Volume 144, Issue 1 pp. 118-124

Skin diseases in children in rural Kenya: long-term results of a dermatology project within the primary health care system

W. Schmeller

W. Schmeller

Doctors in Aid of Children with Skin Diseases in Africa (‘Aerzte helfen hautkranken Kindern in Afrika e.V.’) Bad Soden am Taunus, Germany

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A. Dzikus

A. Dzikus

Shelter Branch, United Nations Centre for Human Settlement (HABITAT), Nairobi, Kenya

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First published: 07 July 2008
Citations: 27
Prof. Dr W.Schmeller, Rosenparkklinik, Heidelberger Landstr. 20, D-64297 Darmstadt, Germany. E-mail: [email protected]

Abstract

Background  Following an epidemiological study on skin diseases in 5780 pupils from 13 schools in rural western Kenya in 1993, a dermatology project within the primary health care system was established in 1994 by the German non-government organization (NGO) ‘Doctors in Aid of Children with Skin Diseases in Africa’. Within this project trained community health workers carried out regular visits to schools and nurseries and treated children with hydrocortisone acetate 1% cream for dermatitis, gentian violet 1% solution for bacterial skin infections, Whitfield’s ointment for dermatophytoses and benzylbenzoate emulsion 25% for scabies.

Objectives  To assess the impact of this intervention.

Methods  In 1999, after a 5-year period, 4961 pupils from the same 13 schools were re-examined and the prevalence rates were compared.

Results  Non-infective dermatitis had a prevalence of 1·7% in 1993 as well as in 1999; among the communicable diseases bacterial infections declined from 12·7% to 11·3% (not significant), fungal infections rose from 10·1% to 13·9% (P < 0·05) and arthropod infections (mainly scabies) remained at similar levels of 8·3% in 1993 and 8·0% in 1999. A distinctive reduction could only be found for tropical ulcers (0·1% in 1999 compared with 1·2% in 1993).

Conclusions  The prevalence of dermatoses in children in rural Africa does not only depend on treatment schemes within the primary health care system, but on the socio-economic conditions available.

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