Skin disorders among schoolchildren in rural Tanzania and an assessment of contributing factors and therapeutic needs

The present study was carried out to obtain data about the spectrum and prevalence of skin diseases among primary schoolchildren in Ifakara in rural Tanzania. The therapeutic needs, necessity for intervention and the influence of living conditions and hygiene behaviour on the magnitude of the prevalence were assessed. The records of healthcare facilities were checked to assess the incidence of scabies in the area of Ifakara. Finally, the extent of ivermectin distribution among the study population within the WHO Onchocercosis Control Program (OCP) was checked to assess the influence of this drug on the prevalence of ectoparasitoses. <br>820 primary school children aged 6 to 19 years old were examined. 55% of the children had one or more skin disorders. The most frequent diagnosis was tinea versicolor (prevalence: 26.2%) followed by pyoderma (8.4%) and dermatophytoses (tinea capitis: 5.4%, tinea pedis: 3.2%, tinea faciei/corporis: 2.6%). Other diagnoses included clean wounds (3.3%) and pruritic dermatoses (3.3%). Only 1.5% of the children had scabies infestations; 1.2% had eczematous lesions. Treatment was indicated in 33.2% of all diagnoses, mostly in dermatophytoses and pyoderma. The prevalence of dermatophytoses was linked with crowded living conditions, as was the prevalence of infectious skin diseases and tinea versicolor. Skin diseases did not represent a public health problem among primary school children in rural Ifakara at the time of the investigation. Treatment was considered necessary in only one third of the diagnoses and locally available drugs were sufficient for this purpose. The high prevalence of tinea versicolor was probably due to the age structure of the study population and the hot and humid climate at the time of the survey. The previous implementation of prevention measures and improving hygiene conditions probably led to the low prevalence of ectoparasitoses observed. It is unlikely that ivermectin treatment given at two and three years before this survey continued to influence their prevalence. The prevalence rate of eczematous lesions will vary in different locations. This may explain the relatively low prevalence observed amongst the study population. High rates of attendance reported from skin clinics are probably due to an accumulation of severe cases in reference centres. <br>Supply of health care facilities with cheap essential drugs as well as regular training of health staff is needed to guarantee adequate treatment and avoid unnecessary strains on local household budgets. Regular school visits by paramedical staff to provide treatment for the most frequent skin diseases could control conditions such as tinea capitis and tropical ulcers. Regular soap use has also shown promising results in the treatment of dermatomycoses and should be subject to investigation. As high prevalence of infectious skin diseases is significantly associated with high household density, any attempt to tackle skin diseases would have to include a change in living conditions and domestic routine.

Authors dc:creator

• Ferié, Julia Franziska
• Hatz, Christoph

• Einflussfaktoren
• Primary Schoolchildren
• Tropendermatologie
• Skin Disorders
• rural
• Tanzania
• Africa
• Therapy

Repository record source_url

https://freidok.uni-freiburg.de/data/2505

OAI identifier oai:identifier

oai:freidok.uni-freiburg.de:2505