02046nas a2200313   4500000000100000008004100001260005300042653002400095653002700119653001700146100001500163700001300178700001600191700001300207700001200220700001300232700001500245700001200260700001300272700001400285700001400299700001400313245015000327856006000477300001400537490000700551520114900558022002501707       2022                            d  bCenters for Disease Control and Prevention (CDC)10aInfectious Diseases10aMicrobiology (medical)10aEpidemiology1 aTimothy JW1 aRogers E1 aHalliday KE1 aMulbah T1 aMarks M1 aZaizay Z1 aGiddings R1 aKempf M1 aMarion E1 aWalker SL1 aKollie KK1 aPullan RL00aQuantifying Population Burden and Effectiveness of Decentralized Surveillance Strategies for Skin-Presenting Neglected Tropical Diseases, Liberia  uhttps://wwwnc.cdc.gov/eid/article/28/9/pdfs/21-2126.pdf  a1755-17640 v283 a<p>We evaluated programmatic approaches for skin neglected tropical disease (NTD) surveillance and completed a robust estimation of the burden of skin NTDs endemic to West Africa (Buruli ulcer, leprosy, lymphatic filariasis morbidity, and yaws). In Maryland, Liberia, exhaustive case finding by community health workers of 56,285 persons across 92 clusters identified 3,241 suspected cases. A total of 236 skin NTDs (34.0 [95% CI 29.1-38.9]/10,000 persons) were confirmed by midlevel healthcare workers trained using a tailored program. Cases showed a focal and spatially heterogeneous distribution. This community health worker‒led approach showed a higher skin NTD burden than prevailing surveillance mechanisms, but also showed high (95.1%) and equitable population coverage. Specialized training and task-shifting of diagnoses to midlevel health workers led to reliable identification of skin NTDs, but reliability of individual diagnoses varied. This multifaceted evaluation of skin NTD surveillance strategies quantifies benefits and limitations of key approaches promoted by the 2030 NTD roadmap of the World Health Organization.</p>
  a1080-6040, 1080-6059