Towards a toolkit for cross-neglected tropical disease morbidity and disability assessment

Noordende, Anna T. van ‘t; Kuiper, Heleen; Ramos, Alberto Novaes; Mieras, Liesbeth; Barbosa, Jaqueline Caracas; Pessoa, Sarah Maria Fraxe; Souza, Eliana Amorim de; Fernandes, Thayse A.; Hinders, Duane C.; Praciano, Margarida M. A.; Brakel, Wim H. van

doi:10.1093/inthealth/ihw006

Cited by 24 publications

(32 citation statements)

References 38 publications

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“…An integrated paradigm should be adopted: either in setting up rapid epidemiological assessments for CL alone or in taking opportunities to include CL with other skin-NTDs [ 113 , 114 ]. Recognising the common challenges of a vertical approach to each NTD affecting the skin, a common tool to monitor disability has been piloted [ 115 ]. Furthermore, WHO has recently released guidelines for the training of skin NTD for frontline health workers [ 116 , 117 ].…”

Section: Discussionmentioning

confidence: 99%

Uncharted territory of the epidemiological burden of cutaneous leishmaniasis in sub-Saharan Africa—A systematic review

et al. 2018

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IntroductionCutaneous leishmaniasis (CL) is the most frequent form of leishmaniasis, with 0.7 to 1.2 million cases per year globally. However, the burden of CL is poorly documented in some regions. We carried out this review to synthesize knowledge on the epidemiological burden of CL in sub-Saharan Africa.MethodsWe systematically searched PubMed, CABI Global health, Africa Index Medicus databases for publications on CL and its burden. There were no restrictions on language/publication date. Case series with less than ten patients, species identification studies, reviews, non-human, and non-CL focused studies were excluded. Findings were extracted and described. The review was conducted following PRISMA guidelines; the protocol was registered in PROSPERO (42016036272).ResultsFrom 289 identified records, 54 met eligibility criteria and were included in the synthesis. CL was reported from 13 of the 48 sub-Saharan African countries (3 eastern, nine western and one from southern Africa). More than half of the records (30/54; 56%) were from western Africa, notably Senegal, Burkina Faso and Mali. All studies were observational: 29 were descriptive case series (total 13,257 cases), and 24 followed a cross-sectional design. The majority (78%) of the studies were carried out before the year 2000. Forty-two studies mentioned the parasite species, but was either assumed or attributed on the historical account. Regional differences in clinical manifestations were reported. We found high variability across methodologies, leading to difficulties to compare or combine data. The prevalence in hospital settings among suspected cases ranged between 0.1 and 14.2%. At the community level, CL prevalence varied widely between studies. Outbreaks of thousands of cases occurred in Ethiopia, Ghana, and Sudan. Polymorphism of CL in HIV-infected people is a concern. Key information gaps in CL burden here include population-based CL prevalence/incidence, risk factors, and its socio-economic burden.ConclusionThe evidence on CL epidemiology in sub-Saharan Africa is scanty. The CL frequency and severity are poorly identified. There is a need for population-based studies to define the CL burden better. Endemic countries should consider research and action to improve burden estimation and essential control measures including diagnosis and treatment capacity.

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Section: Discussionmentioning

confidence: 99%

Uncharted territory of the epidemiological burden of cutaneous leishmaniasis in sub-Saharan Africa—A systematic review

et al. 2018

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“…To establish consensus on indicators to assess the quality of MMDP services, a Delphi methodology was implemented. The Delphi methodology has been utilized by others in the neglected tropical disease (NTD) field to obtain consensus on programmatic targets as well as indicators for programme monitoring and evaluation [ 8 , 9 ]. It is a quantitative mechanism to gain consensus on a particular topic among a panel of subject matter experts [ 10 ].…”

Section: Methodsmentioning

confidence: 99%

A Delphi consultation to assess indicators of readiness to provide quality health facility-based lymphoedema management services

et al. 2018

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BackgroundThe World Health Organization (WHO) in collaboration with partners is developing a toolkit of resources to guide lymphatic filariasis (LF) morbidity management and disability prevention (MMDP) implementation and evaluation. Direct health facility inspection is the preferred method for documenting the readiness of a country programme to provide quality lymphoedema management services, one of the three MMDP criteria used to demonstrate the elimination of LF as a public health problem.Methodology/Principal findingsAs component of tool development, a Delphi consultation was implemented to gain consensus on six proposed domains and fourteen proposed tracer indicators to measure national programme readiness to provide quality health facility-based lymphoedema management services. A seven-point Likert-type scale was used to rank the importance of proposed domains and tracer indicators. Consensus for inclusion of the indicator was defined a priori as 70% or more of respondents ranking the proposed indicator in the top three tiers (5–7). Purposive sampling was used to select 43 representative experts including country representatives, programme implementers, and technical experts. A 55.8% response rate (n = 24) was achieved for the survey. Analysis of the responses demonstrated that consensus for inclusion had been reached for all proposed domains including trained staff (mean = 6.9, standard deviation (SD) = 0.34), case management and education materials (mean = 6.1, SD = 0.65), water infrastructure (mean = 6.3, SD = 0.81), medicines and commodities (mean = 6.3, SD = 0.69), patient tracking system (mean = 6.3, SD = 0.85), and staff knowledge (mean = 6.5, SD = 0.66).SignificanceThe Delphi consultation provided an efficient and structured method for gaining consensus among lymphatic filariasis experts around key lymphoedema management quality indicators. The results from this analysis were used to refine the indicators included within the direct inspection protocol tool to ensure its ability to assess health facility readiness to provide quality lymphoedema management services.

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“…The burden of disease resulting from chronic complications of skin NTDs is poorly understood, and more data are needed to support political advocacy and fundraising. Efforts are being made to address this, for example, through the development of a toolkit for monitoring morbidity and disability across multiple NTDs [ 52 ]. The prototype toolkit was validated in Northeast Brazil in patients with Chagas’ disease (American trypanosomiasis), leishmaniasis, leprosy, and schistosomiasis, where it was well accepted.…”

Section: Morbidity Managementmentioning

confidence: 99%

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

Chandler

Fuller

2018

TropicalMed

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Many of the neglected tropical diseases (NTDs) have major skin manifestations. These skin-related NTDs or ‘skin NTDs’ cause significant morbidity and economic hardship in some of the poorest communities worldwide. We draw attention to the collective burden of skin disease and suggest that the skin be used as a platform for the integration of control activities for NTDs. The opportunities for integration are numerous, ranging from diagnosis and disease mapping to mass drug administration and morbidity management. The dermatology community has an important role to play, and will be expected to support research and control activities globally.

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Towards a toolkit for cross-neglected tropical disease morbidity and disability assessment

Abstract: Our findings support the acceptability and relevance of five of the six instruments tested and the concept of a cross-NTD toolkit.

Cited by 24 publications

References 38 publications

Uncharted territory of the epidemiological burden of cutaneous leishmaniasis in sub-Saharan Africa—A systematic review

Uncharted territory of the epidemiological burden of cutaneous leishmaniasis in sub-Saharan Africa—A systematic review

A Delphi consultation to assess indicators of readiness to provide quality health facility-based lymphoedema management services

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

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