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Study of common dermatoses in school children of rural area of Dakshina Kannada district, India: a cross-sectional study

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Shreekrishna G. N.
Shreekrishna G. N.
Shreekrishna G. N.
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Sinchana Bhat
Sinchana Bhat
Sinchana Bhat
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Background: Prevalence of skin diseases amongst children of a community is an indicator of health and personal hygiene of a society. School children are more prone for skin infections and majority of them are preventable. Present study aimed to find the common dermatoses in school children of rural area.Methods: This was a cross sectional study conducted among 400 children from three randomly selected schools. Socio-demographic data was collected using a pretested semi structured questionnaire and skin conditions were identified by examination.Results: Out of the total 400 children, 224 (56%) were boys and 176 (44%) were girls. The overall prevalence of skin conditions was 222 (55.5%). Majority (27.5%) had fungal infection, 15% had bacterial infection, 10% had parasitic infection and 3 % had viral infection.Conclusions: Prevalence of skin infections is high in present study, hence creating awareness about personal hygiene among parents, children and teachers is the need of the hour.
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International Journal of Contemporary Pediatrics | September-October 2018 | Vol 5 | Issue 5 Page 1939
International Journal of Contemporary Pediatrics
Shreekrishna GN et al. Int J Contemp Pediatr. 2018 Sep;5(5):1939-1942
http://www.ijpediatrics.com
pISSN 2349-3283 | eISSN 2349-3291
Original Research Article
Study of common dermatoses in school children of rural area of
Dakshina Kannada district, India: a cross-sectional study
Shreekrishna G. N., Sinchana Bhat*
INTRODUCTION
Schools provide excellent arenas for public health
research and interventions.1 Previous studies from
developing countries have reported high prevalence of
skin disorders among school children, the spectrum of
which has been highly variable.2 A World Health
Organization (WHO) review of prevalence studies done
on skin diseases among children reported an overall
prevalence ranging from 21% to 87%.3
Status of health, hygiene, and personal cleanliness of a
society can be judged from the prevalence of certain skin
diseases in the children of the community.4 School survey
is a useful method to screen a large number of children of
the particular age group for the presence of diseases at a
time. The purpose of studying the prevalence of
paediatric dermatoses is to assess the level of health
awareness and availability of health‑care services which
is useful to build child health‑care strategies that cope
with actual community requirements.5
Skin disorders or conditions focussed here are mainly
about the infection of the superficial layer of skin and
common conditions refers to those which has a
prevalence of more than 1% in the community or at a
primary healthcare setting. Keeping in mind the above
definitions the main disorders encountered here are
pyoderma (folliculitis, furuncle, carbuncle), scabies, and
other common ectoparasitoses (pediculosis), tinea capitis
and other superficial mycoses (dermatophytosis,
candidiasis, pityriasis versicolor), benign viral tumours
ABSTRACT
Background: Prevalence of skin diseases amongst children of a community is an indicator of health and personal
hygiene of a society. School children are more prone for skin infections and majority of them are preventable. Present
study aimed to find the common dermatoses in school children of rural area.
Methods: This was a cross sectional study conducted among 400 children from three randomly selected schools.
Socio-demographic data was collected using a pretested semi structured questionnaire and skin conditions were
identified by examination.
Results: Out of the total 400 children, 224 (56%) were boys and 176 (44%) were girls. The overall prevalence of skin
conditions was 222 (55.5%). Majority (27.5%) had fungal infection, 15% had bacterial infection, 10% had parasitic
infection and 3 % had viral infection.
Conclusions: Prevalence of skin infections is high in present study, hence creating awareness about personal hygiene
among parents, children and teachers is the need of the hour.
