disease management (IDM) or both, as is the case for some diseases such as lymphatic filariasis, trachoma, and yaws. Several NTDs exhibit significant cutaneous manifestations that are associated with long-term disfigurement and disability, including Buruli ulcer (BU); cutaneous leishmaniasis (CL); leprosy; mycetoma; yaws; hydrocele and lymphoedema (resulting from lymphatic filariasis); and depigmentation, subcutaneous nodules, severe itching, and hanging groin (resulting from onchocerciasis). Skin examination offers an opportunity to screen people in the communities or children in schools to identify multiple conditions in a single visit. This common approach to skin diseases justifies the integrated delivery of health care interventions to both increase cost-effectiveness and expand coverage. WHO’s Department of Control of NTDs (WHO/NTD) plans to promote an integrated strategy for the skin NTDs requiring IDM. Targeting skin NTDs also provides a platform for treatment of common skin conditions and, therefore, has wider public health benefits. An informal panel of experts (writing this manuscript) was established to help develop guidance in support of the new WHO strategic direction and to develop a proposal for a change in policy for the integrated control and management of the skin NTDs. A symposium at the 2015 ASTMH meeting[1] initiated a discussion of opportunities around integration of surveillance and control of NTDs that affect the skin, but this paper moves these ideas forward and includes some initial recommendations about how these opportunities could be realised. We aim to provide specific pragmatic information and actual recommendations about potential surveillance and management approaches.