[Public health and dermatology in developing countries].
Recently some common skin diseases (SD) (i.e. pyoderma, scabies, and superficial mycosis) received special interest in terms of public health assessing their significance in developing countries (DC). The importance of this problem has been established through several kinds of studies: studies from specialized dermatology centres, where the main reasons for consulting were common infectious skin diseases; prevalence studies in the general population pointing out very high prevalence rates for common infectious SD; and studies conducted in non-specialized health centres, where those SD represented about 10% of the total number of consultations. Classical complications of common infectious SD, such as post-streptococcic nephritis, appear rather unusual. However, the costs related to SD have been established as significant; this is partly due to the low efficiency of the health agents when trying to manage SD, and to their usual lack of training. So far, SD have been considered as having a very low priority level, due to their low lethality rate, and therefore have been ignored by health authorities. However, it seems unwise to ignore a health problem for which such a demand of the populations is expressed. Health policies aiming at the improvement of this situation have to be aware of the economic and health system context in DC, and should take into account every step of the health system. The following actions have been proposed: definition of SD priorities; training of non-specialized health agents to a basic management of SD priorities; promotion of use and availability of low-cost "essential dermatologic drugs"; education of the populations regarding measures to prevent certain SD. The feasibility and the impact of such a "public health dermatology" program remain to be evaluated.
Mahé
A
A
Institut d'hygiène sociale, Dakar, Sénégal. mahe@refer.sn
Faye
O
O
Fanello
S
S
D003906:Developing Countries; D006801:Humans; D011634:Public Health; D012871:Skin Diseases / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control