02941nas a2200253   4500000000100000008004100001260001200042100001400054700001500068700001100083700001200094700001600106700001300122700001500135700001600150700001300166700001600179245012300195856007800318300001300396490000700409520225700416022001402673       2022                            d  c10/20221 aToppino S1 aN'Krumah R1 aKone B1 aKoffi D1 aCoulibaly I1 aTobian F1 aPluschke G1 aStojkovic M1 aBonfoh B1 aJunghanss T00aSkin wounds in a rural setting of Côte d'Ivoire: Population-based assessment of the burden and clinical epidemiology.  uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9560139/pdf/pntd.0010608.pdf  ae00106080 v163 a<p><strong>BACKGROUND: </strong>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.</p>

<p><strong>METHODS: </strong>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.</p>

<p><strong>RESULTS: </strong>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.</p>

<p><strong>CONCLUSIONS: </strong>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.</p>

<p><strong>TRIAL REGISTRATION: </strong>Registration at ClinicalTrials.gov NCT03957447.</p>
  a1935-2735