Healthcare-seeking behaviour in reporting of scabies and skin infections in Ghana – a review of reported cases

Background: scabies is a neglected tropical disease. In resource-poor settings, scabies and other skin infections are often unreported to a health centre, or misdiagnosed. Dermatological expertise and training are often lacking. Little is known about patient healthcare-seeking behaviour. This study reviewed diagnosed skin infections reported to urban (Greater Accra) and rural (Oti region) study health centres in Ghana over six months in 2019.

Methods: study staff received classroom and clinical dermatology training. Skin infection diagnoses and anonymised patient information were recorded. Descriptive statistics and spatial analysis described patient demographics, and distance travelled to clinic, noting bypassing of their nearest centre.

Results: overall, 385 cases of skin infectionswere reported across the Greater Accra and Oti study clinics, with 45 scabies cases (11.6%). For scabies, 29 (64.4%) cases were in males. Scabies was the third most common diagnosis, behind bacterial dermatitis (102, 26.5%) and tinea (75, 19.5%). In the rural Oti region, 48.4% of patients bypassed their nearest clinic, travelling a mean 6.2 km further than they theoretically needed to. Females travelled further in comparison to males.

Conclusions: there must be greater public and professional awareness of scabies and skin infections as highburden but treatable conditions, along with assessment of their community burden.

Ghana, NTDs, dermatology, neglected tropical diseases, scabies, skin infections

10.1093/trstmh/traa071

0035-9203

830-837

Head, Michael

67ce0afc-2fc3-47f4-acf2-8794d27ce69c

Dotse-Gborgbortsi, Winfred

02d3e356-268e-4650-9fb9-9638ccdb6eff

Boateng, Laud

fef98898-6a82-4622-aa70-4fc7e9e066b0

Lartey, Margaret

7dfd5502-c5c1-4d69-8b78-4f03366e936f

1 November 2020

Head, Michael

67ce0afc-2fc3-47f4-acf2-8794d27ce69c

Dotse-Gborgbortsi, Winfred

02d3e356-268e-4650-9fb9-9638ccdb6eff

Boateng, Laud

fef98898-6a82-4622-aa70-4fc7e9e066b0

Lartey, Margaret

7dfd5502-c5c1-4d69-8b78-4f03366e936f

Head, Michael, Dotse-Gborgbortsi, Winfred, Boateng, Laud and Lartey, Margaret (2020) Healthcare-seeking behaviour in reporting of scabies and skin infections in Ghana – a review of reported cases. Transactions of the Royal Society of Tropical Medicine and Hygiene, 114 (11), 830-837. (doi:10.1093/trstmh/traa071).

Record type: Article

Abstract

Conclusions: there must be greater public and professional awareness of scabies and skin infections as highburden but treatable conditions, along with assessment of their community burden.

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Accepted/In Press date: 24 July 2020

e-pub ahead of print date: 27 August 2020

Published date: 1 November 2020

Additional Information: Funding Information: This work was supported by the University of Southampton Strategic Development Fund (no reference number). The full study team list is as follows, in alphabetical order of family name/surname: Frempong Adom, Ghana Health Service, Ghana; Paul Angwaawie, Ghana Health Service, Ghana; Laud Boateng, Ghana Health Service, Ghana; Esther Danquah, Ghana Health Service, Ghana; Winfred Dotse-Gborgborsti, University of Southampton, UK; Rita- Patricia Frimpong-Amenyo, Ghana Health Service, Ghana; Michael Head, University of Southampton, UK; Rudolph Lamptey, Ghana Health Service, Ghana; Abraham Lartey, Ghana Health Service, Ghana; Margaret Lartey, University of Ghana, Ghana; Roseline Osazuwa, Rabito Clinic, Ghana; Bright Osei, Ghana Health Service, Ghana; Ann Sena Patamia, Ghana Health Service, Ghana; Emmanuel Kofi Sevor, Ghana Health Service, Ghana; Adolph Sika, Ghana Health Service, Ghana; Castro Yakubu, Rabito Clinic, Ghana. The study team would like to acknowledge all GHS staff in Nkwanta South and Kpone-Katamanso who contributed to or supported the project. This includes Evans Attivor, Emmanuel Abgodogli and Kpemlie Christine fromNkwanta South. We would like to acknowledge the input of Dominic Atweam and the GHS NTD Office for their support around reporting of scabies. We would also like to thank Ms Karen Hendrickson (Chief Executive Officer of Rabito Clinics), Dermatologist Dr Claudia Donkor and Rabito Clinics for their support with the study, and for hosting the clinic training day. Publisher Copyright: © 2020 The Author(s).

Keywords: Ghana, NTDs, dermatology, neglected tropical diseases, scabies, skin infections