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Fulgence KK, Marie KBPC, Akoua VBT, Massafoma KEG, Etienne AK, Abibatou KT, Henriette VBA, Sebastien MAJ, Vincent D, William Y, Hervé MEI. Dermatophytosis and the associated risk factors among primary school children in southern and central Côte d'Ivoire. Mycoses 2023; 66:869-875. [PMID: 37309262 DOI: 10.1111/myc.13624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 05/22/2023] [Accepted: 05/27/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND Dermatophytosis, particularly the subtype tinea capitis, is common among African children; however, the risk factors associated with this condition are poorly understood. OBJECTIVES This study aimed to determine the factors associated with tinea capitis and the prevalence rate of other dermatophytoses among primary school students in the rural and urban areas of the southern and central Côte d'Ivoire. PATIENTS AND METHODS The study was carried out in seven towns of Côte d'Ivoire from October 2008 to July 2009, among 17,745 children aged 4-17 years and attending urban and rural primary schools; a complete physical examination of the skin and appendages, including nails and hair, was performed by the physicians. Direct microscopic examination using 30% potassium hydroxide solution and culture on Sabouraud's dextrose agar supplemented with 0.5 g/L chloramphenicol and 0.4 g/L actidione was performed during sampling. RESULTS For the 17,745 children clinically examined, 2645 exhibited symptoms suggestive of tinea capitis. Positive cultures for dermatophytes were found in 2635 patients, and the overall prevalence rate of tinea capitis was 14.8%. The following factors, age, sex, pets at home, number of bathing daily, sharing of sponges, combs and towels and hair length, were statistically associated with tinea capitis (p < .001). In addition to tinea capitis, other superficial fungal infections were identified among these children. These included tinea corporis (0.9%), tinea unguium (0.6%) and pityriasis versicolor (0.4%). CONCLUSION Tinea capitis is common among pupils in rural southern and central Côte d'Ivoire, especially in young boys.
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Affiliation(s)
- Kassi Kondo Fulgence
- Department of Parasitology and Mycology, Faculty of Pharmacy, Felix Houphouët-Boigny University, Abidjan, Côte d'Ivoire
- Laboratory of Parasitology and Mycology of the Diagnosis and Research Centre on AIDS and the Others Infectious Diseases, Abidjan, Côte d'Ivoire
| | | | - Valerie Bedia-Tanoh Akoua
- Department of Parasitology and Mycology, Faculty of Pharmacy, Felix Houphouët-Boigny University, Abidjan, Côte d'Ivoire
| | - Koné Estelle Gnanyo Massafoma
- Department of Parasitology and Mycology, Faculty of Pharmacy, Felix Houphouët-Boigny University, Abidjan, Côte d'Ivoire
- Laboratory of Parasitology and Mycology of the Diagnosis and Research Centre on AIDS and the Others Infectious Diseases, Abidjan, Côte d'Ivoire
| | - Angora Kpongbo Etienne
- Department of Parasitology and Mycology, Faculty of Pharmacy, Felix Houphouët-Boigny University, Abidjan, Côte d'Ivoire
| | - Konaté-Touré Abibatou
- Department of Parasitology and Mycology, Faculty of Pharmacy, Felix Houphouët-Boigny University, Abidjan, Côte d'Ivoire
| | - Vanga-Bosson Abo Henriette
- Department of Parasitology and Mycology, Faculty of Pharmacy, Felix Houphouët-Boigny University, Abidjan, Côte d'Ivoire
| | | | - Djohan Vincent
- Department of Parasitology and Mycology, Faculty of Pharmacy, Felix Houphouët-Boigny University, Abidjan, Côte d'Ivoire
| | - Yavo William
- Department of Parasitology and Mycology, Faculty of Pharmacy, Felix Houphouët-Boigny University, Abidjan, Côte d'Ivoire
| | - Menan Eby Ignace Hervé
- Department of Parasitology and Mycology, Faculty of Pharmacy, Felix Houphouët-Boigny University, Abidjan, Côte d'Ivoire
- Laboratory of Parasitology and Mycology of the Diagnosis and Research Centre on AIDS and the Others Infectious Diseases, Abidjan, Côte d'Ivoire
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Yotsu RR, Almamy D, Vagamon B, Ugai K, Itoh S, Koffi YD, Kaloga M, Dizoé LAS, Kouadio K, Aka N, Yeboue LKG, Yao KA, Blanton RE. An mHealth App (eSkinHealth) for Detecting and Managing Skin Diseases in Resource-Limited Settings: Mixed Methods Pilot Study. JMIR DERMATOLOGY 2023; 6:e46295. [PMID: 37632977 PMCID: PMC10335127 DOI: 10.2196/46295] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/17/2023] [Accepted: 05/08/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND In sub-Saharan Africa, the disease burden from skin diseases, including skin-related neglected tropical diseases (skin NTDs), is extremely high. These diseases often are overlooked due to limited access to health care stemming from, for example, remote geographical locations and a lack of experts. To address these gaps, we developed a mobile health app, eSkinHealth, which is a field-adapted platform to serve as a portable electronic patient chart and for teledermatology. OBJECTIVE The purpose of the study is to evaluate the usability and effectiveness of the app in rural Côte d'Ivoire for diagnosing and managing skin NTDs and other skin diseases. METHODS A 2-arm trial with local health care providers and patients with skin diseases was implemented over a 3-month period. The providers were assigned to an intervention receiving the eSkinHealth app or control with usual care. Four nurses and 8 community health care workers participated in each arm. The training was provided on the use of the app to the intervention arm only, while both arms were trained on skin diseases. For the usability study, we evaluated our approach with the System Usability Scale (SUS) and in-depth interviews. For the effectiveness study, our primary outcome was to evaluate the detection and management of 5 skin NTDs as our targeted diseases, namely, Buruli ulcer, leprosy, lymphatic filariasis, scabies, and yaws, using the eSkinHealth app. Procedures of our methods were reviewed and approved by the institutional review board of the Ministry of Health and by Tulane University. RESULTS The mean age of our participants (providers) was 40.5 and 42.5 years for the intervention and control arms, respectively, and all were male (n=24). The average SUS scores taken from the intervention arm at baseline, the midpoint (6 weeks), and the end of study (12 weeks) were 72.3 (SD 11.5), 72.3 (SD 12.4), and 86.3 (SD 10.8), respectively. All participants interviewed, including 4 dermatologists and program managers, were satisfied with the app. Especially community health care workers felt empowered by being equipped with the tool. A total of 79 cases of skin NTDs were reported in the intervention arm as compared to 17 cases in the control arm (P=.002). Besides the skin NTDs, more skin diseases and conditions were reported from the control than from the intervention arm (P<.001). However, 100 cases (66%) were not given any particular diagnosis in the control arm and were documented only as a "dermatosis." In the intervention arm, 151 cases (72.9%) were diagnosed within the eSkinHealth platform, and the remaining were diagnosed on-site by dermatologists. CONCLUSIONS The study provided evidence for the usability and effectiveness of the eSkinHealth app embedded into our surveillance approach to improve the detection and management of skin NTDs and other skin diseases in Côte d'Ivoire and, furthermore, is expected to contribute to knowledge on mobile health approaches in the control of skin diseases in resource-limited settings. TRIAL REGISTRATION ClinicalTrials.gov NCT05300399; https://clinicaltrials.gov/ct2/show/NCT05300399.
