Promoting the integrated approach to skin-related neglected tropical diseases

Skin diseases are the third most prevalent cause of illness and one of the top 10 causes of disability. They are also among the 10 most common causes of outpatient visits.

Of the 20 neglected tropical diseases (NTDs), more than half present with skin manifestations (the so‐called skin NTDs) and are often associated with long-term disability, stigmatization and mental health problems. The skin NTDs include Buruli ulcer, cutaneous leishmaniasis, post-kala azar dermal leishmaniasis, leprosy, lymphatic filariasis (lymphoedema and hydrocele), mycetoma, onchocerciasis, scabies, yaws, and fungal diseases. They all require similar detection and case-management approaches that present opportunities for integration, which both increases cost–effectiveness and expands coverage.

The major areas in which integrated approaches can be developed include community awareness, epidemiological surveillance and disease mapping, training for health workers and community health workers, and programme monitoring and evaluation.

In areas of treatment, common approaches such as wound and lymphoedema management, prevention of disability, surgery and rehabilitation can be implemented using the same health infrastructure and health workers. Most nongovernmental organizations and health professional organizations are involved in multiple skin NTDs.WHO has developed a manual to help primary health workers deal with skin NTDs and other common skin diseases. The manual has also been translated into a mobile app for wider dissemination in both Android and iOS.

In the new NTD road map 2021–2030, the goal of an integrated approach to skin NTDs is to reduce morbidity, disability and the psychosocial impacts of debilitating skin NTDs. Progress will be measured primarily by the number of countries that adopt and implement an integrated approach to control skin NTDs.