Introduction

Neglected tropical diseases are a diverse group of 20 conditions mainly prevalent in tropical areas, where they affect more than one billion people who live in impoverished communities. In recent years, factors such as climate change, migrations and travel and the presence of local conflicts in the affected areas brought diseases outside the limit of the endemic regions of the tropical belt. The burden of many neglected tropical diseases (NTDs) is not limited to the acute phase of the infection but extends to chronic sequelae, which include non-communicable conditions. Among morbidities, the damage of cardiovascular or cerebrovascular interest or oncologic manifestations are described in occasional case reports and series. In an endemic setting, the surgical management of these conditions is impaired by several factors. First of all, the scarcity of evidence in the literature on this specific aspect of neglected diseases, notwithstanding its high prevalence among endemic populations, suggests a potential under-report bias. For cases that do reach medical attention, the scarcity of medical, pharmacological, diagnostic and surgical tools and professional personnel needed for case management are barriers to provision and access to quality surgery. Research is also impaired, and the paucity of reliable disease data archives is an impediment to the management of the unique clinical problems in this specific context. In this chapter, we provide a general view of the epidemiology of neglected tropical diseases, of the mechanisms leading to vascular damage in affected patients and, finally, of the challenges that burden the surgical management of these conditions in endemic settings.