The Skin—A Common Pathway for Integrating Diagnosis and Management of NTDs

Chandler, David; Fuller, L.C.

doi:10.3390/tropicalmed3030101

Cited by 20 publications

(18 citation statements)

References 60 publications

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“…Further lessons can be drawn from a recent study on the feasibility of integration of self-care for filarial lymphoedema into existing community leprosy self-help groups in Nepal [30]. Thus, integrated management of skin NTDs provides opportunity not only for morbidity impairments but for integration into existing patient support groups of specific NTDs [30][31][32] This study has some strengths and limitations. First, a key strength of this study was that it was carried out in a setting that is co-endemic for the skin-NTDs (leprosy, BU and LF) where a pilot project on integrated morbidity management of these diseases is being carried-out and where little or no literature is available.…”

Section: Discussionmentioning

confidence: 99%

Investigating barriers and challenges to the integrated management of neglected tropical skin diseases in an endemic setting in Nigeria

Ukwaja

Alphonsus²,

Eze³

et al. 2020

PLoS Negl Trop Dis

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Background There is a dearth of experience in and evidence for cost-effective integrated communitybased management of skin neglected tropical diseases (NTDs). The objective of this study was to assess the knowledge, attitude and care-seeking practices including self-care with a view to introducing appropriate community-based interventions for skin NTDs in an endemic setting in Southern Nigeria. Methods/Principal findings This exploratory study adopted a mixed-methods design consisting of cross-sectional surveys of community members and health workers using interviewer-administered questionnaires; and focus group discussions (FGDs) with community members, health care workers and patients with NTDs in Anambra State, Nigeria. The survey was completed by 353 community members (61.8% female) and 15 health care workers (100.0% female). A total of 52 individuals participated in six FGDs. Of the community members, 236 (66.9%) had heard or seen a case of leprosy; 324 (91.8%) and 131 (37.5%) had heard or seen a case of Buruli ulcer and lymphatic filariasis, respectively. Again, 213 (60.3%) of the respondents reported that the diseases were caused by witchcraft or curse. As regards prevention, 241 (68.3%) suggested avoiding handshake with affected persons. Up to 223 (63.2%) of respondents strongly agreed to the seriousness of skin NTDs in their community. Meanwhile, 272 (77.1%) of the respondents believed that the transmission of these skin NTDs can be prevented. Furthermore, 324 (91.7%) desired active community engagement for control of skin NTDs. Regarding community care seeking practices, 197 (55.8%) would first visit the health centre/hospital, followed by 91 (25.8%) traditional healer/herbalist and 35 (9.9%) pharmacy/ patent medicine vendor if they develop a skin NTD. Overall, 332 (94.1%) of respondents expressed interest in being taught self-care practices for skin NTDs. Out of 15 healthcare workers, 13 (86.7%) were able to correctly diagnose two of these skin NTDs and 10 (66.7%) would encourage patients to practice self-care. Prominent themes in the FGDs were belief PLOS NEGLECTED TROPICAL DISEASES

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Section: Discussionmentioning

confidence: 99%

Investigating barriers and challenges to the integrated management of neglected tropical skin diseases in an endemic setting in Nigeria

Ukwaja

Alphonsus²,

Eze³

et al. 2020

PLoS Negl Trop Dis

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“…There are numerous opportunities to integrate control activities for NTDs that affect the skin [83, 84]. This is particularly the case for podoconiosis and other causes of tropical lymphoedema, which are frequently co-endemic and benefit from a similar approach to management as described earlier.…”

Section: Towards Elimination Of Podoconiosismentioning

confidence: 99%

With Bare Feet in the Soil: Podoconiosis, a Neglected Cause of Tropical Lymphoedema

2020

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Podoconiosis is a form of lymphoedema that occurs in tropical highland areas in genetically susceptible individuals who are exposed to irritant volcanic soils. The disease is preventable through consistent use of footwear and attention to foot hygiene; however, in endemic areas there is a strong barefoot tradition, and many cannot afford shoes. Patients with podoconiosis face significant physical disability, psychological comorbidity, reduced quality of life and experience frequent episodes of systemic illness due to acute dermatolymphangioadenitis. This review provides an overview of this important and neglected tropical skin disease and summarizes the latest research findings.

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“…Traditionally, all skin NTDs have been managed through single-disease vertical programmes that duplicate efforts in some areas and suffer similar gaps in investment in others, resulting in fragmented and ineffective responses [10]. These shared needs represent opportunities for integrated case management strategies that, if implemented effectively, may contribute to reducing the burden of these diseases [11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

“Buruli ulcer and leprosy, they are intertwined”: Patient experiences of integrated case management of skin neglected tropical diseases in Liberia

et al. 2020

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Background Skin neglected tropical diseases (NTDs) such as Buruli ulcer (BU) and leprosy produce significant stigma and disability. Shared clinical presentations and needs for care present opportunities for integrated case management in co-endemic areas. As global policies are translated into local integrated services, there remains a need to monitor what new configurations of care emerge and how individuals experience them. Methods To explore patient experiences of integrated case management for skin NTDs, in 2018, we conducted a field-based qualitative case series in a leprosy rehabilitation centre in Ganta, Liberia where BU services were recently introduced. Twenty patients with BU (n = 10) and leprosy (n = 10) participated in in-depth interviews that incorporated photography methods. We contextualised our findings with field observations and unstructured interviews with health workers.

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The Skin—A Common Pathway for Integrating Diagnosis and Management of NTDs

Cited by 20 publications

References 60 publications

Investigating barriers and challenges to the integrated management of neglected tropical skin diseases in an endemic setting in Nigeria

Investigating barriers and challenges to the integrated management of neglected tropical skin diseases in an endemic setting in Nigeria

With Bare Feet in the Soil: Podoconiosis, a Neglected Cause of Tropical Lymphoedema

“Buruli ulcer and leprosy, they are intertwined”: Patient experiences of integrated case management of skin neglected tropical diseases in Liberia

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