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Affiliation(s)
- Rie R Yotsu
- Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, United States
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Dermatology, National Center for Global Health and Medicine, Shinjuku, Japan
| | - Diabate Almamy
- Department of Dermatology, Université Alassane Ouattara, Bouaké, Côte d'Ivoire
| | - Bamba Vagamon
- Department of Dermatology, Université Alassane Ouattara, Bouaké, Côte d'Ivoire
- Raoul Follereau Institute Côte d'Ivoire, Adzopé, Côte d'Ivoire
| | - Kazuko Ugai
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Sakiko Itoh
- Department of Genome Informatics, Graduate School of Medicine, Osaka University, Suita, Japan
- Department of Home Health and Palliative Care Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yao Didier Koffi
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- National Buruli Ulcer Control Program, Ministry of Health of Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Mamadou Kaloga
- National Buruli Ulcer Control Program, Ministry of Health of Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Ligué Agui Sylvestre Dizoé
- National Control Program for Elimination of Leprosy, Ministry of Health of Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | | | | | | | | | - Ronald E Blanton
- Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, United States
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Toppino S, Koffi DY, Kone BV, N’Krumah RTAS, Coulibaly ID, Tobian F, Pluschke G, Stojkovic M, Bonfoh B, Junghanss T. Community-based wound management in a rural setting of Côte d'Ivoire. PLoS Negl Trop Dis 2022; 16:e0010730. [PMID: 36227844 PMCID: PMC9560516 DOI: 10.1371/journal.pntd.0010730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 08/10/2022] [Indexed: 11/05/2022] Open
Abstract
Background Wounds are a neglected health problem in rural communities of low-income countries, mostly caused by trauma and ulcerative skin diseases including Neglected Tropical Diseases (NTDs) and associated with systemic complications and disability. Rural communities have limited access to high quality health services-based wound care. Methods We conducted a prospective observational study on wound management at three levels–community (C), health centre (HC), district hospital (DH)—in a rural community of Côte d’Ivoire. Patients with skin wounds actively identified in a house-to-house survey and passively in the health services in a defined area of the Taabo Health and Demographic Surveillance System were asked to participate and followed-up longitudinally. Endpoints were proportion of wounds closed, time to wound closure, wound size over time, frequency of secondary bacterial infection, need for recapturing after follow-up interruption, and duration of treatment stratified by health service level and wound aetiology. Results We enrolled 561 patients with 923 wounds between May 2019 and March 2020. The observation period ended in March 2021. Median age was 10 years (IQR 7–15), 63.0% of patients were male. Almost all (99.5%, 870/874) wounds closed within the observation period, 5.3% (49/923) were lost to follow-up. Wounds primarily treated in C, HC and DH closed within a median time of 10, 16 and 170 days, respectively. Median time to acute wound and chronic wound closure was 13 and 72 days, respectively. Wounds treated in C, HC and DH presented with secondary bacterial infections in 10.3% (36/350), 31.0% (133/429) and 100% (5/5) of cases, respectively. Recapturing was required in 68.3% (630/923) of wounds with participants reporting wound closure as the main reason for not attending follow-up. Conclusions We describe a wound management model based on national and WHO recommendations focusing on early identification and treatment in the community with potential for broad implementation in low-income countries. Trial registration Registration at ClinicalTrials.gov (NCT03957447). Wounds are a neglected health problem in rural communities of low-income countries, mostly caused by trauma and ulcerative skin diseases including Neglected Tropical Diseases (NTDs) and associated with systemic complications and disability. Rural communities have limited access to high quality health services-based wound care. We conducted a prospective observational study on WHO recommendation-based wound management at three levels–community, health centre, district hospital—in a rural community of Côte d’Ivoire. The healthcare personnel were trained in wound identification and treatment. Patients with skin wounds of all causes identified actively in a house-to-house survey and passively in the health services in a defined area of a Health and Demographic Surveillance System were included in the study and followed-up longitudinally. Most wounds could be treated with basic wound care in the community or at the health centre by local healthcare personnel and closed within 2 to 3 weeks. Few wounds required referral to the district hospital or specific treatment. The results of our study indicate that a community-centred wound management model based on WHO recommendations and focusing on early identification and treatment of all wounds independent of the cause has potential for broad implementation in low-income countries.
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Affiliation(s)
- Simone Toppino
- Division Infectious Diseases and Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany
- * E-mail:
| | - Didier Yao Koffi
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Programme National de Lutte contre l’Ulcère de Buruli, Abidjan, Côte d’Ivoire
- Université Félix Houphouët-Boigny d’Abidjan, Abidjan, Côte d’Ivoire
| | - Bognan Valentin Kone
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Raymond T. A. S. N’Krumah
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Université Peleforo Gon Coulibaly de Korhogo, Korhogo, Côte d’Ivoire
| | - Ismaël Dognimin Coulibaly
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Université Peleforo Gon Coulibaly de Korhogo, Korhogo, Côte d’Ivoire
| | - Frank Tobian
- Division Infectious Diseases and Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Gerd Pluschke
- Molecular Immunology Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Marija Stojkovic
- Division Infectious Diseases and Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Bassirou Bonfoh
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Thomas Junghanss
- Division Infectious Diseases and Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany
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Skin wounds in a rural setting of Côte d'Ivoire: Population-based assessment of the burden and clinical epidemiology. PLoS Negl Trop Dis 2022; 16:e0010608. [PMID: 36227839 PMCID: PMC9560139 DOI: 10.1371/journal.pntd.0010608] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 06/26/2022] [Indexed: 11/05/2022] Open
Abstract
Background Data on the burden and clinical epidemiology of skin wounds in rural sub-Saharan Africa is scant. The scale of the problem including preventable progression to chronic wounds, disability and systemic complications is largely unaddressed. Methods We conducted a cross-sectional study combining active (household-based survey) and passive case finding (health services-based survey) to determine the burden and clinical epidemiology of wounds within the Taabo Health and Demographic Surveillance System (HDSS) in rural Côte d’Ivoire. Patients identified with wounds received free care and were invited to participate in the wound management study simultaneously carried out in the survey area. The data were analysed for wound prevalence, stratified by wound and patient characteristics. Results 3842 HDSS-registered persons were surveyed. Overall wound prevalence derived from combined active and passive case finding was 13.0%. 74.1% (403/544) of patients were below the age of 15 years. Most frequent aetiologies were mechanical trauma (85.3%), furuncles (5.1%), burns (2.9%) and Buruli ulcer (2.2%). Most wounds were acute and smaller than 5 cm2 in size. 22.0% (176/799) of wounds showed evidence of secondary bacterial infection. 35.5% (22/62) of chronic wounds had persisted entirely neglected for years. Buruli ulcer prevalence was 2.3 per 1000 individuals and considerably higher than expected from an annual incidence of 0.01 per 1000 individuals as reported by WHO for Côte d’Ivoire at the time of the study. Conclusions Skin wounds are highly prevalent in rural West Africa, where they represent a widely neglected problem. The HDSS-based survey with combined active and passive case finding adopted in this study provides a better estimate than school- and health institution-based surveys which underestimate the frequency of skin wounds and, particularly, of neglected tropical diseases of the skin, such as Buruli ulcer and yaws. A comparison with country-specific WHO data suggests underreporting of Buruli ulcer cases. Trial registration Registration at ClinicalTrials.gov NCT03957447. Data on the burden and clinical epidemiology of skin wounds in rural sub-Saharan Africa is scant. The scale of the problem including preventable progression to chronic wounds, disability and systemic complications is largely unaddressed. We conducted a cross-sectional study combining active (household-based survey) and passive case finding (health services-based survey) to determine the burden and clinical epidemiology of wounds within the Taabo Health and Demographic Surveillance System (HDSS) in rural Côte d’Ivoire. Patients identified were invited to participate in the wound management study simultaneously carried out in the survey area. We surveyed approximately 4000 HDSS-registered persons and found a high overall wound prevalence (13.0%), predominately in children. Mechanical trauma was the leading cause, followed by furuncles, burns and Buruli ulcer. Most wounds were acute and had a size of less than 5 cm2, but a substantial proportion was large, complicated, or chronic, some of the latter persisting neglected for years. The HDSS-based survey with combined active and passive case finding adopted in this study provides a better estimate than school- and health institution-based surveys which underestimate the frequency of skin wounds and, particularly, of neglected tropical diseases of the skin, such as Buruli ulcer and yaws. A comparison with country-specific WHO data suggests underreporting of Buruli ulcer cases.
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Tanaka A, Niimi N, Takahashi M, Takahashi H, Nagata K, Nishiyama N, Noda H, Hara T, Maeda M, Mizuiri Y, Morikawa H, Yanase T, Yano T, Yamura M, Okano S. Prevalence of skin diseases and prognosis of atopic dermatitis in primary school children in populated areas of Japan from 2010 to 2019: The Asa Study in Hiroshima, Japan. J Dermatol 2022; 49:1284-1290. [PMID: 36120740 DOI: 10.1111/1346-8138.16577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 08/22/2022] [Accepted: 08/24/2022] [Indexed: 12/01/2022]
Abstract
Skin diseases are common in children. However, the prevalence of childhood skin diseases in Japan has not been reported extensively. In this study, dermatologists conducted face-to-face examinations of primary school children over a 10-year period to determine the prevalence of each skin disease. Atopic dermatitis (AD, 12.3%) was the most common disease among first graders, followed by eczema other than AD (9.7%), molluscum contagiosum (1.9%), and verruca vulgaris (1.1%). Among sixth graders, acne vulgaris was most common (9.6%), followed by AD (8.9%), eczema other than AD (6.7%), and verruca vulgaris (3.1%). The prevalence of AD remained stable among first graders after 2010, at approximately 10%-15%, but it increased slightly among sixth graders. Of the 87 children who had AD in first grade, 51 (58.6%) were in remission in sixth grade. On the other hand, AD was diagnosed in 30 (4.5%) sixth graders who had been among the 665 children who did not have it in first grade. The more severe the symptoms were in first grade, the more likely a child was to still have AD in sixth grade, and the more severe the later symptoms tended to be. This study investigated recent trends in skin diseases in Japanese primary school children and found that the prevalence of some skin diseases differed between first and sixth graders. It was also found that children with moderate AD in first grade were more likely to be moderate in sixth grade than those with mild AD.