Keywords: Rural, School children, Skin diseases
Department of Pediatrics, A. J. Institute of Medical Sciences, Mangalore, Karnataka, India
Received: 27 June 2018
Accepted: 26 July 2018
*Correspondence:
Dr. Sinchana Bhat,
E-mail: bhat.sinchana@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20183535
Shreekrishna GN et al. Int J Contemp Pediatr. 2018 Sep;5(5):1939-1942
International Journal of Contemporary Pediatrics | September-October 2018 | Vol 5 | Issue 5 Page 1940
(verrucae, molluscum contagiosum) and dermatitis.6
78% of Indian population stay in rural areas and children
below 14 years constitute about 38% of the total
population.7 Therefore, the present study was conducted
to find the prevalence and pattern of skin diseases among
school‑going children of age 5-14 years in present rural
service area.
METHODS
This was a school based cross-sectional study conducted
in 400 primary school children selected from two
government primary schools and 1 private school located
in the rural area of Mangalore in Dakshina Kannada
district of Karnataka. Children studying from 1st to 7th
standard were included in the study. Those who were
absent at two consecutive visits and those who had been
previously diagnosed with other skin conditions were
excluded. Convenient Sampling method was used, and
the study was conducted in a period of 4 months (January
2017-April 2017). Written informed consent was taken
from the school headmaster and parent of the subjects
before the study was conducted.
Study procedure
The three schools were selected purposively for
convenience based on the location from rural area of
Mangalore. One division of each standard was randomly
selected from each school after obtaining the list of total
number of divisions from the respective school office.
After obtaining permission from the respective school
heads data was collected using a pretested semi structured
questionnaire which consisted of age, gender, religion,
educational status of parents and total number of family
members.
A detailed head to toe examination was done in a separate
room under sunlight in the presence of teachers. At first
whole body skin examination was done by medical
professionals who were adequately trained based on
operational definitions for common skin conditions based
on causative agents like bacterial, viral, parasitic and
fungal.6 Difficult to diagnose lesions were confirmed by
the help of dermatologist.
RESULTS
Out of the total 400 children, 224 (56%) were boys and
176(44%) were girls. 230 (57.5%) were Hindus by
religion, 120 (30%) were Muslims and 12.5% were
Christians.
The overall prevalence of skin conditions in this study
was 222 (55.5%). Out of which higher proportion
(27.5%) had fungal infection, 15% had bacterial
infection, 10% had parasitic infection and 3 % had viral
infection.
Table 1: Overall prevalence of skin conditions among
school children (n=400).
Type of skin infection
Fungal
Bacterial
Parasitic
Viral
Total
Two hundred twenty-two (55.5%) of the studied
population had skin infections. Out of this, majority
(27.5%) had fungal infection, 15% had bacterial
infection, 10% parasitic infections and the least (3%)
were viral infection.
Table 2: Distribution of bacterial infection in study
subjects (n=400).
Bacterial infection
Number (N=400)
Percentage
Folliculitis
10
2.5
Acne
22
5.5
Erythrasma
2
0.5
Furuncle
6
1.5
Pityriasis rosea
2
0.5
Pitted keratolysis
2
0.5
Pyoderma
16
4
Total
60
15
60 out of 400 children (15%) bacterial infections. 22
(38%) had acne followed by pyoderma in 16 (34%)
children and folliculitis in 10 (2.5%).
Table 3: Distribution of fungal infection in study
subjects (n=400).
Fungal infections
Number (n=615)
Percentage
Tinea cruris
30
7.5
Tinea pedis
10
2.5
Pityriasis versicolor
70
17.5
Total
110
27.5
Out of 110 with fungal infection, 70 (17.5%) had
Pityriasis versicolor and 30 (7.5%) had Tinea cruris and
10 (2.5%) had Tinea pedis.
Table 4: Distribution of viral infection in study
subjects (n= 400).
Viral infections
Number (n =400)
Percentage
Varicella
1
0.25
Warts
3
0.75
Corns
8
2
Total
12
3
Only 12 (3%) had viral infection with more number of
corn cases.
Shreekrishna GN et al. Int J Contemp Pediatr. 2018 Sep;5(5):1939-1942
International Journal of Contemporary Pediatrics | September-October 2018 | Vol 5 | Issue 5 Page 1941
Table 5: Distribution of parasitic infections in study
population (n=400).
