Sightsavers Reports

Developing an integrated community-based case detection and referral system for neglected tropical diseases affecting the skin: A pilot study in Kaduna and Ogun States, Nigeria

Status: Recently completed

Main Objectives

This study aimed to address current knowledge gaps regarding how best to detect and refer skin NTDs cases at community levels based on varying health worker capacities.


Many neglected tropical diseases (NTDs) have significant skin manifestations, which can lead to chronic and lifelong disability, morbidity and stigma, with many affected persons. Affected people often attend for treatment at health facilities at the latter stages of disease once symptoms become severe. Early case detection of skin NTDs is therefore important to minimise the negative health impacts that delays in diagnosis can cause.

The WHO Department for the Control of NTDs has proposed integrating programme implementation for more effective and efficient management.

In Nigeria, Buruli ulcer, Leprosy, and clinical manifestations of lymphatic filariasis, specifically lymphedema and hydrocele, are four skin NTDs being prioritized for integrated (across disease and within the health system) case management.

It is anticipated that the findings from this study will support the Federal Ministry of Health (FMOH) in Nigeria to deliver their operational plan for the Integrated Case Management of Neglected Tropical Diseases.

Kaduna and Ogun states were selected because they are both endemic for two or more of the NTDs affecting the skin and there is variation in partner support; Kaduna state has had partner support while Ogun has not.

Phase One: Reflect

Existing mechanisms for case detection, referral and treatment of skin NTDs were explored through literature reviews and participatory meetings with affected persons and frontline health workers in Ogun.

Phase Two: Plan

Findings from phase one informed participatory action planning meetings with community and health system stakeholders from Ogun and Kaduna to co-design an intervention for improving case detection, referral and treatment of skin NTDs.

Phase Three: Act

The implementation of the intervention over 6 months in two local government areas (LGAs) within each of the study states.

Phase Four: Observe

Evaluation of the intervention. Methods included analysis of routinely collected health systems information about the number of cases detected and the level of disability or morbidity at point of detection pre, mid-point and post-intervention. This also included semi-structured interviews, focus group discussions (FGDs), and review meetings.

Main Contact

Luret Lar
Team Lead
[email protected]


Liverpool School of Tropical Medicine
Federal Ministry of Health, Nigeria



October 2019 – September 2021

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