03179nas a2200301   4500000000100000008004100001260001200042653001800054653002400072653001500096653003700111100001300148700001300161700001700174700001800191700001200209700001400221700001400235700001500249700001300264700001200277245011500289856009900404300001100503490000700514520234200521022001402863       2026                            d  c08/202610aMental Health10aSocial determinants10aOne Health10aSkin neglected tropical diseases1 aHotopf I1 aDiallo I1 aLjungqvist J1 aTecklenborg J1 aKnauf S1 aFahrion A1 aJuhász A1 aMcCollum R1 aTurner G1 aEaton J00aMental health, social determinants and One Health in skin neglected tropical diseases (NTDs): A scoping review  uhttps://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0014034&type=printable  a1 - 270 v203 a<p><strong>BACKGROUND: </strong></p>

<p>Skin NTDs cause mental ill health, primarily through social stigma and discrimination, overburdening services and undermining elimination efforts. A holistic One Health (OH) approach is essential for NTD elimination, but evidence and operational guidance lack. This scoping review documents the current state of integration of mental health and OH-based skin-NTD programmes. It forms part of a series of reviews on the role of OH in skin NTDs, led by the WHO skin NTD working groups.</p>

<p><strong>METHODOLOGY: </strong></p>

<p>We searched four peer-reviewed databases for terms related to skin NTDs, OH, mental health and social determinants of health (SDH). Peer-reviewed articles exploring all four concepts were eligible, with no language/geographical/time constraints. Grey literature, conference abstracts and non-peer-reviewed materials were excluded. Abstract screening and extraction was supported by ASreview and NotebookLM. Outcomes related to mental health, OH/SDH and skin NTDs were analysed and charted, using a descriptive thematic analysis approach.</p>

<p><strong>PRINCIPAL FINDINGS: </strong></p>

<p>Twenty-two papers were included; predominantly quantitative studies in Africa, focused on cutaneous leishmaniasis (CL), with few intervention studies. Mental health was typically explored as a downstream effect (primarily stigma and distress), with limited use of validated instruments. Few studies meaningfully embedded OH approaches, including cross-sectoral collaboration and changes were rarely attributed to climate change. A theoretical framework for the multi-directional and intersectional relationship between mental health, SDH and OH is presented.</p>

<p><strong>CONCLUSIONS/SIGNIFICANCE: </strong></p>

<p>The underlying mechanisms of mental health remain poorly characterised, with a lack of integrated OH thinking. Exposure to skin NTDs is generally due to lack of agency and choice. Evidence on the role of household economic conditions and climate change in relation to mental health and skin NTDs lacks. Participatory research has a critical role to play in co-designing nuanced OH-informed interventions, but it is critical that we build on identified synergies within existing frameworks, including person-centred care and syndemics.</p>
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