03450nas a2200277   4500000000100000008004100001260004600042653003900088653001400127653001500141653001900156653001100175653000900186653002400195100001500219700001700234700001700251700001300268700001600281245010500297856009900402300000900501490000700510520264100517022001403158       2025                            d  c12/2025bPublic Library of Science (PLoS)10aNeglected tropical diseases (NTDs)10aMorbidity10aDisability10adisfigurements10aAfrica10agaps10acare and management1 aPfavayi LT1 aOsakunor DNM1 aChiombola CE1 aMutapi F1 aTamarozzi F00aIdentifying gaps in the care and management of NTD morbidity, disability and disfigurement in Africa  uhttps://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0013834&type=printable  a1-200 v193 a<p><strong>Background</strong></p>

<p>Neglected tropical diseases (NTDs) affect about 1.7 billion people worldwide, with the highest burden in sub-Saharan Africa. While global initiatives have reduced infection prevalence, the chronic impacts of NTDs, including morbidity, disability, and disfigurement, remain severely neglected, perpetuating poverty, social exclusion, and mental health challenges. This study aimed to identify gaps in care and management for individuals living with chronic NTD-related disabilities and to validate the situational analysis findings through participatory workshops.</p>

<p><strong>Methodology/Principal Findings</strong></p>

<p>A mixed-methods approach was employed, comprising a situational analysis of national policies, healthcare services, and control strategies across the World Health Organization (WHO) African Region, complemented by participatory workshops, including focus group discussions (FGDs) and in-depth interviews (IDIs) with affected individuals and stakeholders, in Zimbabwe and Tanzania. Qualitative data were thematically analysed to capture key challenges, including healthcare access barriers, stigma, and gaps in care and management. The situational analysis revealed critical gaps in chronic NTD care, including lack of comprehensive policies for NTD disability management, fragmented health services, limited access to rehabilitation and mental health support, and where available at all, weak integration of morbidity management into national health systems. Findings from FGDs and IDIs corroborated these findings, highlighting barriers to healthcare access, policy deficiencies, socioeconomic burden, deep-rooted stigma, and psychological distress. Participants emphasised the urgency of integrating chronic care into national health systems, strengthening service delivery, and ensuring financial protection.</p>

<p><strong>Conclusions/Significance</strong></p>

<p>Current NTD programs prioritise infection control and disease elimination while neglecting long-term disability management. To ensure end-to-end health service provision, it is imperative to integrate morbidity management, disability support, psychosocial support, and rehabilitation into existing healthcare frameworks, informed directly by the voices of those affected. Ultimately, by bridging the gaps between policy, healthcare, and community engagement, and mainstreaming NTD morbidity management, we can ensure that individuals affected by NTDs receive comprehensive, long-term support, and that progress in disease control translates into sustained improvements in well-being.</p>
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