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Affiliation(s)
- Akio Tanaka
- Department of Dermatology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | | | - Masakazu Takahashi
- Graduate School of Innovation and Technology Management, Yamaguchi University, Yamaguchi, Japan
| | | | | | | | | | - Takeshi Hara
- Gion Dermatology Gynecology Skin Care Clinic, Hiroshima, Japan
| | | | | | | | - Tetsuji Yanase
- Department of Dermatology, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
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Yotsu RR, Itoh S, Yao KA, Yeboue LG, Kouadio K, Ugai K, Koffi YD, Almamy D, Vagamon B, Blanton RE. Early Detection and Case Management of Skin Diseases with a Mobile Health Application 'eSkinHealth': Protocol for a Mixed-Methods Pilot Study in Côte d'Ivoire. JMIR Res Protoc 2022; 11:e39867. [PMID: 35922062 PMCID: PMC9536527 DOI: 10.2196/39867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/26/2022] [Accepted: 07/30/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The prevalence of skin diseases is extremely high in sub-Saharan Africa, among which are skin neglected tropical diseases (skin NTDs) that could lead to life-long disabilities and deformities if not diagnosed and treated early. To achieve early detection and early treatment of these skin diseases, we developed a mobile health application (mHealth app): 'eSkinHealth.' OBJECTIVE This paper outlines a protocol for evaluating the effect of our eSkinHealth app in the early detection and effective management of skin diseases in Côte d'Ivoire. METHODS A mixed-methods pilot trial will be conducted in Côte d'Ivoire and will consist of 3 phases: phase 1, the development and improvement of the eSkinHealth app; phase 2, a pilot trial to evaluate the usability of the eSkinHealth app for local medical staff in Côte d'Ivoire; and phase 3, a pilot trial to evaluate the effectiveness of early detection and case management of targeted skin NTDs (Buruli ulcer, leprosy, yaws, and lymphatic filariasis) with the eSkinHealth app in Côte d'Ivoire. The pilot study will be implemented as a 2-arm trial with local healthcare providers and patients with skin NTDs over a 3-month follow-up period. The local healthcare providers will be assigned to an intervention group receiving the eSkinHealth app to be used in their daily practices or a control group. Training will be provided on the usage and implementation of the app and diagnostic pipeline to the intervention group only, while both groups will receive training on skin diseases. Our primary outcome is to evaluate the early detection and effective management of skin diseases using the eSkinHealth app in Côte d'Ivoire by number of cases diagnosed and managed. Additionally, we will evaluate the eSkinHealth app with validated questionnaires and in-depth interviews. Procedures of our methods have been reviewed and approved by the IRB of the Ministry of Health, Côte d'Ivoire and by Tulane University in 2021. RESULTS This study was funded in 2021. We started enrolment of patients in February 2022, and data collection is currently underway. We expect the first results to be submitted for publication in 2023. CONCLUSIONS Our 'eSkinHealth' is a field-adapted platform that could both provide direct diagnostic and management assistance to health workers in remote settings. The study will provide evidence for the usability and the effectiveness of the eSkinHealth app to improve the early detection and case management of skin NTDs in Côte d'Ivoire; and further, are expected to contribute to knowledge on mobile health approaches in the control of skin NTDs. CLINICALTRIAL 2020-2054 (Clinicaltrials.gov).
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Affiliation(s)
- Rie R Yotsu
- Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, 1440 Canal St, New Orleans, US.,School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, JP.,Department of Dermatology, National Center for Global Health and Medicine, Shinjuku, JP
| | - Sakiko Itoh
- Department of Genome Informatics, Graduate School of Medicine, Osaka University, Suita, JP
| | - Koffi Aubin Yao
- Hope Commission International, Abidjan, Côte d'Ivoire, Abidjan, CI
| | | | | | - Kazuko Ugai
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, JP
| | - Yao Didier Koffi
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, CI.,National Buruli Ulcer Control Program, Ministry of Health of Côte d'Ivoire, Abidjan, CI
| | - Diabate Almamy
- Department of Dermatology, Universite Alassane Ouattara, Bouaké, CI.,Raoul Follereau Institute Côte d'Ivoire, Adzopé, CI
| | - Bamba Vagamon
- Raoul Follereau Institute Côte d'Ivoire, Adzopé, CI.,Department of Dermatology, Universite Alassane Ouattara, Bouaké, CI
| | - Ronald E Blanton
- Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, 1440 Canal St, New Orleans, US
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Tempark T, Whaidee K, Bongsebandhu-Phubhakdi C, Suteerojntrakool O. Prevalence of skin diseases in school-age children. Fam Pract 2022; 39:340-345. [PMID: 34871400 DOI: 10.1093/fampra/cmab164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The prevalence of community-based skin diseases, especially among school-age children, depends on topography, climate, and age of population. OBJECTIVE We determined the prevalence of skin diseases among community-based primary school-age children and identified demographic characteristics in relation to particular skin conditions. METHODS This was a cross-sectional descriptive survey study of a subproject school cohort in children aged 5-14 years of 2 community-based primary schools. Demographic data and whole-body skin examination were collected. The association of individual skin conditions was analysed by using bivariate and multivariable binary logistic regression. RESULTS A total of 556 children were enrolled in this study. Of these, 90.2% had at least 1 skin disease. The most common skin disease was postinflammatory hyperpigmentation (PIH) (58.3%), followed by nevus/mole (40.1%), insect bite reaction (28.0%), acanthosis nigricans (20.0%), acne (13.7%), and pityriasis alba (12.9%). There was an increase of body mass index (BMI) in PIH and acanthosis nigricans with the adjusted odds ratios of 2.01 (95% confidence interval [CI] 1.40-2.87, P < 0.001) and 1.93 (95% CI 1.49-2.49, P < 0.001), respectively. Insect bite reaction was related to PIH with the adjusted odds ratio of 5.66 (95% CI 3.15-10.17, P = 0.001). CONCLUSIONS The most common skin disease in community-based primary school-age children is PIH which related to acanthosis nigricans and insect bite reaction. A decrease of BMI may lower the risk for PIH and acanthosis nigricans. Education on common skin diseases is recommended for both community-based schools and school-age children.
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Affiliation(s)
- Therdpong Tempark
- Division of Ambulatory Pediatrics, Department of Pediatrics, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Khwaunrat Whaidee
- Department of Pediatrics, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Chansuda Bongsebandhu-Phubhakdi
- Division of Ambulatory Pediatrics, Department of Pediatrics, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Orapa Suteerojntrakool
- Division of Ambulatory Pediatrics, Department of Pediatrics, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Anwar ET, Gupta N, Porwal O, Sharma A, Malviya R, Singh A, Fuloria NK. Skin Diseases and their Treatment Strategies in Sub-Saharan African Regions. Infect Disord Drug Targets 2021; 22:e270921196808. [PMID: 34579638 DOI: 10.2174/1871526521666210927120334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 06/08/2021] [Accepted: 08/10/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND In the rural areas of sub-Saharan African regions, skin diseases are so common. Due to which the population of the sub-Saharan region suffers from different types of skin disorders. In these regions, many treatment options are not available for the treatment of skin disease. AIM The current study aims to discuss various skin diseases and their treatment strategies specifically in sub-Saharan African regions. METHOD Extensive literature survey was carried out by using scopus, science direct, elsevier, google scholar and bentham science databases. RESULT AND DISCUSSION It was demonstrated from the literature surveys that different effective techniques are used in the management of skin disease. In the result, it was shown that the condition of the disease is at a dangerous level which must be controlled. CONCLUSION It is concluded from the manuscript that the skin disorder in the sub-Saharan region is at a very dangerous level. The research must be done to develop a better understanding of the disease and its treatment.
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Affiliation(s)
- Esra Tariq Anwar
- Department of Pharmacy, Tishk International University, Erbil-Kurdistan. Iraq
| | - Nandan Gupta
- Department of Pharmacy, School of Medical and Allied Sciences, Galgotias University, Greater Noida, Gautam Buddha Nagar, Uttar Pradesh. India
| | - Omji Porwal
- Department of Pharmacy, Tishk International University, Erbil-Kurdistan. Iraq
| | - Akanksha Sharma
- Department of Pharmacy, School of Medical and Allied Sciences, Galgotias University, Greater Noida, Gautam Buddha Nagar, Uttar Pradesh. India
| | - Rishabha Malviya
- Department of Pharmacy, School of Medical and Allied Sciences, Galgotias University, Greater Noida, Gautam Buddha Nagar, Uttar Pradesh. India
| | - Amit Singh
- Department of Pharmacy, School of Medical and Allied Sciences, Galgotias University, Greater Noida, Gautam Buddha Nagar, Uttar Pradesh. India
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Badiane AS, Diongue K, Seck MC, Ndiaye M, Ndiaye D. Epidemiological aspects of superficial fungal infections in Koranic schools in two localities of Senegal (Thies and Touba). Mycoses 2021; 64:1132-1136. [PMID: 34076914 DOI: 10.1111/myc.13330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 04/07/2021] [Accepted: 05/01/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND In developing countries, superficial fungal infections (SFI) are endemic and cause a therapeutic problem because of the duration and cost of treatment. Community living and promiscuity are key factors in the direct or indirect transmission and spread of these diseases. OBJECTIVES The objective was to study the epidemiological aspects of SFI, among koranic school children in two localities in Senegal. PATIENTS/METHODS School koranic students were recruited in Thies and Touba. Diagnosis of fungal diseases was carried out using conventional techniques (microscopic examination and culture). RESULTS Among 210 children, the overall prevalence of SFI was 25.71%, with 27.63% in Touba and 20.68% in Thiès. The clinical lesions were epidermophytosis (0.5%), intertrigo (0.9%), palmoplantar keratoderma (KPP) (0.9%), onychomycosis (7.7%) and tinea capitis (TC) (90%). The species responsible for the SFI were Trichophyton soudanense (85.18%), Microsporum audouinii langeronii (9.25%), Trichophyton rubrum (3.70%) and Chrysosporium keratinophilum (1.85%). The prevalence of infection was higher among boys (85.18%). CONCLUSION Superficial fungal infections are prevalent in koranic school children and attention should be given to non-dermatophytic species that could be responsible for SFI.
