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Problem Lymphatic filariasis and podoconiosis are the major causes of tropical lymphoedema in Ethiopia. The diseases require a similar provision of care, but until recently the Ethiopian health system did not integrate the morbidity management. Approach To establish health-care services for integrated lymphoedema morbidity management, the health ministry and partners used existing governmental structures. Integrated disease mapping was done in 659 out of the 817 districts, to identify endemic districts. To inform resource allocation, trained health extension workers carried out integrated disease burden assessments in 56 districts with a high clinical burden. To ensure standard provision of care, the health ministry developed an integrated lymphatic filariasis and podoconiosis morbidity management guideline, containing a treatment algorithm and a defined package of care. Experienced professionals on lymphoedema management trained government-employed health workers on integrated morbidity management.To monitor the integration, an indicator on the number of lymphoedema-treated patients was included in the national health management information system. Local setting In 2014, only 24% (87) of the 363 health facilities surveyed provided lymphatic filariasis services, while 12% (44) provided podoconiosis services. Relevant changes To date, 542 health workers from 53 health centres in 24 districts have been trained on integrated morbidity management. Between July 2013 and June 2016, the national health management information system has recorded 46487 treated patients from 189 districts. Lessons learnt In Ethiopia, an integrated approach for lymphatic filariasis and podoconiosis morbidity management was feasible. The processes used could be applicable in other settings where these diseases are co-endemic. Probleme La filariose lymphatique et la podoconiose sont les principales causes du lymphcedeme tropical en Ethiopie. Ces maladies requierent une prestation de soins similaire, mais en 2012, le systeme de sante ethiopien n'a pas integre la gestion de la morbidite. Approche Le ministere de la Sante et ses partenaires ont utilise les structures gouvernementales existantes pour mettre en place des services de sante en vue de la gestion integree de la morbidite liee au lymphcedeme. Une cartographie integree de la maladie a ete realisee dans 659 des 817 districts pour reperer ceux ou elle etait endemique. Afin d'orienter l'affectation des ressources, des agents de vulgarisation sanitaire qualifies ont integre des evaluations de la charge de morbidite dans 56 districts presentant une charge clinique elevee. Pour assurer une prestation standard de soins, le ministere de la Sante a redige des directives sur la gestion integree de la morbidite liee a la filariose lymphatique et a la podoconiose. Ces directives comportent un algorithme de traitement et un programme de soins precis. Des professionnels possedant de l'experience dans la gestion du lymphoedeme ont forme des agents de sante employes par le gouvernement a la gestion integree de la morbidite. Pour suivre l'integration, un indicateur relatif au nombre de patients pris en charge pour un lymphcedeme a ete inclus dans le systeme national d'information sanitaire. Environnement local En 2014, seuls 24% (87) des 363 etablissements de sante participant a l'enquete ont fourni des services lies a la filariose lymphatique et 12% (44) ont fourni des services lies a Ia podoconiose. Changements significatifs A ce jour, 542 agents de sante provenant de 53 centres de sante repartis dans 24 districts ont ete formes a la gestion integree de la morbidite. Entre juillet 2013 et juin 2016, le systeme national d'information sanitaire a enregistre 46487 patients pris en charge dans 189 districts. Lecons tirees La mise en place d'une approche integree pour la gestion de la morbidite liee a la filariose lymphatique et a la podoconiose a ete possible en Ethiopie. Les processus utilises pourraient etre appliques dans d'autres environnements ou ces maladies sont co-endemiques. Situacion La filariasis linfatica y la podoconiosis son las mayores causas del iinfedema tropical en Etiopia. Las enfermedades requieren una atencion sanitaria similar, pero en 2012 el sistema sanitario de Etiopia no integro la gestion de la morbilidad. Enfoque Para establecer servicios sanitarios para la gestion integrada de la morbilidad por Iinfedema, el ministerio de salud y colaboradores utilizaron estructuras gubernamentales existentes. Se realizo un mapeo integrado de la enfermedad en 659 de 817 distritos para identificar los distritos endemicos. Para informar sobre la asignacion de recursos, agentes formados de extension sanitaria integraron evaluaciones sobre la carga de la enfermedad en 56 distritos con una carga clinica elevada. Para garantizar un suministro estandar de la atencion, el ministerio de salud desarrollo unas directrices para la gestion integrada de la morbilidad de la filariasis linfatica y la podoconiosis, las cuales contenian un algoritmo de tratamiento y un paquete definido de cuidados. Profesionales con experiencia en la gestion del linfedema formaron a trabajadores de la salud empleados por el gobierno sobre la gestion integrada de la morbilidad. Para controlar la integracion, se incluyo un indicador del numero de pacientes tratados de iinfedema en el sistema nacional de informacion para la gestion de la salud. Marco regional En 2014, solo el 24% (87) de los 363 centros sanitarios encuestados ofrecian servicios para la filariasis linfatica, mientras que el 12% (44) ofrecian servicios para la podoconiosis. Cambios importantes Hasta la fecha, 542 trabajadores sanitarios de 53 centros de salud en 24 distritos han sido formados acerca de la gestion integrada de la morbilidad. Entre julio de 2013 yjunio de 2016, el sistema nacional de informacion para la gestion de la salud registro 46 487 pacientes tratados de 189 distritos. Lecciones aprendidas En Etiopia, fue viable un enfoque integrado de la gestion de la morbilidad para la filariasis linfatica y la podoconiosis. Los procesos utilizados podrian ser aplicables en otros lugares donde estas enfermedades son coendemicas., Introduction Lymphatic filariasis and podoconiosis are major causes of lymphoedema in tropical areas. (1) Lymphatic filariasis is a mosquito-borne parasitic infection, while podoconiosis is an inflammatory disease caused by prolonged [...]

Background Skin-presenting neglected tropical diseases (skin-NTDs) impose large burdens on affected people, families and communities. The NTD Roadmap 2021–2030 presents a strategic plan to guide collaborative, multisectoral action to overcome these burdens, defining targets to control, eliminate and/or eradicate skin-NTDs by 2030. One of its targets is for 40 countries to adopt integrated skin-NTD strategies. Despite this high-level support for integration, only four countries were implementing integrated skin-NTD strategies in 2020. Methods We hosted workshops at the 2021 annual meeting of the Coalition for Operational Research on NTDs, to discuss the operationalisation of Roadmap goals into national strategies and interventions for skin-NTD control. Speakers included NTD Programme Managers from NTD-endemic countries, technical experts and researchers of different aspects of skin-NTDs. Results Challenges include community perceptions of interventions, demonstrating the cost-effectiveness of integrated care, availability and accessibility of community-based and primary healthcare services, the quality of data on skin-NTD morbidity and changes to operational structures required for integration. Research priorities included the identification of optimal case detection platforms, evaluation of integrated care, understanding the impacts of integration on community members and community health staff and development of point-of-care diagnostics. Conclusions The operational research priorities are intended to support the scale-up of integrated skin-NTDs programmes. [ABSTRACT FROM AUTHOR]