We evaluated programmatic approaches for skin neglected tropical disease (NTD) surveillance and completed a robust estimation of the burden of skin NTDs endemic to West Africa (Buruli ulcer, leprosy, lymphatic filariasis, and yaws). In Maryland, Liberia, exhaustive case finding by community health workers of 56,285 persons across 92 clusters identified 3,241 suspected cases. A total of 236 skin NTDs were confirmed by midlevel healthcare workers trained to use a tailored program. Cases showed a focal and spatially heterogeneous distribution. This community health worker‒led approach showed a higher skin NTD burden than prevailing surveillance mechanisms, but also showed high (95.1%) and equitable population coverage. Specialized training and task-shifting of diagnoses to midlevel health workers led to reliable identification of skin NTDs, but reliability of individual diagnoses varied. This multifaceted evaluation of skin NTD surveillance strategies quantifies benefits and limitations of key approaches promoted by the 2030 NTD roadmap of the World Health Organization.

我们评估了皮肤被忽视的热带病 (NTD) 监测的计划方法，并完成了对西非地方性皮肤 NTD（布鲁里溃疡、麻风病、淋巴丝虫病和雅司病）负担的稳健估计。在利比里亚的马里兰州，社区卫生工作者对 92 个集群的 56,285 人进行了详尽的病例发现，发现了 3,241 例疑似病例。受过使用定制计划培训的中级医疗保健工作者确认了总共 236 例皮肤 NTD。病例显示出局灶性和空间异质分布。这种以社区卫生工作者为主导的方法显示出比现行监测机制更高的皮肤 NTD 负担，但也显示出高 (95.1%) 和公平的人口覆盖率。中级卫生工作者的专业培训和诊断任务转移导致皮肤 NTD 的可靠识别，但个别诊断的可靠性各不相同。这种对皮肤 NTD 监测策略的多方面评估量化了世界卫生组织 2030 年 NTD 路线图所提倡的关键方法的益处和局限性。