Skin wounds in a rural setting of Côte d’Ivoire: Population-based assessment of the burden and clinical epidemiology
<h4>Background</h4> Data on the burden and clinical epidemiology of skin wounds in rural sub-Saharan Africa is scant. The scale of the problem including preventable progression to chronic wounds, disability and systemic complications is largely unaddressed. <h4>Methods</h4> W...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2022-10-01
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| Series: | PLoS Neglected Tropical Diseases |
| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9560139/?tool=EBI |
| _version_ | 1798030048871055360 |
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| author | Simone Toppino Raymond T. A. S. N’Krumah Bognan Valentin Kone Didier Yao Koffi Ismaël Dognimin Coulibaly Frank Tobian Gerd Pluschke Marija Stojkovic Bassirou Bonfoh Thomas Junghanss |
| author_facet | Simone Toppino Raymond T. A. S. N’Krumah Bognan Valentin Kone Didier Yao Koffi Ismaël Dognimin Coulibaly Frank Tobian Gerd Pluschke Marija Stojkovic Bassirou Bonfoh Thomas Junghanss |
| author_sort | Simone Toppino |
| collection | DOAJ |
| description | <h4>Background</h4> Data on the burden and clinical epidemiology of skin wounds in rural sub-Saharan Africa is scant. The scale of the problem including preventable progression to chronic wounds, disability and systemic complications is largely unaddressed. <h4>Methods</h4> We conducted a cross-sectional study combining active (household-based survey) and passive case finding (health services-based survey) to determine the burden and clinical epidemiology of wounds within the Taabo Health and Demographic Surveillance System (HDSS) in rural Côte d’Ivoire. Patients identified with wounds received free care and were invited to participate in the wound management study simultaneously carried out in the survey area. The data were analysed for wound prevalence, stratified by wound and patient characteristics. <h4>Results</h4> 3842 HDSS-registered persons were surveyed. Overall wound prevalence derived from combined active and passive case finding was 13.0%. 74.1% (403/544) of patients were below the age of 15 years. Most frequent aetiologies were mechanical trauma (85.3%), furuncles (5.1%), burns (2.9%) and Buruli ulcer (2.2%). Most wounds were acute and smaller than 5 cm2 in size. 22.0% (176/799) of wounds showed evidence of secondary bacterial infection. 35.5% (22/62) of chronic wounds had persisted entirely neglected for years. Buruli ulcer prevalence was 2.3 per 1000 individuals and considerably higher than expected from an annual incidence of 0.01 per 1000 individuals as reported by WHO for Côte d’Ivoire at the time of the study. <h4>Conclusions</h4> Skin wounds are highly prevalent in rural West Africa, where they represent a widely neglected problem. The HDSS-based survey with combined active and passive case finding adopted in this study provides a better estimate than school- and health institution-based surveys which underestimate the frequency of skin wounds and, particularly, of neglected tropical diseases of the skin, such as Buruli ulcer and yaws. A comparison with country-specific WHO data suggests underreporting of Buruli ulcer cases. <h4>Trial registration</h4> Registration at ClinicalTrials.gov NCT03957447. Author summary Data on the burden and clinical epidemiology of skin wounds in rural sub-Saharan Africa is scant. The scale of the problem including preventable progression to chronic wounds, disability and systemic complications is largely unaddressed. We conducted a cross-sectional study combining active (household-based survey) and passive case finding (health services-based survey) to determine the burden and clinical epidemiology of wounds within the Taabo Health and Demographic Surveillance System (HDSS) in rural Côte d’Ivoire. Patients identified were invited to participate in the wound management study simultaneously carried out in the survey area. We surveyed approximately 4000 HDSS-registered persons and found a high overall wound prevalence (13.0%), predominately in children. Mechanical trauma was the leading cause, followed by furuncles, burns and Buruli ulcer. Most wounds were acute and had a size of less than 5 cm2, but a substantial proportion was large, complicated, or chronic, some of the latter persisting neglected for years. The HDSS-based survey with combined active and passive case finding adopted in this study provides a better estimate than school- and health institution-based surveys which underestimate the frequency of skin wounds and, particularly, of neglected tropical diseases of the skin, such as Buruli ulcer and yaws. A comparison with country-specific WHO data suggests underreporting of Buruli ulcer cases. |
| first_indexed | 2024-04-11T19:34:02Z |
| format | Article |
| id | doaj.art-4ceb228a3c4a421fb4ad0ff289f2ef7e |
| institution | Directory Open Access Journal |
| issn | 1935-2727 1935-2735 |
| language | English |
| last_indexed | 2024-04-11T19:34:02Z |
| publishDate | 2022-10-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Neglected Tropical Diseases |
