title: Point and period prevalences of eczema in rural and urban schoolchildren in Ghana, Gabon and Rwanda.
abstract: BACKGROUND
  Eczema is a growing problem in Africa, particularly amongst children.
  
  
  OBJECTIVE
  To investigate the point-prevalences of eczema by physical examination in schoolchildren living in rural and urban areas and with different socioeconomic backgrounds in Ghana, Gabon and Rwanda. In Ghana period-prevalences were also estimated by questionnaire and compared with the point-prevalences.
  
  
  METHODS
  In total, 4839 schoolchildren in Ghana, Gabon and Rwanda were seen by at least one dermatologist. The point-prevalences of eczema were estimated on the basis of physical examination. Period-prevalences were measured in Ghana with questionnaire based-interviews adapted from the International Study of Asthma and Allergies in Childhood (ISAAC).
  
  
  RESULTS
  The point-prevalences were 1.5% and 1.6% in the two Ghanaian studies; 4% in Gabon and 0.8% in Rwanda. The period-prevalences were 2.6% and 4.4% in the two Ghanaian studies. The prevalences of eczema were not significantly different when comparing the urban and rural groups as well as the different socioeconomic levels. The sensitivity and positive predictive value to identify eczema cases based on the questionnaires compared to the diagnoses by physical examination were only 33% and 22% in the first Ghanaian study and 10% and 4% in the second Ghanaian study respectively.
  
  
  CONCLUSIONS
  The point-prevalences of eczema in the three African countries studied were low compared with industrialized countries. Physical examination by a dermatologist is still the gold standard to identify eczema cases because the sensitivity and the positive predictive value to identify eczema cases with questionnaires were low in the two Ghanaian studies.
authors.affiliation: Dermatology, Korle-Bu Teaching Hospital, University of Ghana Medical School, Accra, Ghana.
authors.forename: A A
authors.initials: AA
authors.lastname: Hogewoning
authors.forename: J N
authors.initials: JN
authors.lastname: Bouwes Bavinck
authors.forename: A S
authors.initials: AS
authors.lastname: Amoah
authors.forename: D A
authors.initials: DA
authors.lastname: Boakye
authors.forename: M
authors.initials: M
authors.lastname: Yazdanbakhsh
authors.forename: P G
authors.initials: PG
authors.lastname: Kremsner
authors.forename: A A
authors.initials: AA
authors.lastname: Adegnika
authors.forename: S K A D
authors.initials: SK
authors.lastname: De Smedt
authors.forename: R
authors.initials: R
authors.lastname: Willemze
authors.forename: A P M
authors.initials: AP
authors.lastname: Lavrijsen
mesh_terms: D002648:Child; D004485:Eczema / Q000453:epidemiology*; D005260:Female; D005681:Gabon / Q000453:epidemiology; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D008297:Male; D015995:Prevalence; D012424:Rural Population; D012432:Rwanda / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014505:Urban Population