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Affiliation(s)
- Aïda Sadikh Badiane
- Cheikh Anta Diop University of Dakar, Dakar, Senegal.,Aristide LeDantec Hospital, Dakar, Senegal
| | - Khadim Diongue
- Cheikh Anta Diop University of Dakar, Dakar, Senegal.,Aristide LeDantec Hospital, Dakar, Senegal
| | - Mame Cheikh Seck
- Cheikh Anta Diop University of Dakar, Dakar, Senegal.,Aristide LeDantec Hospital, Dakar, Senegal
| | - Mouhamadou Ndiaye
- Cheikh Anta Diop University of Dakar, Dakar, Senegal.,Aristide LeDantec Hospital, Dakar, Senegal
| | - Daouda Ndiaye
- Cheikh Anta Diop University of Dakar, Dakar, Senegal.,Aristide LeDantec Hospital, Dakar, Senegal
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Sounouvou HT, Toukourou H, Catteau L, Toukourou F, Evrard B, Van Bambeke F, Gbaguidi F, Quetin-Leclercq J. Antimicrobial potentials of essential oils extracted from West African aromatic plants on common skin infections. SCIENTIFIC AFRICAN 2021. [DOI: 10.1016/j.sciaf.2021.e00706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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11
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Ibeneme C, Ewurum O, Nnaji T, Ikefuna A. Healthcare-seeking behavior of parents and guardians of school children with skin diseases in Umuahia, South East Nigeria. NIGERIAN JOURNAL OF MEDICINE 2021. [DOI: 10.4103/njm.njm_103_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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12
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Mosojane KI, Giovanni D, Forrestel AK, Conic RZ, Kovarik C, Williams VL. Patterns of Skin Disease in the Context of a High Prevalence HIV Population in Botswana. Dermatol Clin 2020; 39:1-14. [PMID: 33228853 DOI: 10.1016/j.det.2020.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The authors reviewed outpatients in a tertiary dermatology clinic in Botswana to expand knowledge on patterns of skin disease in this population with a high prevalence of human immunodeficiency virus (HIV). Approximately one-third of new and follow-up patients were HIV positive. Common dermatologic conditions included eczematous eruptions, viral and fungal infections, malignant neoplasms, vascular disorders, disorders of pigmentation, and mechanical/physical injury-related disorders. HIV has impacted patterns of dermatologic disease in Botswana, with Kaposi sarcoma being the most frequently biopsied condition. Given the shortage of dermatology specialists, resources should be allocated toward education and management of these most prevalent skin conditions.
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Affiliation(s)
| | - Damiani Giovanni
- Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Riccardo Galeazzi, 4, 20161 Milan, Italy; Department of Dermatology, Case Western Reserve University, Biomedical Research Building 5th Floor, 2109 Adelbert Road, Cleveland, OH, USA
| | - Amy K Forrestel
- Department of Dermatology, University of Pennsylvania, 2 Maloney Building, 3600 Spruce St, Philadelphia, PA 19104, USA; Botswana UPenn Partnership, P.O. Box AC 157 ACH, Gaborone, Botswana
| | - Rosalynn Z Conic
- Department of Dermatology, Case Western Reserve University, Biomedical Research Building 5th Floor, 2109 Adelbert Road, Cleveland, OH, USA
| | - Carrie Kovarik
- Department of Dermatology, University of Pennsylvania, 2 Maloney Building, 3600 Spruce St, Philadelphia, PA 19104, USA
| | - Victoria L Williams
- Ministry of Health and Wellness, Headquarters, Private Bag 0038, Gaborone, Botswana; Department of Dermatology, University of Pennsylvania, 2 Maloney Building, 3600 Spruce St, Philadelphia, PA 19104, USA; Botswana UPenn Partnership, P.O. Box AC 157 ACH, Gaborone, Botswana.
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Henshaw EB, Olasode OA. Prevalence of skin infections, infestations, and papular urticaria among adolescents in secondary schools in Calabar, Nigeria. Ghana Med J 2020; 53:287-293. [PMID: 32116340 PMCID: PMC7036438 DOI: 10.4314/gmj.v53i4.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Acne is an inflammatory disorder of the pilosebaceous gland, and the most common dermatosis in adolescents globally. Infectious dermatoses are common in the tropics, but due to the paucity of epidemiologic surveys, not much is known about the prevalence and common types found in different sub-populations including adolescents. It is however presumed that the prevalence will be high and the pattern diverse. We therefore conducted a school-based survey to ascertain the prevalence and pattern of infectious dermatoses, infestations, and papular urticaria (insect bite reactions) in teenage adolescents in Calabar, Nigeria. Methods A cross sectional observational survey of adolescents aged 13–19 years attending randomly selected secondary schools in Calabar, Nigeria. It involved the use of questionnaires and subsequent whole body examination. Results A total of 1447 senior secondary school students were examined. Infectious dermatoses, infestations, and papular urticaria (IDIP) were observed in 505 (34.9%) persons, among whom were 269 (53.3%) males, and 236 (46.7%) females (X2=34.87, p=<0.001). Fungal dermatoses constituted more than 90% of the diseases, the bulk of which was contributed by pityriasis versicolor [430 (79.6%)]. The six most common dermatoses in descending order of frequencies were Pityriasis versicolor, tinea, papular urticaria, candidiasis, furuncles, and viral warts. Conclusion A high prevalence of cutaneous infections exists among teenage adolescents in Calabar, Nigeria. Males have a higher predisposition to fungal dermatoses. Control of the predominant cause of cutaneous infections — pityriasis versicolor, will significantly affect the prevalence of infectious dermatoses, and invariably, the burden of skin disorders in adolescents in Calabar, Nigeria. Funding Self sponsored
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Affiliation(s)
- Eshan B Henshaw
- Department of Internal Medicine, University of Calabar, Eta Agbor Road, Calabar, Cross River State, Nigeria
| | - Olayinka A Olasode
- Department of Dermatology, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
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Yotsu RR, Comoé CC, Ainyakou GT, Konan N, Akpa A, Yao A, Aké J, Vagamon B, Abbet Abbet R, Bedimo R, Hay R. Impact of common skin diseases on children in rural Côte d'Ivoire with leprosy and Buruli ulcer co-endemicity: A mixed methods study. PLoS Negl Trop Dis 2020; 14:e0008291. [PMID: 32421709 PMCID: PMC7274456 DOI: 10.1371/journal.pntd.0008291] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 06/05/2020] [Accepted: 04/14/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Skin-related neglected tropical diseases (skin NTDs) occur against a background of a very high prevalence of common skin diseases in sub-Saharan Africa. In this study, we examined the knowledge, attitude and practices (KAP) and the impact of common skin diseases in children living in a leprosy and Buruli ulcer (BU) co-endemic district in a west African country of Côte d'Ivoire, in order to help inform disease control efforts for skin NTDs. METHODS AND PRINCIPLE FINDINGS Fourteen focus group discussions (FGDs) with schoolchildren, 5 FGDs with parents of a child affected with skin disease(s), and 27 in-depth semi-structured interviews with key personnel were conducted. The Children's Dermatology Quality of Life Index (CDLQI) questionnaire was applied to 184 schoolchildren with skin diseases. We found that there was ignorance or neglect towards skin diseases in general, due to their high prevalence and also the perceived minimal impact on children's daily lives. While the median score for the CDLQI questionnaire was 5 (IQR 2-9) out of 30, a range of scores was observed. Symptoms such as pruritus and experiencing bullying by classmates contributed to reduction in their quality of life. Poor hygiene was considered as a major cause of skin diseases. CONCLUSIONS/SIGNIFICANCE Despite their high impact on affected populations, we observed a high level of ignorance and neglect toward common skin diseases. There is a critical need to increase awareness of skin diseases, or skin health promotion, which supports changing of the health-seeking behaviour for skin conditions. This will aid in early detection and treatment of the skin NTDs, in addition to providing benefits for those affected by other skin diseases. Educational opportunities should be utilized to their utmost. One would be associated with water, sanitation, and hygiene (WASH) strategies, but careful messages need to be developed and delivered.