| spelling | doaj.art-4ceb228a3c4a421fb4ad0ff289f2ef7e2022-12-22T04:06:55ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352022-10-011610Skin wounds in a rural setting of Côte d’Ivoire: Population-based assessment of the burden and clinical epidemiologySimone ToppinoRaymond T. A. S. N’KrumahBognan Valentin KoneDidier Yao KoffiIsmaël Dognimin CoulibalyFrank TobianGerd PluschkeMarija StojkovicBassirou BonfohThomas Junghanss<h4>Background</h4> Data on the burden and clinical epidemiology of skin wounds in rural sub-Saharan Africa is scant. The scale of the problem including preventable progression to chronic wounds, disability and systemic complications is largely unaddressed. <h4>Methods</h4> We conducted a cross-sectional study combining active (household-based survey) and passive case finding (health services-based survey) to determine the burden and clinical epidemiology of wounds within the Taabo Health and Demographic Surveillance System (HDSS) in rural Côte d’Ivoire. Patients identified with wounds received free care and were invited to participate in the wound management study simultaneously carried out in the survey area. The data were analysed for wound prevalence, stratified by wound and patient characteristics. <h4>Results</h4> 3842 HDSS-registered persons were surveyed. Overall wound prevalence derived from combined active and passive case finding was 13.0%. 74.1% (403/544) of patients were below the age of 15 years. Most frequent aetiologies were mechanical trauma (85.3%), furuncles (5.1%), burns (2.9%) and Buruli ulcer (2.2%). Most wounds were acute and smaller than 5 cm2 in size. 22.0% (176/799) of wounds showed evidence of secondary bacterial infection. 35.5% (22/62) of chronic wounds had persisted entirely neglected for years. Buruli ulcer prevalence was 2.3 per 1000 individuals and considerably higher than expected from an annual incidence of 0.01 per 1000 individuals as reported by WHO for Côte d’Ivoire at the time of the study. <h4>Conclusions</h4> Skin wounds are highly prevalent in rural West Africa, where they represent a widely neglected problem. The HDSS-based survey with combined active and passive case finding adopted in this study provides a better estimate than school- and health institution-based surveys which underestimate the frequency of skin wounds and, particularly, of neglected tropical diseases of the skin, such as Buruli ulcer and yaws. A comparison with country-specific WHO data suggests underreporting of Buruli ulcer cases. <h4>Trial registration</h4> Registration at ClinicalTrials.gov NCT03957447. Author summary Data on the burden and clinical epidemiology of skin wounds in rural sub-Saharan Africa is scant. The scale of the problem including preventable progression to chronic wounds, disability and systemic complications is largely unaddressed. We conducted a cross-sectional study combining active (household-based survey) and passive case finding (health services-based survey) to determine the burden and clinical epidemiology of wounds within the Taabo Health and Demographic Surveillance System (HDSS) in rural Côte d’Ivoire. Patients identified were invited to participate in the wound management study simultaneously carried out in the survey area. We surveyed approximately 4000 HDSS-registered persons and found a high overall wound prevalence (13.0%), predominately in children. Mechanical trauma was the leading cause, followed by furuncles, burns and Buruli ulcer. Most wounds were acute and had a size of less than 5 cm2, but a substantial proportion was large, complicated, or chronic, some of the latter persisting neglected for years. The HDSS-based survey with combined active and passive case finding adopted in this study provides a better estimate than school- and health institution-based surveys which underestimate the frequency of skin wounds and, particularly, of neglected tropical diseases of the skin, such as Buruli ulcer and yaws. A comparison with country-specific WHO data suggests underreporting of Buruli ulcer cases.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9560139/?tool=EBI |
| spellingShingle | Simone Toppino Raymond T. A. S. N’Krumah Bognan Valentin Kone Didier Yao Koffi Ismaël Dognimin Coulibaly Frank Tobian Gerd Pluschke Marija Stojkovic Bassirou Bonfoh Thomas Junghanss Skin wounds in a rural setting of Côte d’Ivoire: Population-based assessment of the burden and clinical epidemiology PLoS Neglected Tropical Diseases |
| title | Skin wounds in a rural setting of Côte d’Ivoire: Population-based assessment of the burden and clinical epidemiology |
| title_full | Skin wounds in a rural setting of Côte d’Ivoire: Population-based assessment of the burden and clinical epidemiology |
| title_fullStr | Skin wounds in a rural setting of Côte d’Ivoire: Population-based assessment of the burden and clinical epidemiology |
| title_full_unstemmed | Skin wounds in a rural setting of Côte d’Ivoire: Population-based assessment of the burden and clinical epidemiology |
| title_short | Skin wounds in a rural setting of Côte d’Ivoire: Population-based assessment of the burden and clinical epidemiology |
| title_sort | skin wounds in a rural setting of cote d ivoire population based assessment of the burden and clinical epidemiology |
| url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9560139/?tool=EBI |
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