title: The Global Epidemiology of Impetigo: A Systematic Review of the Population Prevalence of Impetigo and Pyoderma.
abstract: OBJECTIVE
  We conducted a comprehensive, systematic review of the global childhood population prevalence of impetigo and the broader condition pyoderma.
  
  
  METHODS
  PubMed was systematically searched for impetigo or pyoderma studies published between January 1 1970 and September 30 2014. Two independent reviewers extracted data from each relevant article on the prevalence of impetigo.
  
  
  RESULTS
  Sixty-six articles relating to 89 studies met our inclusion criteria. Based on population surveillance, 82 studies included data on 145,028 children assessed for pyoderma or impetigo. Median childhood prevalence was 12·3% (IQR 4·2-19·4%). Fifty-eight (65%) studies were from low or low-middle income countries, where median childhood prevalences were 8·4% (IQR 4·2-16·1%) and 14·5% (IQR 8·3-20·9%), respectively. However, the highest burden was seen in underprivileged children from marginalised communities of high-income countries; median prevalence 19·4%, (IQR 3·9-43·3%).
  
  
  CONCLUSIONS
  Based on data from studies published since 2000 from low and low-middle income countries, we estimate the global population of children suffering from impetigo at any one time to be in excess of 162 million, predominantly in tropical, resource-poor contexts. Impetigo is an under-recognised disease and in conjunction with scabies, comprises a major childhood dermatological condition with potential lifelong consequences if untreated.
authors: Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia; Department of Infectious Diseases, Princess Margaret Hospital for Children, Perth, Western Australia, Australia; Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia.
authors: Asha C
authors: AC
authors: Bowen
authors: Department of Dermatology, Hôpital Pasteur, Colmar, France.
authors: Antoine
authors: A
authors: Mahé
authors: International Foundation for Dermatology, London, United Kingdom; Skin Infection Clinic, Kings College Hospital NHS Trust, Denmark Hill, United Kingdom.
authors: Roderick J
authors: RJ
authors: Hay
authors: Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
authors: Ross M
authors: RM
authors: Andrews
authors: Royal Children's Hospital, Melbourne, Victoria, Australia; Institute for Child Health Research, University of Melbourne, Victoria, Australia.
authors: Andrew C
authors: AC
authors: Steer
authors: Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia; Department of Infectious Diseases, Royal Darwin Hospital, Darwin, Northern Territory, Australia.
authors: Steven Y C
authors: SY
authors: Tong
authors: Department of Infectious Diseases, Princess Margaret Hospital for Children, Perth, Western Australia, Australia; Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia.
authors: Jonathan R
authors: JR
authors: Carapetis
mesh_terms: D002648:Child; D002675:Child, Preschool; D006801:Humans; D007169:Impetigo / Q000453:epidemiology*; D015995:Prevalence; D011711:Pyoderma / Q000453:epidemiology*; D012959:Socioeconomic Factors