GD03: A skin disease survey of the Maasai in Northern Tanzania

Sidra S. Khan,¹ Darren M. Ashcroft,^2,3,4 Daudi Mavura,⁵ Rune N. Philemon,⁵ Doriane Sabushmike,⁵ Rebekah Swan,⁴ Tina Tian,¹ Niro Trialonis-Suthakharan,⁴ Aakaash Varma⁶ and Christopher E.M. Griffiths^1,3,4

¹Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester, UK; ²Division of Pharmacy and Optometry, ³NIHR Manchester Biomedical Research Centre and ⁴Global Psoriasis Atlas, University of Manchester, Manchester, UK; ⁵Regional Dermatology Training Centre, Moshi, United Republic of Tanzania; and ⁶Department of Dermatology, Northwell Health Mather Hospital, New York, NY, USA

The Maasai are a Nilotic ethnic group that now live in Eastern Africa. They are well known for their nomadic, pastoralist way of life. The complex relationship that exists between the human–livestock interface and migration makes this population potentially susceptible to environmental skin disease and zoonotic infections. However, there remains a paucity of health data on the Maasai in general, and, to the best of our knowledge, no data on skin disease within this group, have been published. We therefore set out to conduct a skin disease survey of adults within this population to better understand their dermatological needs. In July 2019, an outreach dermatology clinic was run by members of the Global Psoriasis Atlas in conjunction with the Regional Dermatology Training Centre, in Moshi, Tanzania. Ethical approval was granted by the University of Manchester and Kilimanjaro Christian Medical University College. The population was sensitized to the outreach clinic beforehand. Data collection included information on age, sex, number of individuals per household, shoe ownership, dermatological diagnosis(es) and previous treatments. Data were also gathered on the impact of their skin disease on daily living and social and work life. Fifty-one adults who attended the clinic met the inclusion criteria [any adults (> 18 years old) who attended the outreach clinic with skin disease]. Mean age was 43·9 years (range 20–90). There were 19 (37%) males and 32 females (63%). The mean (SD) number of individuals per household was 2·2 (1·1) and the rate of shoe ownership was 100% within this group. Clinical diagnoses were made based on the International Classification of Diseases, 11th Revision. Infections of the skin, particularly fungal skin infection (n = 21; 41%), were the most common dermatoses. This was followed by dermatitis and eczema (n = 13; 25%), xerosis cutis (n = 3; 6%), pruritus (n = 3; 6%), acne (n = 1; 2%), palmoplantar keratoderma (n = 1; 2%), pruritus of pregnancy (n = 1; 2%), lipoma (n = 1; 2%), seborrhoeic keratosis (n = 1; 2%), epidermal naevus (n = 1; 2%), papular urticaria (n = 1; 2%), scalp folliculitis (n = 1; 2%) and traumatic ulceration of skin (n = 1; 2%). More than half the patients had sought previous treatment for their skin disease (n = 29; 57%). In summary, skin disease was common among the Maasai. The most common dermatosis was fungal skin infection, followed by dermatitis and eczema. Further research is needed to better understand the skin care needs of this population, prevent days lost at work, improve quality of life and prevent wastage of resources both from an individual and community health perspective.