Health Insurance-Supported Dermato-Pathology for Neglected Tropical Diseases in Nepal: A Clinical and Epidemiological Analysis

Summary: Introduction: Neglected tropical diseases(NTDs) represent a substantial health burden in Nepal, often affecting marginalized populations with limited access to healthcare. Methods: A retrospective analysis of 120 cases of clinically suspected NTDs at a provincial tertiary dermatology center in Nepal was conducted. Patients, covered by the national health insurance scheme, received free biopsies for diagnostic confirmation. Clinical and biopsy data were collected for leprosy, cutaneous leishmaniasis, and filariasis cases, and statistical analysis was performed to assess biopsy utility, diagnostic yield, and epidemiological patterns. Results: Of the 120 cases, biopsies confirmed NTDs in68% of cases, with a notable distribution of leprosy (40%),cutaneous leishmaniasis(18%), and filariasis(10%). Biopsy use was particularly high among rural and low-income patients who benefited from free biopsy access through health insurance, thus improving diagnostic accuracy. Epidemiologically, NTDs were more prevalent among populations in low-resource settings, with a male-to-female ratio of 1.3:1. Statistical analysis revealed that biopsy-confirmed diagnoses led to more accurate and timely management, with a reduction in misdiagnosis rates by32%. Conclusion: Health insurance-supported biopsies are proving instrumental in advancing the diagnostic accuracy of NTDs in Nepal, particularly among underserved populations. Dermato-pathology emerges as an effective tool to confirm clinical suspicions,thus improving patient outcomes and reducing health disparities.