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Affiliation(s)
- Rie Roselyne Yotsu
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Dermatology, National Center for Global Health and Medicine, Tokyo, Japan
- Department of Tropical Medicine, Tulane University School of Public Health and Tropical Medicine, New Orleans, United States of America
| | - Colombe Coffie Comoé
- Department of Social Sciences, University of Felix Houphouët Boigny (UFHB), Abidjan, Côte d’Ivoire
- Laboratoire d’Étude et de Recherches Interdisciplinaire en Sciences Sociales (LERISS), Abidjan, Côte d’Ivoire
| | - Germaine Taïba Ainyakou
- Laboratoire d’Étude et de Recherches Interdisciplinaire en Sciences Sociales (LERISS), Abidjan, Côte d’Ivoire
- Department of Social Sciences, University of Peleforo Gon Coulibaly, Korhogo, Côte d’Ivoire
| | | | - Amari Akpa
- MAP International Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Aubin Yao
- MAP International Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Julien Aké
- MAP International Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Bamba Vagamon
- Raoul Follereau Institute Côte d’Ivoire, Adzopé, Côte d’Ivoire
- Department of Dermatology, Université Alassane Ouattara, Bouaké, Côte d’Ivoire
| | | | - Roger Bedimo
- Division of Infectious Diseases, University of Texas Southwestern, Dallas, United States of America
| | - Roderick Hay
- International Foundation for Dermatology, London, United Kingdom
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Chang AY, Scheel A, Dewyer A, Hovis IW, Sarnacki R, Aliku T, Okello E, Bwanga F, Sable C, Maurer TA, Beaton AZ. Prevalence, Clinical Features and Antibiotic Susceptibility of Group A Streptococcal Skin Infections in School Children in Urban Western and Northern Uganda. Pediatr Infect Dis J 2019; 38:1183-1188. [PMID: 31568247 PMCID: PMC10495073 DOI: 10.1097/inf.0000000000002467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Group A Streptococcus (GAS) skin infections can lead to invasive sepsis, poststreptococcal glomerulonephritis, and potentially rheumatic heart disease (RHD). Within a study to identify predisposing factors of RHD in Ugandan schoolchildren, we determined the prevalence of skin infections and assessed the clinical features and antibiotic susceptibility of GAS skin infection. METHODS Cross-sectional study conducted at 3 urban primary schools in Western and Northern Uganda in March 2017. A dermatologist rendered clinical diagnoses and obtained a skin swab specimen from lesions with signs of bacterial infection. Beta-hemolytic colonies underwent Lancefield grouping, species identification by polymerase chain reaction and antimicrobial susceptibility testing. RESULTS From 3265 schoolchildren, we observed 32% with ≥1 fungal, 1.8% with ≥1 bacterial, 0.9% with ≥1 viral, and 0.2% with ≥1 ectoparasitic infection. Of 79, 25 (32%) specimens were GAS-positive, of which one-third demonstrated tetracycline resistance. Of 17 impetigo cases, 13 (76%) were located on the leg/foot and 3 (18%) on the head/neck. Prevalence of GAS skin infection was 0.8% (25 of 3265). In Northern Uganda, where subclinical definite RHD prevalence is 1.1%, GAS skin infection prevalence was 1.2% (4 of 343) and 0.9% (3 of 352). CONCLUSION This study identifies tetracycline-resistant GAS in Ugandan communities, suggests modified skin examination of exposed anatomic locations may be appropriate for population-based GAS skin infection studies, and underscores need for clear case definitions of GAS skin infection. Future studies are needed to evaluate the role of GAS skin infection in development of RHD in Ugandan communities.
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Affiliation(s)
- Aileen Y. Chang
- University of California, San Francisco, Department of Dermatology, San Francisco, USA
| | - Amy Scheel
- Emory University, School of Medicine, Atlanta, GA, USA
| | - Alyssa Dewyer
- Children’s National Health System, Division of Cardiology, Washington, D.C., USA
| | - Ian W. Hovis
- Children’s National Health System, Division of Cardiology, Washington, D.C., USA
| | - Rachel Sarnacki
- Children’s National Health System, Division of Cardiology, Washington, D.C., USA
| | - Twalib Aliku
- Uganda Heart Institute, Mulago National Referral Hospital, Kampala, Uganda
| | - Emmy Okello
- Uganda Heart Institute, Mulago National Referral Hospital, Kampala, Uganda
| | - Freddie Bwanga
- Department of Medical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda
| | - Craig Sable
- Children’s National Health System, Division of Cardiology, Washington, D.C., USA
| | - Toby A. Maurer
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, USA
| | - Andrea Z. Beaton
- Cincinnati Children’s Hospital Medical Center, Cincinnati, USA
- University of Cincinnati College of Medicine, Cincinnati, USA
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Estimated Burden of Serious Fungal Infections in Ghana. J Fungi (Basel) 2019; 5:jof5020038. [PMID: 31083531 PMCID: PMC6616901 DOI: 10.3390/jof5020038] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 04/11/2019] [Accepted: 04/14/2019] [Indexed: 12/14/2022] Open
Abstract
Fungal infections are increasingly becoming common and yet often neglected in developing countries. Information on the burden of these infections is important for improved patient outcomes. The burden of serious fungal infections in Ghana is unknown. We aimed to estimate this burden. Using local, regional, or global data and estimates of population and at-risk groups, deterministic modelling was employed to estimate national incidence or prevalence. Our study revealed that about 4% of Ghanaians suffer from serious fungal infections yearly, with over 35,000 affected by life-threatening invasive fungal infections. Incidence of cryptococcal meningitis, Pneumocystis jirovecii pneumonia, and disseminated histoplasmosis cases in AIDS was estimated at 6275, 12,610 and 724, respectively. Oral and esophageal candidiasis collectively affect 27,100 Ghanaians and 42,653 adult asthmatics are estimated to have fungal asthma. We estimate a prevalence of 12,620 cases of chronic pulmonary aspergillosis (CPA and an incidence of 1254 cases of invasive aspergillosis (IA). Estimated cases of candidemia and candida peritonitis cases were 1446 and 217, respectively. The estimated prevalence of recurrent vulvovaginal candidiasis (RVVC) and tinea capitis was 442,621 and 598,840, respectively. Mucormycosis and fungal keratitis each may affect 58 and 810 Ghanaians. These data highlight the urgent need for intensified awareness to improve diagnosis and management.
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Kelbore AG, Owiti P, Reid AJ, Bogino EA, Wondewosen L, Dessu BK. Pattern of skin diseases in children attending a dermatology clinic in a referral hospital in Wolaita Sodo, southern Ethiopia. BMC DERMATOLOGY 2019; 19:5. [PMID: 30961561 PMCID: PMC6454754 DOI: 10.1186/s12895-019-0085-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 03/28/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Epidemiological studies to determine the pattern of skin diseases among children are important for proper health care planning and management. The purpose of this study was to describe the pattern of skin diseases among pediatric patients seen at a dermatology outpatient clinic of Wolaita Sodo Teaching and Referral Hospital, southern Ethiopia. METHOD We conducted a retrospective hospital-based, cross-sectional study between January 2016 and December 2017 at a teaching and referral hospital dermatology outpatient department. All children younger than 15 years presenting with newly-diagnosed skin diseases were included. Diagnosis was mainly made clinically, with some laboratory support. RESULTS A total of 1704 children with 1869 new skin diagnoses were included, of whom 139 (8.2%) had more than one disease. Of the children, 52.4% were males and 44.9% within the age-group 5-10 years. Eczematous dermatitis accounted for the largest group (23.9%, n = 447) of skin conditions followed by bacterial infections (21.3%, n = 398), fungal infections (18.8%, n = 351) and infestations (9.9%, n = 185). Seasonal variation was demonstrated, with eczematous conditions and bacterial infections being higher during autumn and winter. CONCLUSION Overall, eczema, bacterial and fungal infections were the three major pediatric skin diseases occurring among children attending this hospital's outpatient department. There was seasonal variation in some of the skin diseases. This study gives a snapshot of skin disorders presenting to hospital in children in southern Ethiopia and may help to plan dermatology service expansion, educational programs and preventive measures.
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Affiliation(s)
- Abraham Getachew Kelbore
- College of Health Sciences and Medicine, Dermatology Department, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Philip Owiti
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
- The National Tuberculosis, Leprosy and Lung Disease Programme, Ministry of Health, Nairobi, Kenya
| | - Anthony J. Reid
- Operational Research Unit, MedicalDepartment, Operational Centre Brussels, Médecins Sans Frontières, LuxOR, Luxembourg City, Luxembourg
| | - Efa Ambaw Bogino
- College of Health Sciences and Medicine, Dermatology Department, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Lantesil Wondewosen
- College of Health Sciences and Medicine, Dermatology Department, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Blen Kassahun Dessu
- College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
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Yotsu RR. Integrated Management of Skin NTDs-Lessons Learned from Existing Practice and Field Research. Trop Med Infect Dis 2018; 3:E120. [PMID: 30441754 PMCID: PMC6306929 DOI: 10.3390/tropicalmed3040120] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 11/10/2018] [Accepted: 11/11/2018] [Indexed: 12/18/2022] Open
Abstract
Integration of neglected tropical diseases (NTDs) into the public health agenda has been a priority in global health for the last decade. Because a number of these diseases share not only the geographical distribution, but also a common feature which is skin involvement, bringing together a sub-group of 'skin NTDs' is one way forward to promote further integration among NTDs. With these diseases, which include leprosy, Buruli ulcer, yaws, mycetoma, lymphatic filariasis, and leishmaniasis, patients may be left with life-long deformities and disabilities when diagnosis and treatment are delayed. Stigma is another serious consequence of skin NTDs as it places a large barrier on the economic activities and social life of a patient. As a result, this creates a vicious cycle and obstructs a key goal of society, the elimination of poverty. Enhancement in surveillance systems as well as the further development of diagnostic methods, improvement in treatment and management, and identification of preventative measures for skin NTDs are therefore urgently needed. This article summarizes the existing practices and field research on skin NTDs and identifies potential synergies that could be achieved by adopting this integrated approach.
