P Pitché1, B Diatta2, O Faye3, B-F Diané4, A Sangaré5, P Niamba6, C Mandengue7, L Kobengue8, B Saka9, A Diop2, F Ly2, M-T Dieng2, A Dicko3, M-M Soumah4, M Cissé4, S-H Kourouma5, Y-I Kouassi5, T Boukari9, S Akakpo9, K Tchangaï-Walla9. 1. Service de dermato-vénéréologie, CHU Sylvanus Olympio, université de Lomé, 08 BP 81056, Lomé 08, Togo. Electronic address: ppitche@yahoo.fr. 2. Service de dermatologie, CHU Le Dantec, Dakar, université Cheik Anta Diop, Dakar, Sénégal. 3. Service de dermatologie, CNAM, Bamako, université de Bamako, Bamako, Mali. 4. Service de dermatologie-MST, CHU Donka, Conakry, université de Conakry, Conakry, Guinée. 5. Centre de dermatologie, CHU Treichville, université de Cocody, Cocody, Côte d'Ivoire. 6. Service de dermatologie, CHU Yaldago Ouédraogo, Ouagadougou, université de Ouagadougou, Ouagadougou, Burkina Faso. 7. Service de dermatologie, clinique universitaire des Montagnes, Banganté, Cameroun. 8. Service de dermatologie, CHU de Bangui, université de Bangui, Bangui, Centrafrique. 9. Service de dermato-vénéréologie, CHU Sylvanus Olympio, université de Lomé, 08 BP 81056, Lomé 08, Togo.
Abstract
BACKGROUND: Acute bacterial cellulitis of the leg (erysipelas) is a common problem involving considerable morbidity in dermatology practice in Africa. Previous studies conducted in Europe and North Africa have highlighted lymphoedema and toe-web intertrigo as independent factors associated with leg erysipelas. The aim of this case-control study was to identify risk factors associated with leg erysipelas in sub-Saharan Africa, within a different socio-economic and culture context. PATIENTS AND METHODS: We conducted a prospective case-control study in hospital dermatology departments in 8 sub-Saharan African countries over a 12-month period (October 2013 to September 2014). Each case of acute leg cellulitis was matched with 2 controls for age (±5 years) and sex. We analysed the general and local factors. RESULTS: During the study period, 364 cases (223 female, 141 male) were matched with 728 controls. The mean age was 42.15±15.15 years for patients and 42.11±36 years for controls. Multivariate analysis showed the following to be independent risk factors associated with leg erysipelas in our study: obesity (odds ratio [OR]=2.82 ; 95% confidence interval: 2.11-3.76), lymphoedema (OR=3.87, 95%CI: 2.17-6.89), voluntary cosmetic depigmentation (OR=4.29, 95%CI: 2.35-7.83), neglected traumatic wound (OR=37.2, 95%CI: 24.9-57.72) and toe-web intertrigo (OR=37.86, 95%CI: 22.27-64.5). CONCLUSION: The results of this study confirms the major role of local risk factors (toe-web intertrigo, lymphoedema) previously identified in other geographical settings. However, the originality of our study consists of the identification of voluntary cosmetic depigmentation as a risk factor for leg erysipelas in sub-Saharan Africa.
BACKGROUND: Acute bacterial cellulitis of the leg (erysipelas) is a common problem involving considerable morbidity in dermatology practice in Africa. Previous studies conducted in Europe and North Africa have highlighted lymphoedema and toe-web intertrigo as independent factors associated with leg erysipelas. The aim of this case-control study was to identify risk factors associated with leg erysipelas in sub-Saharan Africa, within a different socio-economic and culture context. PATIENTS AND METHODS: We conducted a prospective case-control study in hospital dermatology departments in 8 sub-Saharan African countries over a 12-month period (October 2013 to September 2014). Each case of acute leg cellulitis was matched with 2 controls for age (±5 years) and sex. We analysed the general and local factors. RESULTS: During the study period, 364 cases (223 female, 141 male) were matched with 728 controls. The mean age was 42.15±15.15 years for patients and 42.11±36 years for controls. Multivariate analysis showed the following to be independent risk factors associated with leg erysipelas in our study: obesity (odds ratio [OR]=2.82 ; 95% confidence interval: 2.11-3.76), lymphoedema (OR=3.87, 95%CI: 2.17-6.89), voluntary cosmetic depigmentation (OR=4.29, 95%CI: 2.35-7.83), neglected traumatic wound (OR=37.2, 95%CI: 24.9-57.72) and toe-web intertrigo (OR=37.86, 95%CI: 22.27-64.5). CONCLUSION: The results of this study confirms the major role of local risk factors (toe-web intertrigo, lymphoedema) previously identified in other geographical settings. However, the originality of our study consists of the identification of voluntary cosmetic depigmentation as a risk factor for leg erysipelas in sub-Saharan Africa.
Authors: Tsi Njim; Leopold Ndemnge Aminde; Valirie Ndip Agbor; Louise Daniele Toukam; Sara Saheb Kashaf; Eric O Ohuma Journal: BMC Infect Dis Date: 2017-06-12 Impact factor: 3.090