[Dermatology in the primary health care system. Long-term outcome of a self-help project with children in rural Kenya].

BACKGROUND AND

OBJECTIVE

In spite of the importance of skin diseases in Africa south of the Sahara, dermatology is insufficiently represented within the established primary health care systems. Aim of this study was to find out whether an integrated dermatology project could reduce the prevalence of dermatoses.

PATIENTS/

METHODS

Since 1994 trained community health workers have carried out regular weekly visits to schools and nurseries in 10 communities in rural western Kenya. Epidemiological studies were done in 13 schools in 4 communities involving 5780 and 4961 pupils one year before (1993) and 5 years (1999) following the introduction of the dermatology project.

RESULTS

Within this period the prevalence of bacterial skin infections fell from 12.7% to 11.3% (n.s.). Mycoses rose from 10.1% to 13.9% (p < 0.05), while arthropod infections (mainly scabies) remained unchanged with a prevalence of 8.3% in 1993 and 8.0% in 1999 (n.s.). Dermatitis also showed no changes (1.7% in both years).

CONCLUSIONS

The prevalence of infective dermatoses depends not only on medical treatment but also far more on socio-economic factors.