BackgroundEarly detection of several skin-related neglected tropical diseases (skin NTDs)–including leprosy, Buruli ulcer, yaws, and scabies- may be achieved through school surveys, but such an approach has seldom been tested systematically on a large scale in endemic countries. Additionally, a better understanding of the spectrum of skin diseases and the at-risk populations to be encountered during such surveys is necessary to facilitate the process.MethodsWe performed a school skin survey for selected NTDs and the spectrum of skin diseases, among primary schoolchildren aged 5 to 15 in Côte d’Ivoire, West Africa. This 2-phase survey took place in 49 schools from 16 villages in the Adzopé health district from November 2015 to January 2016. The first phase involved a rapid visual examination of the skin by local community healthcare workers (village nurses) to identify any skin abnormality. In a second phase, a specialized medical team including dermatologists performed a total skin examination of all screened students with any skin lesion and provided treatment where necessary.ResultsOf a total of 13,019 children, 3,504 screened positive for skin lesions and were listed for the next stage examination. The medical team examined 1,138 of these children. The overall prevalence of skin diseases was 25.6% (95% CI: 24.3–26.9%). The predominant diagnoses were fungal infections (n = 858, prevalence: 22.3%), followed by inflammatory skin diseases (n = 265, prevalence: 6.9%). Skin diseases were more common in boys and in children living along the main road with heavy traffic. One case of multi-bacillary type leprosy was detected early, along with 36 cases of scabies. Our survey was met with very good community acceptance.ConclusionWe carried out the first large-scale integrated, two-phase pediatric multi-skin NTD survey in rural Côte d’Ivoire, effectively reaching a large population. We found a high prevalence of skin diseases in children, but only limited number of skin NTDs. With the lessons learned, we plan to expand the project to a wider area to further explore its potential to better integrate skin NTD screening in the public health agenda.

Background Skin-related neglected tropical diseases (skin NTDs) occur against a background of a very high prevalence of common skin diseases in sub-Saharan Africa. In this study, we examined the knowledge, attitude and practices (KAP) and the impact of common skin diseases in children living in a leprosy and Buruli ulcer (BU) co-endemic district in a west African country of Cô te d'Ivoire, in order to help inform disease control efforts for skin NTDs. Methods and principle findings Fourteen focus group discussions (FGDs) with schoolchildren, 5 FGDs with parents of a child affected with skin disease(s), and 27 in-depth semi-structured interviews with key personnel were conducted. The Children's Dermatology Quality of Life Index (CDLQI) questionnaire was applied to 184 schoolchildren with skin diseases. We found that there was ignorance or neglect towards skin diseases in general, due to their high prevalence and also the perceived minimal impact on children's daily lives. While the median score for the CDLQI questionnaire was 5 (IQR 2-9) out of 30, a range of scores was observed. Symptoms such as pruritus and experiencing bullying by classmates contributed to reduction in their quality of life. Poor hygiene was considered as a major cause of skin diseases. Conclusions/Significance Despite their high impact on affected populations, we observed a high level of ignorance and neglect toward common skin diseases. There is a critical need to increase awareness PLOS NEGLECTED TROPICAL DISEASES

Objectif : Cette étude a pour objectif de déterminer les effets de la téléphonie mobile sur l’amélioration de l’observance de la prophylaxie post-exposition au centre antirabique d’Abidjan. Méthodes : Il s’agit d’une étude transversale à visée descriptive et analytique, qui s’est déroulée de septembre 2014 à mai 2015. La collecte des données s’est déroulée en deux étapes : d’abord l’interview de tous les patients au centre antirabique lors de leur première consultation, ensuite une interview téléphonique trois jours plus tard, destinée uniquement aux sujets qui avaient abandonné leur traitement prophylactique. Résultats : Les résultats obtenus indiquaient qu’après des appels téléphoniques, le taux d’abandon est passé de 59,3 % à 44,8 %. Les abandons étaient plus rares chez les patients ayant reçu un avis pour effectuer la surveillance vétérinaire (ORa = 0,23 ; IC95 % [0,11-0,48]), ayant déposé au moins un certificat vétérinaire (ORa = 0,25 ; IC95 % [0,15-0,43]) ou ayant reçu plus de deux doses vaccinales (ORa = 0,23 ; IC95 % [0,12-0,42]) avant appel téléphonique. Mais les taux d’abandon étaient élevés chez les patients de la classe d’âge 20 à 29 ans (ORa = 2,66 ; IC95 % [1,25-5,68]) et chez les patients ayant subi une exposition de catégorie III (ORa = 2,19 ; IC95 % [1,12-54,3]). Conclusion : Ces résultats dénotent que la téléphonie mobile est un outil utile pour sensibiliser les patients à adhérer à la prophylaxie post-exposition. Cependant, des campagnes d’information et de sensibilisation des populations sur l’issue fatale de la rage doivent être organisées.

In Côte d'Ivoire, a high number of exposed people abandoned the Post-Exposure Prophylaxis. Our objective was to determine the factors influencing the adherence to the Post-Exposure Prophylaxis  at the anti-rabies Center of Bouaké. Methods: we carried out an ambispective study, based on the review of patient records from January 2014 to December 2015 and on contacting all patients by phone.Results: A total of 1487 people at risk of rabies infection received Post-Exposure Prophylaxis, whom 54, 4% abandoned their treatment. The majority of the victims was under of 15 years old (56, 8%) and was male (59, 1%). Lesions were predominantly of category III (55, 3%) and 2, 3% was located on the head. In 87% of cases, the biting animal was not properly vaccinated and 66% of the victims consulted within 48 hours after exposure. Among the exposed subjects, 54% had discontinued treatment; the main reasons were cost (76%) and neglect (28%) and it was influenced by household's average income RR=0,741; IC95%= [0,353-0,838].Conclusion: Vaccine prevention, the only effective way to prevent human rabies, faces to high drop-out rate of post-exposure prophylaxis. The main obstacles to the correct observance of this treatment are related on the one hand to the distance of care structures for the rural populations and on the other hand to financial inaccessibility.Keywords : Rabies, Post-exposure prophylaxis, Abandonment, associated factors