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Affiliation(s)
- Rie R Yotsu
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki 852-8102, Japan.
- Department of Dermatology, National Center for Global Health and Medicine, Tokyo 162-8655, Japan.
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Kalua K, Zimba B, Denning DW. Estimated Burden of Serious Fungal Infections in Malawi. J Fungi (Basel) 2018; 4:jof4020061. [PMID: 29883439 PMCID: PMC6023453 DOI: 10.3390/jof4020061] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 05/16/2018] [Accepted: 05/17/2018] [Indexed: 12/23/2022] Open
Abstract
Despite efforts to address the burden of fungal infections in Malawi, the prevalence and incidence remain largely unknown. We assessed the annual burden in the general population and among populations at high risk and fungal infection frequencies in each particular population to estimate the national incidence or prevalence. The Malawi population is approximately 17.7 million (2017), with 48% under 15 years of age. Approximately 8% of the population is HIV positive. The most common infections are present in HIV/AIDS patients, with oral candidiasis being the commonest. Life threatening infections among those with AIDS patients include cryptococcal meningitis (8200 cases) and Pneumocystis pneumonia (3690 cases). Pulmonary TB is common, but extra pulmonary TB is rare; an estimated 2329 people have chronic pulmonary aspergillosis after TB. Asthma is a significant problem in Malawi, with an estimated 680,000 adults affected (4.67%) and 14,010 cases of allergic bronchopulmonary aspergillosis (ABPA). Tinea capitis is estimated to be present in over 670,000 young people (21% of school age children). The annual incidence of fungal keratitis is difficult to estimate, but as cases are frequently seen in the eye department, is likely to be a minimum of 1825 (10.3/100,000) cases. Among the most serious infections, cryptococcal meningitis and Pneumocystis pneumonia are top of the list. Overall, some 1,338,523 (7.54%) people are affected by a serious fungal infection in Malawi. These basic estimates are limited, due to poor record keeping, and require epidemiological studies to validate or modify the substantial burden estimates. National surveillance of fungal infections is urgently needed.
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Affiliation(s)
- Khumbo Kalua
- Blantyre Institute for Community Outreach (BICO), Blantyre, Malawi.
- College of Medicine, University of Malawi, Blantyre, Malawi.
| | - Boston Zimba
- College of Medicine, University of Malawi, Blantyre, Malawi.
| | - David W Denning
- National Aspergillosis Centre, Wythenshawe Hospital and The University of Manchester, Manchester M13 9PL, UK.
- Leading International Fungal Education (LIFE) (www.LIFE-Worldwide.org), Cheshire SK10 9AR, UK.
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Yotsu RR, Kouadio K, Vagamon B, N’guessan K, Akpa AJ, Yao A, Aké J, Abbet Abbet R, Tchamba Agbor Agbor B, Bedimo R, Ishii N, Fuller LC, Hay R, Mitjà O, Drechsler H, Asiedu K. Skin disease prevalence study in schoolchildren in rural Côte d'Ivoire: Implications for integration of neglected skin diseases (skin NTDs). PLoS Negl Trop Dis 2018; 12:e0006489. [PMID: 29771976 PMCID: PMC5976208 DOI: 10.1371/journal.pntd.0006489] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 05/30/2018] [Accepted: 05/02/2018] [Indexed: 12/18/2022] Open
Abstract
Background Early detection of several skin-related neglected tropical diseases (skin NTDs)–including leprosy, Buruli ulcer, yaws, and scabies- may be achieved through school surveys, but such an approach has seldom been tested systematically on a large scale in endemic countries. Additionally, a better understanding of the spectrum of skin diseases and the at-risk populations to be encountered during such surveys is necessary to facilitate the process. Methods We performed a school skin survey for selected NTDs and the spectrum of skin diseases, among primary schoolchildren aged 5 to 15 in Côte d’Ivoire, West Africa. This 2-phase survey took place in 49 schools from 16 villages in the Adzopé health district from November 2015 to January 2016. The first phase involved a rapid visual examination of the skin by local community healthcare workers (village nurses) to identify any skin abnormality. In a second phase, a specialized medical team including dermatologists performed a total skin examination of all screened students with any skin lesion and provided treatment where necessary. Results Of a total of 13,019 children, 3,504 screened positive for skin lesions and were listed for the next stage examination. The medical team examined 1,138 of these children. The overall prevalence of skin diseases was 25.6% (95% CI: 24.3–26.9%). The predominant diagnoses were fungal infections (n = 858, prevalence: 22.3%), followed by inflammatory skin diseases (n = 265, prevalence: 6.9%). Skin diseases were more common in boys and in children living along the main road with heavy traffic. One case of multi-bacillary type leprosy was detected early, along with 36 cases of scabies. Our survey was met with very good community acceptance. Conclusion We carried out the first large-scale integrated, two-phase pediatric multi-skin NTD survey in rural Côte d’Ivoire, effectively reaching a large population. We found a high prevalence of skin diseases in children, but only limited number of skin NTDs. With the lessons learned, we plan to expand the project to a wider area to further explore its potential to better integrate skin NTD screening in the public health agenda. Integration of neglected tropical diseases (NTDs) into the public health agenda has been a priority in global health for the last decade. A common feature shared by several NTDs is skin involvement. Conditions within this group of NTDs have now been classified as skin NTDs to promote wider NTD integration. Several skin NTDs including leprosy, Buruli ulcer, yaws, and scabies are co-endemic in Côte d’Ivoire, West Africa. As children are vulnerable to these diseases, we carried out the first large-scale integrated, multi-skin NTD school survey in a rural district of this country. Our strategy of involving community healthcare workers and dermatologists effectively reached a large population. However, the detection of skin NTDs may have been limited because of the low schooling and attendance rate. We found a high prevalence of skin diseases among schoolchildren (26%), possibly due to poor socio-economic status and air pollution, which requires more attention. This high prevalence of skin diseases posed a challenge for our project as the need for medications and those with dermatological skills exceeded our capacity to reach our initial target population. Our study provides important lessons that will aid the framing of future school skin surveys in sub-Saharan Africa.
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Affiliation(s)
- Rie Roselyne Yotsu
- Department of Dermatology, National Center for Global Health and Medicine, Tokyo, Japan
- Department of Dermatology, National Suruga Sanatorium, Shizuoka, Japan
- * E-mail: ,
| | - Kouamé Kouadio
- Eco Epidemiology Unit, Pasteur Institute Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Bamba Vagamon
- Raoul Follereau Institute Côte d’Ivoire, Adzopé, Côte d’Ivoire
| | | | | | - Aubin Yao
- MAP International West Africa, Abidjan, Côte d’Ivoire
| | - Julien Aké
- MAP International West Africa, Abidjan, Côte d’Ivoire
| | - Rigobert Abbet Abbet
- National Program for Leprosy Control (PNEL), Ministry of Health and Public Hygiene, Abidjan, Côte d’Ivoire
| | | | - Roger Bedimo
- Department of Medicine, VA North Texas Healthcare System, Dallas, Texas, United States of America
- Division of Infectious Diseases, University of Texas Dallas Southwestern, Dallas, Texas, United States of America
| | - Norihisa Ishii
- Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - L. Claire Fuller
- International Foundation for Dermatology
- Dermatology Department, Chelsea and Westminster Hospital, London, United Kingdom
| | | | - Oriol Mitjà
- Skin NTD Program, Barcelona Institute for Global Health, Hospital Clinic-University of Barcelona, Barcelona, Spain
| | - Henning Drechsler
- Department of Medicine, VA North Texas Healthcare System, Dallas, Texas, United States of America
- Division of Infectious Diseases, University of Texas Dallas Southwestern, Dallas, Texas, United States of America
| | - Kingsley Asiedu
- Global Buruli Ulcer Initiative, World Health Organization, Geneva, Switzerland
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Doss RW, El-Rifaie AA, Radi N, El-Sherif AY. Antimicrobial Susceptibility of Tinea Capitis in Children from Egypt. Indian J Dermatol 2018; 63:155-159. [PMID: 29692458 PMCID: PMC5903046 DOI: 10.4103/ijd.ijd_519_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Dermatophytic fungi of genera Trichophyton and Microsporum are the most important fungal species causing tinea capitis. Choice of treatment for tinea capitis is determined by the species of fungus. Aim The aim of the study was to investigate the most prevalent fungal species causing tinea capitis in children from Egypt and the most useful antifungal agent for treatment. Patients and Methods A total of 100 patients diagnosed clinically with tinea capitis were included in the study. Samples were collected and sent to the microbiology and immunology laboratory for sample processing and fungal identification by routine laboratory techniques. A study of antifungal susceptibility to chosen antifungal medications (fluconazole, ketoconazole, clotrimazole, miconazole, amphotericin, caspofungin, itraconazole, terbinafine, and griseofulvin) was done by minimum inhibitory concentration technique. Results Our analysis revealed that Microsporum canis is the most commonly isolated strain. Amphotericin was the most effective antifungal agent followed by terbinafine. The most sensitive strain to fluconazole and griseofulvin is Microsporum gypseum, while Microsporum audouinii was mostly responsive to terbinafine. Conclusion Identification and evaluation of the antifungal susceptibility of the pathogenic species in a certain geographic region is important to achieve a good clinical response.