Infection
Number (n =400)
Percentage
Scabies
30
7.5
Pediculosis
10
2.5
Total
40
10
Among parasitic infections, scabies was the most
common (7.5%), followed by pediculosis (2.5%).
DISCUSSION
The overall prevalence of skin infections was 55.5% in
the present study. Almost similar prevalence was seen in
studies conducted by different researchers in different
part of India.
The prevalence rate was 59.3% in a study done by Janaki
M et al in Chennai and almost similar prevalence was
seen in others studies conducted by Komba EV et al in
Dar es Salaam and Valia RA et al9 in Varanasi where the
prevalence was 57.3% and 54% respectively.2,8,9 This
same prevalence can be because of similar
sociodemographic characteristics and climatic conditions
among the different study population.
In the present study, subjects had more of fungal
infections (27.5%) with more preponderance to Pityriasis
Versicolor. This finding is almost similar to a study
conducted by Ewaldo et al in Nigeria and Inaner et al in
Turkey.2,10 But a study conducted by Villa et al in
Telangana showed a low prevalence of superficial
infections among school children.11
The high prevalence in present study could be due to the
humid and hot climatic conditions which directly favours
fungal infections. Bacterial infections (15%) were the
second common skin condition among present study
participants with 5.5% prevalence of acne which is
similar to the findings revealed from a study done by
Shrestha et al in Nepal.12
In the present study, the percentage of parasitic infection
was 10%. Most of them (7.5%) had scabies as the main
problem. This finding is in accordance with a study done
by Rotti SB et al in Karnataka where the prevalence of
the same infection was 8%.13 Pediculosis showed a low
prevalence in this study (2.5%) which is similar to a
study done by Rao et al in Mangalore.14 Viral warts and
corns were the prevalent viral skin conditions in this
study which were similar to findings of studies done by
Patel JK et al and Janaki et al in India.8,15
Limitations of this study were since present study
included only three schools in rural area, the results can’t
be generalised to all schools in Dakshina Kannada.
Authors have only explored the infective skin conditions
except acne, so pattern of non-infective skin conditions
cannot be assessed.
CONCLUSION
The results of the present study conclude that the
prevalence of common skin infections was high among
study subjects. Diagnosing skin problems is highly
important for performing necessary preventive programs
like health education and awareness among school
children. Common skin conditions are easily identifiable
and curable. So, awareness about early detection has to
be encouraged among parents, teachers and even the
school children.
Funding: No funding sources
Conflict of interest: None declared
Ethical approval: The study was approved by the
Institutional Ethics Committee
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Cite this article as: Shreekrishna GN, Bhat S. Study
of common dermatoses in school children of rural
area of Dakshina Kannada district, India: a cross-
sectional study. Int J Contemp Pediatr 2018;5:xxx-xx.
... Similar studies have been conducted in various parts of India and the world among school children and their findings are mentioned in Table 4. [1,3,4,[9][10][11][12][13][14][15][16][17][18][19] In the studies conducted in India, the prevalence of dermatoses ranged between 15.41% and 75.4%, which was lower than the prevalence in our study (89.4%) and the majority were infectious dermatoses. An exception to this are studies by Nijhawan et al. [9] and Vora et al. [14] conducted in Jaipur and Anand, Gujarat, respectively, where non-infectious dermatoses were more common (69.7% and 79.6%, respectively). ...
... The study was conducted in a semi-urban area Shreekrishna and Bhat [10] 2018 Mangalore, Dakshina Kannada 55.5% Fungal infection -27.5% Included only infectious dermatoses Shameena et al. [11] 2017 Mulky, Dakshina Kannada 63% Fungal infection -26.1% Included only infectious dermatoses Jose et al. [3] 2017 Salem, Tamil Nadu 68.2% Infectious dermatoses -50.73% Non-infectious dermatoses -37.1% Nutritional deficiency dermatoses -12.17% ...
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  • Abd Elaziz
  • K M El-Shiekh
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