Skin diseases in children in rural Kenya: long-term results of a dermatology project within the primary health care system.
BACKGROUND
Following an epidemiological study on skin diseases in 5780 pupils from 13 schools in rural western Kenya in 1993, a dermatology project within the primary health care system was established in 1994 by the German non-government organization (NGO) 'Doctors in Aid of Children with Skin Diseases in Africa'. Within this project trained community health workers carried out regular visits to schools and nurseries and treated children with hydrocortisone acetate 1% cream for dermatitis, gentian violet 1% solution for bacterial skin infections, Whitfield's ointment for dermatophytoses and benzylbenzoate emulsion 25% for scabies.


OBJECTIVE
To assess the impact of this intervention.


METHODS
In 1999, after a 5-year period, 4961 pupils from the same 13 schools were re-examined and the prevalence rates were compared.


RESULTS
Non-infective dermatitis had a prevalence of 1.7% in 1993 as well as in 1999; among the communicable diseases bacterial infections declined from 12.7% to 11.3% (not significant), fungal infections rose from 10.1% to 13.9% (P < 0.05) and arthropod infections (mainly scabies) remained at similar levels of 8.3% in 1993 and 8.0% in 1999. A distinctive reduction could only be found for tropical ulcers (0.1% in 1999 compared with 1.2% in 1993).


CONCLUSIONS
The prevalence of dermatoses in children in rural Africa does not only depend on treatment schemes within the primary health care system, but on the socio-economic conditions available.
Schmeller
W
W
Doctors in Aid of Children with Skin Diseases in Africa ('Aerzte helfen hautkranken Kindern in Afrika e.V.') Bad Soden am Taunus, Germany. wilfried.schmeller@t-online.de
Dzikus
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A
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003879:Dermatologic Agents / Q000627:therapeutic use; D003881:Dermatomycoses / Q000188:drug therapy / Q000453:epidemiology; D003906:Developing Countries / Q000706:statistics & numerical data*; D005500:Follow-Up Studies; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D010865:Pilot Projects; D015995:Prevalence; D011320:Primary Health Care / Q000458:organization & administration*; D019035:Rural Health Services / Q000458:organization & administration*; D012532:Scabies / Q000188:drug therapy / Q000453:epidemiology; D012871:Skin Diseases / Q000188:drug therapy / Q000453:epidemiology*; D017192:Skin Diseases, Bacterial / Q000188:drug therapy / Q000453:epidemiology
D003879:Dermatologic Agents