title: [Risk factors associated with leg erysipelas (cellulitis) in sub-Saharan Africa: A multicentre case-control study].
abstract: BACKGROUND
  Acute bacterial cellulitis of the leg (erysipelas) is a common problem involving considerable morbidity in dermatology practice in Africa. Previous studies conducted in Europe and North Africa have highlighted lymphoedema and toe-web intertrigo as independent factors associated with leg erysipelas. The aim of this case-control study was to identify risk factors associated with leg erysipelas in sub-Saharan Africa, within a different socio-economic and culture context.
  
  
  METHODS
  We conducted a prospective case-control study in hospital dermatology departments in 8 sub-Saharan African countries over a 12-month period (October 2013 to September 2014). Each case of acute leg cellulitis was matched with 2 controls for age (±5 years) and sex. We analysed the general and local factors.
  
  
  RESULTS
  During the study period, 364 cases (223 female, 141 male) were matched with 728 controls. The mean age was 42.15±15.15 years for patients and 42.11±36 years for controls. Multivariate analysis showed the following to be independent risk factors associated with leg erysipelas in our study: obesity (odds ratio [OR]=2.82 ; 95% confidence interval: 2.11-3.76), lymphoedema (OR=3.87, 95%CI: 2.17-6.89), voluntary cosmetic depigmentation (OR=4.29, 95%CI: 2.35-7.83), neglected traumatic wound (OR=37.2, 95%CI: 24.9-57.72) and toe-web intertrigo (OR=37.86, 95%CI: 22.27-64.5).
  
  
  CONCLUSIONS
  The results of this study confirms the major role of local risk factors (toe-web intertrigo, lymphoedema) previously identified in other geographical settings. However, the originality of our study consists of the identification of voluntary cosmetic depigmentation as a risk factor for leg erysipelas in sub-Saharan Africa.
authors.affiliation: Service de dermato-vénéréologie, CHU Sylvanus Olympio, université de Lomé, 08 BP 81056, Lomé 08, Togo. Electronic address: ppitche@yahoo.fr.
authors.forename: P
authors.initials: P
authors.lastname: Pitché
authors.affiliation: Service de dermatologie, CHU Le Dantec, Dakar, université Cheik Anta Diop, Dakar, Sénégal.
authors.forename: B
authors.initials: B
authors.lastname: Diatta
authors.affiliation: Service de dermatologie, CNAM, Bamako, université de Bamako, Bamako, Mali.
authors.forename: O
authors.initials: O
authors.lastname: Faye
authors.affiliation: Service de dermatologie-MST, CHU Donka, Conakry, université de Conakry, Conakry, Guinée.
authors.forename: B-F
authors.initials: BF
authors.lastname: Diané
authors.affiliation: Centre de dermatologie, CHU Treichville, université de Cocody, Cocody, Côte d'Ivoire.
authors.forename: A
authors.initials: A
authors.lastname: Sangaré
authors.affiliation: Service de dermatologie, CHU Yaldago Ouédraogo, Ouagadougou, université de Ouagadougou, Ouagadougou, Burkina Faso.
authors.forename: P
authors.initials: P
authors.lastname: Niamba
authors.affiliation: Service de dermatologie, clinique universitaire des Montagnes, Banganté, Cameroun.
authors.forename: C
authors.initials: C
authors.lastname: Mandengue
authors.affiliation: Service de dermatologie, CHU de Bangui, université de Bangui, Bangui, Centrafrique.
authors.forename: L
authors.initials: L
authors.lastname: Kobengue
authors.affiliation: Service de dermato-vénéréologie, CHU Sylvanus Olympio, université de Lomé, 08 BP 81056, Lomé 08, Togo.
authors.forename: B
authors.initials: B
authors.lastname: Saka
authors.affiliation: Service de dermatologie, CHU Le Dantec, Dakar, université Cheik Anta Diop, Dakar, Sénégal.
authors.forename: A
authors.initials: A
authors.lastname: Diop
authors.affiliation: Service de dermatologie, CHU Le Dantec, Dakar, université Cheik Anta Diop, Dakar, Sénégal.
authors.forename: F
authors.initials: F
authors.lastname: Ly
authors.affiliation: Service de dermatologie, CHU Le Dantec, Dakar, université Cheik Anta Diop, Dakar, Sénégal.
authors.forename: M-T
authors.initials: MT
authors.lastname: Dieng
authors.affiliation: Service de dermatologie, CNAM, Bamako, université de Bamako, Bamako, Mali.
authors.forename: A
authors.initials: A
authors.lastname: Dicko
authors.affiliation: Service de dermatologie-MST, CHU Donka, Conakry, université de Conakry, Conakry, Guinée.
authors.forename: M-M
authors.initials: MM
authors.lastname: Soumah
authors.affiliation: Service de dermatologie-MST, CHU Donka, Conakry, université de Conakry, Conakry, Guinée.
authors.forename: M
authors.initials: M
authors.lastname: Cissé
authors.affiliation: Centre de dermatologie, CHU Treichville, université de Cocody, Cocody, Côte d'Ivoire.
authors.forename: S-H
authors.initials: SH
authors.lastname: Kourouma
authors.affiliation: Centre de dermatologie, CHU Treichville, université de Cocody, Cocody, Côte d'Ivoire.
authors.forename: Y-I
authors.initials: YI
authors.lastname: Kouassi
authors.affiliation: Service de dermato-vénéréologie, CHU Sylvanus Olympio, université de Lomé, 08 BP 81056, Lomé 08, Togo.
authors.forename: T
authors.initials: T
authors.lastname: Boukari
authors.affiliation: Service de dermato-vénéréologie, CHU Sylvanus Olympio, université de Lomé, 08 BP 81056, Lomé 08, Togo.
authors.forename: S
authors.initials: S
authors.lastname: Akakpo
authors.affiliation: Service de dermato-vénéréologie, CHU Sylvanus Olympio, université de Lomé, 08 BP 81056, Lomé 08, Togo.
authors.forename: K
authors.initials: K
authors.lastname: Tchangaï-Walla
mesh_terms: D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D000368:Aged; D015992:Body Mass Index; D016022:Case-Control Studies; D004886:Erysipelas / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology*; D005260:Female; D006761:Hospitals; D006801:Humans; D007402:Intertrigo / Q000150:complications; D007866:Leg / Q000473:pathology; D007871:Leg Ulcer / Q000150:complications; D008209:Lymphedema / Q000150:complications; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D011203:Poverty / Q000706:statistics & numerical data; D003668:Pressure Ulcer / Q000150:complications; D011446:Prospective Studies; D012307:Risk Factors
keywords: Afrique subsaharienne; Cosmetic depigmentation; Dépigmentation volontaire; Facteurs de risque; Intertrigo; Leg erysipela; Lymphoedema; Lymphœdème; Risk factors; Sub-Saharan Africa; Érysipèle de jambe