Routinely detected cases of Buruli ulcer (BU) and leprosy, and suspected lymphedema identified through morbidity surveys during mass drug administration campaigns in Ghana in 2014 were remotely georeferenced. We estimated distances from cases’ home communities to the nearest primary healthcare facility (PHC), and compared rates of reported disease, completeness of clinical information, and risk of more severe morbidity, relative to PHC accessibility.

We georeferenced communities of 295/350 reported leprosy cases, 240/333 BU cases, and 1,557/2383 instances of lymphedema. Overlap of these diseases was predominantly around Accra and in the Upper East Region. Rates of reported disease appeared higher in populations with higher accessibility to PHC, and leprosy cases living further from PHC had a higher risk of disability at diagnosis.

This investigation demonstrates the feasibility and value of using routinely collected data to map CM-NTDs at low cost. The maps presented are intended to provide a resource for planning the implementation of integrated CM for NTDs in Ghana. This approach could be easily implemented by national health services in other endemic countries in the future.

Fifty-three patients (87 surgeries) underwent peripheral nerve decompression surgery from 1999 to 2014 at our institution and were eligible for this study. Patients were interviewed with a semi-structured form and established questionnaires (DN-4, McGill Pain Questionnaire, visual analogue scale [VAS], and SALSA) and then physical impairments were assessed by physical examination. Some data were retrospectively retrieved from medical records for comparative analysis.

Surgery occurred with a mean time of 5.1 ± 4.1 years, prior to the interview. Most (59%) patients had one operated limb and 38 (71.7%) declared complete resolution of pain after surgery. There was a 64% reduction in the use of analgesics and an 81% reduction in corticosteroid use. Postoperative chronic pain affected 15 patients (28.3%), mostly of neuropathic type (86.7%). The majority of patients were generally satisfied (87%) with the surgical results and 58.5% of subjects had mild or no functional limitation at the time of the interview.

Patients had a positive experience after neural decompression surgery for leprosy-associated neuropathy in terms of reduced pain and functional limitation, and high levels of satisfaction.

Data were gathered using translated interviewadministrated versions of the questionnaires. The sample included participants with leprosy (n = 16) and lymphatic filariasis (n = 18) experiencing disabling consequences from their NTD. The study focused on item equivalence (relevance and acceptability), semantic equivalence (understanding and meaning) and operational equivalence (format of administration and questions, and suitability of response scales). Testing of the item equivalence showed that 94% thought the questions of WHOQOL-DIS were relevant and 90% felt comfortable with the topics. Concerning the EMIC-AP, 93% thought the questions relevant, and 90% felt comfortable. Semantic equivalence was more problematic with 51% and 23% having difficulties in understanding the WHOQOL-DIS and the EMIC-AP, respectively. Seventy-three percent was positive about the format of the EMIC-AP, while only 58% was positive about the WHOQOL-DIS format.

The item equivalence was good for both the WHOQOL-DIS and EMIC-AP, and the operational equivalence showed room for improvement for the WHOQOL-DIS. The semantic equivalence was relatively poor. This was especially true for the WHOQOL-DIS. The main reason for this is that there are over a 250 different languages in the province of Papua. With minor adjustments, it is likely that the EMIC-AP can be used under the condition that the participants speak sufficient Bahasa. The WHOQOL-DIS does not appear suitable for use with this population.

This study tested two instruments that measure stigma (EMICAP) and quality of life (WHOQOL-DIS) among people affected by leprosy or lymphatic filariasis in Papua, Indonesia. The interviews comprised questions of both instruments and additional questions to get the participants opinion about the instruments. The focus of this study was on whether the participants understood the questions, whether they were relevant and acceptable and if the design of the questionnaires were clear. Using the answers to the additional questions, we could check whether the translations of the instruments were applicable for persons affected by NTDs in Papua. Results showed that the WHOQOL-DIS was not considered suitable for use with NTD-affected people in Papua. In contrast, the EMIC-AP can be used in Papua after some minor adjustments and if participants are fluent in Bahasa Indonesia.