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Affiliation(s)
- Reham William Doss
- Department of Dermatology, Faculty of Medicine, Beni-Suef University, Beni Suef, Egypt
| | - Abdel-Aziz El-Rifaie
- Department of Dermatology, Faculty of Medicine, Beni-Suef University, Beni Suef, Egypt
| | - Nagla Radi
- Department of Microbiology and Immunology, Faculty of Medicine, Beni-Suef University, Beni Suef, Egypt
| | - Aya Yehia El-Sherif
- Department of Dermatology, Faculty of Medicine, Beni-Suef University, Beni Suef, Egypt
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De Luca DA, Maianski Z, Averbukh M. A study of skin disease spectrum occurring in Angola phototype V-VI population in Luanda. Int J Dermatol 2018; 57:849-855. [DOI: 10.1111/ijd.13958] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 02/07/2018] [Indexed: 12/31/2022]
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Bongomin F, Gago S, Oladele RO, Denning DW. Global and Multi-National Prevalence of Fungal Diseases-Estimate Precision. J Fungi (Basel) 2017; 3:E57. [PMID: 29371573 PMCID: PMC5753159 DOI: 10.3390/jof3040057] [Citation(s) in RCA: 1402] [Impact Index Per Article: 200.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 10/12/2017] [Accepted: 10/16/2017] [Indexed: 02/07/2023] Open
Abstract
Fungal diseases kill more than 1.5 million and affect over a billion people. However, they are still a neglected topic by public health authorities even though most deaths from fungal diseases are avoidable. Serious fungal infections occur as a consequence of other health problems including asthma, AIDS, cancer, organ transplantation and corticosteroid therapies. Early accurate diagnosis allows prompt antifungal therapy; however this is often delayed or unavailable leading to death, serious chronic illness or blindness. Recent global estimates have found 3,000,000 cases of chronic pulmonary aspergillosis, ~223,100 cases of cryptococcal meningitis complicating HIV/AIDS, ~700,000 cases of invasive candidiasis, ~500,000 cases of Pneumocystis jirovecii pneumonia, ~250,000 cases of invasive aspergillosis, ~100,000 cases of disseminated histoplasmosis, over 10,000,000 cases of fungal asthma and ~1,000,000 cases of fungal keratitis occur annually. Since 2013, the Leading International Fungal Education (LIFE) portal has facilitated the estimation of the burden of serious fungal infections country by country for over 5.7 billion people (>80% of the world's population). These studies have shown differences in the global burden between countries, within regions of the same country and between at risk populations. Here we interrogate the accuracy of these fungal infection burden estimates in the 43 published papers within the LIFE initiative.
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Affiliation(s)
- Felix Bongomin
- The National Aspergillosis Center, Education and Research Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester M23 9LT, UK.
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK.
- Global Action Fund for Fungal Infections, 1211 Geneva 1, Switzerland.
| | - Sara Gago
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK.
- Global Action Fund for Fungal Infections, 1211 Geneva 1, Switzerland.
- Manchester Fungal Infection Group, Core Technology Facility, The University of Manchester, Manchester M13, 9PL, UK.
| | - Rita O Oladele
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK.
- Global Action Fund for Fungal Infections, 1211 Geneva 1, Switzerland.
| | - David W Denning
- The National Aspergillosis Center, Education and Research Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester M23 9LT, UK.
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK.
- Global Action Fund for Fungal Infections, 1211 Geneva 1, Switzerland.
- Manchester Fungal Infection Group, Core Technology Facility, The University of Manchester, Manchester M13, 9PL, UK.
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Coulibaly O, L’Ollivier C, Piarroux R, Ranque S. Epidemiology of human dermatophytoses in Africa. Med Mycol 2017; 56:145-161. [DOI: 10.1093/mmy/myx048] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 07/06/2017] [Indexed: 11/13/2022] Open
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25
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Rosenbaum BE, Klein R, Hagan PG, Seadey MY, Quarcoo NL, Hoffmann R, Robinson M, Lartey M, Leger MC. Dermatology in Ghana: a retrospective review of skin disease at the Korle Bu Teaching Hospital Dermatology Clinic. Pan Afr Med J 2017; 26:125. [PMID: 28533848 PMCID: PMC5429409 DOI: 10.11604/pamj.2017.26.125.10954] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 02/12/2017] [Indexed: 11/30/2022] Open
Abstract
Introduction Ghana is currently developing its provision of dermatology services. Epidemiologic studies of the skin diseases seen by Ghanaian dermatologists are needed to guide these efforts. We aimed to describe the skin conditions seen by and management practices of Ghanaian dermatologists in a specialized clinic. Methods We conducted a chart review of new patients presenting to the Korle Bu Teaching Hospital dermatology clinic during 2014. Results Among the 529 patients studied, 700 discrete diagnoses were made. The most commonly diagnosed skin conditions were infections (24.6%) and dermatitis (24.6%); atopic dermatitis (8.4%), acne vulgaris (5.3%) and scabies (5.1%) were the most common specific diagnoses. Among infants, children, and adolescents, the most common diagnosis was atopic dermatitis (31.7%, 30.0%, and 14.9%, respectively). Acne vulgaris (12.0%) was the most common skin condition diagnosed in young adults. Irritant contact dermatitis (6.9%) was most common among adults. Lichen planus (9.9%) was the most commonly diagnosed skin condition in the senior population. Diagnoses made by dermatologists differed from the referral diagnosis documented by primary care providers for 65.8% of patients. The most frequently recommended treatments were antihistamines (47.8%) and topical steroids (38.4%). Only 18 diagnostic biopsies were performed. Conclusion Our study summarizes the skin diseases seen and management practices of Ghanaian dermatologists in a specialized clinic at a large public teaching hospital. The results of this study can help to guide future dermatology education and development efforts in Ghana.
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Affiliation(s)
| | - Rebecca Klein
- University of Chicago Pritzker School of Medicine, Chicago, USA.,Department of Psychiatry, Columbia University College of Physicians and Surgeons, USA
| | - Paa Gyasi Hagan
- Dermatology Unit, Department of Medicine, Korle Bu Teaching Hospital, Ghana
| | - Mark-Young Seadey
- Dermatology Unit, Department of Medicine, Korle Bu Teaching Hospital, Ghana
| | | | - Rachel Hoffmann
- The Ronald Perelman Department of Dermatology, New York University School of Medicine, USA
| | - Maria Robinson
- The Ronald Perelman Department of Dermatology, New York University School of Medicine, USA
| | - Margaret Lartey
- Dermatology Unit, Department of Medicine & Therapeutics, University of Ghana School of Medicine and Dentistry, Ghana
| | - Marie C Leger
- The Ronald Perelman Department of Dermatology, New York University School of Medicine, USA.,Department of Dermatology, Weill Cornell Medical College, New York, USA
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Caraballo L, Zakzuk J, Lee BW, Acevedo N, Soh JY, Sánchez-Borges M, Hossny E, García E, Rosario N, Ansotegui I, Puerta L, Sánchez J, Cardona V. Particularities of allergy in the Tropics. World Allergy Organ J 2016; 9:20. [PMID: 27386040 PMCID: PMC4924335 DOI: 10.1186/s40413-016-0110-7] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 05/25/2016] [Indexed: 12/27/2022] Open
Abstract
Allergic diseases are distributed worldwide and their risk factors and triggers vary according to geographical and socioeconomic conditions. Allergies are frequent in the Tropics but aspects of their prevalence, natural history, risk factors, sensitizers and triggers are not well defined and some are expected to be different from those in temperate zone countries. The aim of this review is to investigate if allergic diseases in the Tropics have particularities that deserve special attention for research and clinical practice. Such information will help to form a better understanding of the pathogenesis, diagnosis and management of allergic diseases in the Tropics. As expected, we found particularities in the Tropics that merit further study because they strongly affect the natural history of common allergic diseases; most of them related to climate conditions that favor permanent exposure to mite allergens, helminth infections and stinging insects. In addition, we detected several unmet needs in important areas which should be investigated and solved by collaborative efforts led by the emergent research groups on allergy from tropical countries.
