Gibbs S
Murgwanza Hospital, Ngara, Kagera, Tanzania.
Int J Dermatol. 1996 Sep;35(9):633-9. doi: 10.1111/j.1365-4362.1996.tb03687.x.
Many skin diseases in developing countries are associated with socioeconomic factors. It is generally agreed that a public health approach to dermatology in this setting is particularly appropriate; but, there has been little epidemiologic research done to examine which particular socioeconomic factors are important determinants of the prevalence of skin disease. This is especially true in sub-Saharan Africa.
A survey of two villages in Ngara district, North West Tanzania, involved 254 randomly selected households using a questionnaire, measurements of houses and water quality, and examination of the skin of 1114 household members.
Significant skin disease was encountered in 300 individuals (26.9%). Transmissible diseases comprised the bulk of skin disease (73.9%) with younger age groups being affected most. Socioeconomic conditions were poor, with low quality, crowded housing, low levels of literacy, unsatisfactory water sources, and few households with a regular cash income. Household density was significantly associated with transmissible skin disease. Other indicators of poverty (e.g., no regular cash income and illiteracy) did not correlate with the prevalence of skin disease.
Skin disease as highly prevalent in the villages surveyed, especially transmissible diseases in the younger age groups. Household density was the only socioeconomic factor significantly associated with skin disease. Reduction of household density is an attainable intervention that could reduce the prevalence of skin disease in rural African populations. Simple studies like this one should be the first step in community dermatology, assessing the burden of skin disease in communities and looking for particular factors with which public health interventions could effectively reduce the prevalence of skin disease.
发展中国家的许多皮肤病与社会经济因素相关。人们普遍认为，在这种情况下，采用公共卫生方法来治疗皮肤病尤为合适；但是，几乎没有流行病学研究来考察哪些特定的社会经济因素是皮肤病患病率的重要决定因素。在撒哈拉以南非洲地区尤其如此。
在坦桑尼亚西北部的恩加拉区对两个村庄进行了一项调查，随机选取了254户家庭，使用问卷进行调查，测量房屋和水质，并对1114名家庭成员的皮肤进行检查。
300人（26.9%）患有严重皮肤病。传染性疾病占皮肤病的大部分（73.9%），年龄较小的群体受影响最大。社会经济状况较差，住房质量低且拥挤，识字率低，水源不理想，有固定现金收入的家庭很少。家庭密度与传染性皮肤病显著相关。其他贫困指标（如无固定现金收入和文盲）与皮肤病患病率无关。
在所调查的村庄中，皮肤病非常普遍，尤其是年龄较小群体中的传染性疾病。家庭密度是与皮肤病显著相关的唯一社会经济因素。降低家庭密度是一项可行的干预措施，可以降低非洲农村人口的皮肤病患病率。像这样的简单研究应该是社区皮肤病学的第一步，评估社区中皮肤病的负担，并寻找公共卫生干预措施可以有效降低皮肤病患病率的特定因素。
