Rie Roselyne Yotsu1,2,3, Colombe Coffie Comoé4,5, Germaine Taïba Ainyakou5,6, N'guessan Konan7, Amari Akpa7, Aubin Yao7, Julien Aké7, Bamba Vagamon8,9, Rigobert Abbet Abbet10, Roger Bedimo11, Roderick Hay12. 1. School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan. 2. Department of Dermatology, National Center for Global Health and Medicine, Tokyo, Japan. 3. Department of Tropical Medicine, Tulane University School of Public Health and Tropical Medicine, New Orleans, United States of America. 4. Department of Social Sciences, University of Felix Houphouët Boigny (UFHB), Abidjan, Côte d'Ivoire. 5. Laboratoire d'Étude et de Recherches Interdisciplinaire en Sciences Sociales (LERISS), Abidjan, Côte d'Ivoire. 6. Department of Social Sciences, University of Peleforo Gon Coulibaly, Korhogo, Côte d'Ivoire. 7. MAP International Côte d'Ivoire, Abidjan, Côte d'Ivoire. 8. Raoul Follereau Institute Côte d'Ivoire, Adzopé, Côte d'Ivoire. 9. Department of Dermatology, Université Alassane Ouattara, Bouaké, Côte d'Ivoire. 10. Ministry of Health, Abidjan, Côte d'Ivoire. 11. Division of Infectious Diseases, University of Texas Southwestern, Dallas, United States of America. 12. International Foundation for Dermatology, London, United Kingdom.
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.
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.