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Affiliation(s)
- Luis Caraballo
- />Institute for Immunological Research, University of Cartagena, Cra. 5 # 7-77, Cartagena, Colombia
| | - Josefina Zakzuk
- />Institute for Immunological Research, University of Cartagena, Cra. 5 # 7-77, Cartagena, Colombia
| | - Bee Wah Lee
- />Khoo Teck Puat- National University Children’s Medical Institute, National University Health System, Singapore, Singapore
- />Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Nathalie Acevedo
- />Department of Medicine Solna, Karolinska Institutet, Translational Immunology Unit, Stockholm, Sweden
| | - Jian Yi Soh
- />Khoo Teck Puat- National University Children’s Medical Institute, National University Health System, Singapore, Singapore
- />Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Mario Sánchez-Borges
- />Allergy and Clinical Immunology Department, Centro Médico- Docente La Trinidad and Clínica El Avila, Caracas, Venezuela
| | - Elham Hossny
- />Pediatric Allergy and Immunology Unit, Children’s Hospital, Ain Shams University, Cairo, Egypt
| | - Elizabeth García
- />Allergy Section, Fundación Santa Fe de Bogotá, Faculty of Medicine, Universidad de los Andes, Bogotá, Colombia
| | - Nelson Rosario
- />Federal University of Parana, Rua General Carneiro, Curitiba, Brazil
| | - Ignacio Ansotegui
- />Department of Allergy and Immunology, Hospital Quirón Bizkaia, Bilbao, Spain
| | - Leonardo Puerta
- />Institute for Immunological Research, University of Cartagena, Cra. 5 # 7-77, Cartagena, Colombia
| | - Jorge Sánchez
- />Department of Pediatrics, Graduate Program on Allergology, University of Antioquia, Medellín, Colombia
| | - Victoria Cardona
- />Allergy Section, Department of Internal Medicine, Hospital Vall d’Hebron, Barcelona, Spain
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Coulibaly O, Kone AK, Niaré-Doumbo S, Goïta S, Gaudart J, Djimdé AA, Piarroux R, Doumbo OK, Thera MA, Ranque S. Dermatophytosis among Schoolchildren in Three Eco-climatic Zones of Mali. PLoS Negl Trop Dis 2016; 10:e0004675. [PMID: 27124571 PMCID: PMC4849727 DOI: 10.1371/journal.pntd.0004675] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 04/08/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Dermatophytosis, and particularly the subtype tinea capitis, is common among African children; however, the risk factors associated with this condition are poorly understood. To describe the epidemiology of dermatophytosis in distinct eco-climatic zones, three cross-sectional surveys were conducted in public primary schools located in the Sahelian, Sudanian and Sudano-Guinean eco-climatic zones in Mali. PRINCIPAL FINDINGS Among 590 children (average age 9.7 years) the overall clinical prevalence of tinea capitis was 39.3%. Tinea capitis prevalence was 59.5% in the Sudano-Guinean zone, 41.6% in the Sudanian zone and 17% in the Sahelian eco-climatic zone. Microsporum audouinii was isolated primarily from large and/or microsporic lesions. Trichophyton soudanense was primarily isolated from trichophytic lesions. Based on the multivariate analysis, tinea capitis was independently associated with male gender (OR = 2.51, 95%CI [1.74-3.61], P<10(-4)) and residing in the Sudano-Guinean eco-climatic zone (OR = 7.45, 95%CI [4.63-11.99], P<10(-4)). Two anthropophilic dermatophytes species, Trichophyton soudanense and Microsporum audouinii, were the most frequent species associated with tinea capitis among primary schoolchildren in Mali. CONCLUSIONS Tinea capitis risk increased with increasing climate humidity in this relatively homogenous schoolchild population in Mali, which suggests a significant role of climatic factors in the epidemiology of dermatophytosis.
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Affiliation(s)
- Oumar Coulibaly
- IP-TPT UMR MD3, Aix-Marseille Université, Marseille, France
- Département d’Épidémiologie des Affections Parasitaires/Malaria Research and Training Center, Faculté de Médecine, Université des Sciences, des Techniques et Technologies de Bamako, Bamako, Mali
| | - Abdoulaye K. Kone
- Département d’Épidémiologie des Affections Parasitaires/Malaria Research and Training Center, Faculté de Médecine, Université des Sciences, des Techniques et Technologies de Bamako, Bamako, Mali
| | - Safiatou Niaré-Doumbo
- Département d’Épidémiologie des Affections Parasitaires/Malaria Research and Training Center, Faculté de Médecine, Université des Sciences, des Techniques et Technologies de Bamako, Bamako, Mali
| | - Siaka Goïta
- Département d’Épidémiologie des Affections Parasitaires/Malaria Research and Training Center, Faculté de Médecine, Université des Sciences, des Techniques et Technologies de Bamako, Bamako, Mali
| | - Jean Gaudart
- SESSTIM, Institut National de la Santé et de la Recherche Médicale / Institut de Recherche pour le Développement / Aix-Marseille Université, Marseille, France
| | - Abdoulaye A. Djimdé
- Département d’Épidémiologie des Affections Parasitaires/Malaria Research and Training Center, Faculté de Médecine, Université des Sciences, des Techniques et Technologies de Bamako, Bamako, Mali
| | - Renaud Piarroux
- IP-TPT UMR MD3, Aix-Marseille Université, Marseille, France
- Parasitologie & Mycologie, Hôpital de la Timone, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Ogobara K. Doumbo
- Département d’Épidémiologie des Affections Parasitaires/Malaria Research and Training Center, Faculté de Médecine, Université des Sciences, des Techniques et Technologies de Bamako, Bamako, Mali
| | - Mahamadou A. Thera
- Département d’Épidémiologie des Affections Parasitaires/Malaria Research and Training Center, Faculté de Médecine, Université des Sciences, des Techniques et Technologies de Bamako, Bamako, Mali
| | - Stéphane Ranque
- IP-TPT UMR MD3, Aix-Marseille Université, Marseille, France
- Parasitologie & Mycologie, Hôpital de la Timone, Assistance Publique-Hôpitaux de Marseille, Marseille, France
- * E-mail:
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Bowen AC, Mahé A, Hay RJ, Andrews RM, Steer AC, Tong SYC, Carapetis JR. The Global Epidemiology of Impetigo: A Systematic Review of the Population Prevalence of Impetigo and Pyoderma. PLoS One 2015; 10:e0136789. [PMID: 26317533 PMCID: PMC4552802 DOI: 10.1371/journal.pone.0136789] [Citation(s) in RCA: 156] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 08/06/2015] [Indexed: 11/29/2022] Open
Abstract
Objective We conducted a comprehensive, systematic review of the global childhood population prevalence of impetigo and the broader condition pyoderma. Methods PubMed was systematically searched for impetigo or pyoderma studies published between January 1 1970 and September 30 2014. Two independent reviewers extracted data from each relevant article on the prevalence of impetigo. Findings Sixty-six articles relating to 89 studies met our inclusion criteria. Based on population surveillance, 82 studies included data on 145,028 children assessed for pyoderma or impetigo. Median childhood prevalence was 12·3% (IQR 4·2–19·4%). Fifty-eight (65%) studies were from low or low-middle income countries, where median childhood prevalences were 8·4% (IQR 4·2–16·1%) and 14·5% (IQR 8·3–20·9%), respectively. However, the highest burden was seen in underprivileged children from marginalised communities of high-income countries; median prevalence 19·4%, (IQR 3·9–43·3%). Conclusion Based on data from studies published since 2000 from low and low-middle income countries, we estimate the global population of children suffering from impetigo at any one time to be in excess of 162 million, predominantly in tropical, resource-poor contexts. Impetigo is an under-recognised disease and in conjunction with scabies, comprises a major childhood dermatological condition with potential lifelong consequences if untreated.
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Affiliation(s)
- Asha C. Bowen
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- Department of Infectious Diseases, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
- * E-mail:
| | - Antoine Mahé
- Department of Dermatology, Hôpital Pasteur, Colmar, France
| | - Roderick J. Hay
- International Foundation for Dermatology, London, United Kingdom
- Skin Infection Clinic, Kings College Hospital NHS Trust, Denmark Hill, United Kingdom
| | - Ross M. Andrews
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Andrew C. Steer
- Royal Children’s Hospital, Melbourne, Victoria, Australia
- Institute for Child Health Research, University of Melbourne, Victoria, Australia
| | - Steven Y. C. Tong
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- Department of Infectious Diseases, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Jonathan R. Carapetis
- Department of Infectious Diseases, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
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Moto JN, Maingi JM, Nyamache AK. Prevalence of Tinea capitis in school going children from Mathare, informal settlement in Nairobi, Kenya. BMC Res Notes 2015; 8:274. [PMID: 26116079 PMCID: PMC4483201 DOI: 10.1186/s13104-015-1240-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 06/17/2015] [Indexed: 11/18/2022] Open
Abstract
Background Tinea capitis is a common infection especially in poor resource settings. This study was aimed at determining the prevalence Tinea capitis in children from selected schools from an urban slum in Nairobi city of Kenya. Methods A cross-sectional study was carried out in 150 school going children during the period between May and September 2013. A questionnaire was administered and cultures of scalps, skin scrapping/hair stubs samples were performed and the etiological agents identified and confirmed. Results In a total of one hundred and fifty (150) children recruited 89 (59.3%) were males and 61 (40.7%) females aged between 3 and 14 years. The overall prevalence rates in dermatophytes infection was 81.3% (122/150) with etiological agents consisting Trichophyton spp. (61.3%), Microsporum spp. (13.3%) and Epidermophyton spp. (7.3%) infections with infections occurring either singly (56%), duo (38%) or tipple co-infections (6%). Conclusion This study demonstrates a high prevalence of Tinea infections with Trichophyton tonsurans as the predominant etiological agent in school going children of the urban slums of Nairobi. Electronic supplementary material The online version of this article (doi:10.1186/s13104-015-1240-7) contains supplementary material, which is available to authorized users.
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