Strengthening frontline capacity for skin neglected tropical diseases: Findings from a global survey

BACKGROUND: Skin-related neglected tropical diseases (skin NTDs) remain a major source of morbidity in resource-limited settings. These conditions include Buruli ulcer, chromoblastomycosis and other deep mycoses, cutaneous leishmaniasis, post-kala-azar dermal leishmaniasis, leprosy, lymphatic filariasis, mycetoma, noma, onchocerciasis, scabies, tungiasis, and yaws. Recent efforts have focused on developing training materials to help frontline health workers diagnose and treat skin NTDs. However, little is known about how these materials are perceived and utilized in endemic regions. We performed a global online survey to identify gaps and establish priorities for future training resource development. METHODS: We conducted a cross-sectional, anonymous online survey to assess training needs for skin NTDs. The survey was disseminated by the World Health Organization's Global Neglected Tropical Diseases Programme via the WHO website, targeted email distribution to NTD professionals, and outreach on LinkedIn. Respondents identified skin NTDs most urgently requiring improved training resources in their settings and reported on priority topics, target audiences, languages, formats, and barriers to access. RESULTS: A total of 308 participants from 48 countries completed the survey during the one-month response period. The three most frequently reported skin NTDs in need of additional training resources were leprosy (64.6%), scabies (60.7%), and lymphatic filariasis (55.6%). Early detection and diagnosis were the most prioritized training topics (86.0%). Most respondents preferred English-language resources (62.7%), with printed manuals and guidelines identified as the most useful format (70.1%). The most commonly reported barrier was limited availability of up-to-date materials (75.3%). CONCLUSIONS: We highlight persistent gaps in the accessibility of training materials for skin NTDs. While many high-quality resources exist, their dissemination, adaptation, and translation remain limited. Respondent-identified priorities provide a framework to enhance training resources, strengthen the capacity of frontline healthcare workers, and ultimately advance global skin NTD control, elimination, and eradication goals.