SKIN AND HEALTH: AN OPERATIONAL RESEARCH IN TIGRAY (ETHIOPIA)
Morrone A., Padovese V., Terranova M., Cosulich A., Gardellin A., Estifanos K., Hagos T., Tsegay Y., Barnabas G. A.
Dermatological care for all “A basic human right”
Addis Abeba, November 1-4, 2006
Background: Sub-Saharan Africa, has the highest incidence of HIVAIDS infection in the world.
Lack of access to necessary antiretroviral therapy leads to the increased presence of advanced AIDS and severe pathological conditions related to the infection. The skin represents a sensible indicator of HIV infection and multiple skin disorder are part of the list established from WHO for the staging of HIV/AIDS
Patients and Methods: We report our experience at the Italian Dermatological Centre (IDC) in Mekele, Tigray, the northernmost regional state in Ethiopia. The IDC is the only dermatological centre in a region counting more than 4 millions inhabitants. From January 2005 to September 2006, 659 HIV positive patients have been examined with related skin-disorders. Young women were more affected from HIV than males (399 females and 260 males). Commonest alterations we recorded included impetigo, dermatophytosis, viral warts and molluscum contagiosus. Atypical clinical presentations (extensive distribution of the skin lesions or presence of multiple infections in the same patient) represented HIV indicator. Papular Pruritic Eruption (PPE) represented an important role in the early detection of HIV infection and one of the most common symptoms encountered in patients with HIV. It is a not-infectious skin disorder, which involve not only the
body but also the face, permitting in this way the immediate diagnosis of HIV infection.
Investigations for STIs, according to the literature, showed high incidence in HIV patients and, in our experience, genital warts represented the commonest.
IISMAS, in collaboration with the Italian Cooperation-HSPD, Tigray Regional Health Bureau and Tigray Medical Association is leading an operational research (OR) to spread information about the strong relation between HIV infection and skin disorders. The aim of this project is to improve diagnosis and management skill of peripheral health workers on common skin condition related to HIV/AIDS.
Conclusions: Dermatological knowledge represents one of the fundamental clinical bases to diagnose HIV infection worldwide. We believe in the importance of spreading this dermatological skill to permit early detection and diagnosis of HIV infection. For this reason, as part of the OR, we are teaching dermatological discipline in multiple district of Tigray region. Early diagnosis represents one of the aims to decrease mortality HIV-related.
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