エチオピアでの疥癬の増加する課題

タイトル: Magnitude and pattern of scabies among patients attending dermatology clinic of ALERT hospital; Addis Ababa, Ethiopia

概要: BackgroundScabies is a global public health problem and the highest prevalence of scabies occurs in tropical area, especially among marginal age groups and resource-limited communities. And it is one of the most common diseases seen in dermatology clinics. ObjectiveTo assess magnitude and pattern of scabies among patients attending dermatology clinic of alert hospital during the study period MethodHospital based retrospective study was conducted on scabies patients attending dermatology & venerology clinic, in ALERT hospital located in Addis Ababa, capital city of Ethiopia. The study population was all patients attending dermatology and venereology department at ALERT center between April 09,2015 to May 09, 2020. Data was collected about the number and demographic pattern of patients diagnosed with scabies from health management information systems (HMIS) registration book at dermatology clinic and sample of medical records of patients was reviewed by structured checklist about the clinical and treatment pattern of the disease. ResultHigh frequency of scabies in patients presenting to a dermatology clinic is shown by this study. 5455 cases of scabies were registered from April 9,2015 to May 9,2020. 37226 total cases were seen in dermatology clinic of ALERT hospital between December 10, 2017 and November 11,2019. out of theis 37226 cases 2911 were scabies cases; making 7.8% of the outpatient visits by scabies patients.Of 5455 scabies cases registered, the majority (47.9%) belonged to the 15-45 years age group, and 26.8 % belonged to the 0-4 year age group. Those between 5-14 years of age consisted of 16.3 % of the total. Of the total scabies cases from the record, 3138 (57.5 %) were male and 2314 (42.4 %) were female. 1706 (28.9%) cases Kolfe keraniyo sub city, Addis Ababa and the other cases came to this hospital from different sub cities of Addis Ababa and rest of the country. The highest number of cases (n=1464) was registered during year September 12,2017 to September 10,2018. The median duration of symptoms for 25.7 % of the patients, is one month and three months for 17.3% (n=33) of them. Upper extremities were the most commonly affected body parts as mentioned on medical records of seventy patients. While the lower extremity genitalia and finger webs were mentioned as affected body parts following upper extremities. 87% of the lesions the patients were mentioned to be papules and the rest of the lesions constitutes of vesicle, plaque and Macule. 8 % (n=390) patients have had signs of infection. One patients diagnosis was mentioned as crusted scabies. Skin scraping was done for none of the patients. At ALERT hospital Benzyl benzoate was prescribed for 61.5% (n=249) of patients. 32.1% (n= 130) were given sulfur and 6.2% (n=25) were given permethrin. On this study,0.2% (n=1) patient was given ivermecin tablets. Permethrin soap was prescribed for four patients (0.9%) in addition to other drugs. 8 % (n=34) of the patients were given oral antibiotics because they had visible signs of infection. 7.8 % (n=33) were given anti pruritic agent. From a total of 71 medical records on which patients status after follow up was mentioned 62% (n=44) states the patient status as improved up on follow up. 23.9% (n=17) have the same disease status and 1.4 %(n=1) has worsened and 12.7(n=9) have post scabies itch. 0.04 % (n=16) from the total of 424 medical records revised have their diagnosis changed upon follow up and 0.07 % (n=29) have been retreated. ConclusionHigh frequency of scabies in patients presenting to a dermatology clinic is shown by this study.5455 cases of scabies were registered from April 9,2015 to May 9,2020. 37226 total cases were seen in dermatology clinic of ALERT hospital between December 10, 2017 and November 11,2019. out of these 37226 cases 2911 were scabies cases; making 7.8% of the outpatient visits by scabies patients.The highest proportion of the cases were male (57.5%) belonged to the 15-45 years age group and were widely from Kolfe keraniyo sub city (28.9%), Addis Ababa .Peak number of cases (n=1464) was registered from September 12,2017 to September 10,2018. The median duration of symptoms of scabies seen was one month. Upper extremities were mentioned as the most affected parts on the medical records of patients. Papules were the commonest lesion type mentioned on these records. Skin scraping was done for none of the patients. Benzyl benzoate was commonest drug prescribed. 62% patients status had improved up on follow up and 12.7% had post scabies itch.