Impact of common skin diseases on children in rural Côte d’Ivoire with leprosy and Buruli ulcer co-endemicity: A mixed methods study
Open accessAbstract
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 Côte 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 of skin diseases, or skin health promotion, which supports changing of the health-seeking behaviour for skin conditions. This will aid in early detection and treatment of the skin NTDs, in addition to providing benefits for those affected by other skin diseases. Educational opportunities should be utilized to their utmost. One would be associated with water, sanitation, and hygiene (WASH) strategies, but careful messages need to be developed and delivered.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Geographical barriers to accessing health care or the health-seeking behavior of patients and their families contribute to patients not usually visiting health care facilities for skin lesions.
“Sometimes, it is also because of geographical barriers to accessing health care or the health-seeking behavior of patients and their families that they do not usually visit health care facilities for skin lesions [8].”
From An mHealth App (eSkinHealth) for detecting and managing skin diseases in resource-limited settings: mixed methods Pilot Study (2023) · cites this paper as [8]
Skin diseases in sub-Saharan Africa are most often overlooked due to a lack of local specialists and a lack of experience among Western specialists looking at darker skin.
“These diseases are most often overlooked due to a lack of local specialists and a lack of experience among Western specialists looking at darker skin [8,9].”
From An mHealth App (eSkinHealth) for detecting and managing skin diseases in resource-limited settings: mixed methods Pilot Study (2023) · cites this paper as [8]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
James, S. L., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., Abbastabar, H., Abd-Allah, F., Abdela, J., Abdelalim, A., et al. (2018) · The Lancet · doi:10.1016/s0140-6736(18)32279-7 · Cited by 13,867 · see citing works
Vos, T., Abajobir, A. A., Abate, K. H., Abbafati, C., Abbas, K. M., Abd-Allah, F., Abdulkader, R. S., Abdulle, A. M., Abebo, T. A., Abera, S. F., et al. (2017) · The Lancet · doi:10.1016/s0140-6736(17)32154-2 · Cited by 13,220 · see citing works
Qualitative research practice: a guide for social science students and researchers
Ruhl, K. (2003) · Choice Reviews Online · doi:10.5860/choice.41-1319 · Cited by 10,514 · see citing works
Are We There Yet? Data Saturation in Qualitative Research
Fusch, P., & Ness, L. (2015) · The Qualitative Report · doi:10.46743/2160-3715/2015.2281 · Cited by 4,460 · see citing works
Self-stigma and the “why try” effect: impact on life goals and evidence-based practices
CORRIGAN, P. W., LARSON, J. E., & RÜSCH, N. (2009) · World Psychiatry · doi:10.1002/j.2051-5545.2009.tb00218.x · Cited by 1,074 · see citing works
Social stigma towards neglected tropical diseases: a systematic review
Hofstraat, K., & van Brakel, W. H. (2016) · International Health · doi:10.1093/inthealth/ihv071 · Cited by 208 · see citing works
Beliefs and attitudes toward Buruli ulcer in Ghana.
Stienstra, Y., van der Graaf, W. T. A., Asamoa, K., & van der Werf, T. S. (2002) · American Journal of Tropical Medicine and Hygiene · doi:10.4269/ajtmh.2002.67.207 · Cited by 183 · see citing works
Integrated Control and Management of Neglected Tropical Skin Diseases
Mitjà, O., Marks, M., Bertran, L., Kollie, K., Argaw, D., Fahal, A. H., Fitzpatrick, C., Fuller, L. C., Garcia Izquierdo, B., Hay, R., et al. (2017) · PLOS Neglected Tropical Diseases · doi:10.1371/journal.pntd.0005136 · Cited by 183 · see citing works
Self-citationStigma in leprosy: concepts, causes and determinants
Sermrittirong, S., & van Brakel, W. H. (2014) · Leprosy Review · doi:10.47276/lr.85.1.36 · Cited by 169 · see citing works
Prevalence of Skin Disorders in School Children in Ibadan, Nigeria
Ogunbiyi, A. O., Owoaje, E., & Ndahi, A. (2005) · Pediatric Dermatology · doi:10.1111/j.1525-1470.2005.22101.x · Cited by 147 · see citing works
The Children's Dermatology Life Quality Index: validation of the cartoon version
Holme, S. A., Man, I., Sharpe, J., Dykes, P. J., Lewis‐Jones, M. S., & Finlay, A. Y. (2003) · British Journal of Dermatology · doi:10.1046/j.1365-2133.2003.05157.x · Cited by 141 · see citing works
Olsen, J., Gallacher, J., Finlay, A. Y., Piguet, V., & Francis, N. A. (2015) · British Journal of Dermatology · doi:10.1111/bjd.14361 · Cited by 138 · see citing works
Worth, C., Heukelbach, J., Fengler, G., Walter, B., Liesenfeld, O., & Feldmeier, H. (2012) · International Journal of Dermatology · doi:10.1111/j.1365-4632.2011.05017.x · Cited by 123 · see citing works
Internalized stigma in psoriasis: A multicenter study
Alpsoy, E., Polat, M., Karaman, B. F., Karadağ, A. S., Kartal, S. P., Yalçın, B., Emre, S., Balcı, D. D., Temel, A. B., Arca, E., et al. (2017) · The Journal of Dermatology · doi:10.1111/1346-8138.13841 · Cited by 119 · see citing works
Parasitic skin diseases: health care‐seeking in a slum in north‐east Brazil
Heukelbach, J., Haeff, E. V., Rump, B., Wilcke, T., Moura, R. C. S., & Feldmeier, H. (2003) · Tropical Medicine & International Health · doi:10.1046/j.1365-3156.2003.01038.x · Cited by 117 · see citing works
Buruli Ulcer: a Review of the Current Knowledge
Yotsu, R. R., Suzuki, K., Simmonds, R. E., Bedimo, R., Ablordey, A. S., Yeboah‐Manu, D., Phillips, R. O., & Asiedu, K. B. (2018) · Current Tropical Medicine Reports · doi:10.1007/s40475-018-0166-2 · Cited by 116 · see citing works
Self-citationFigueroa, J. L., Fuller, L. C., Abraha, A., & Hay, R. J. (1996) · Pediatric Dermatology · doi:10.1111/j.1525-1470.1996.tb00704.x · Cited by 95 · see citing works
Self-citationSkin diseases of children in Mali: a public health problem
Mahé, A., Prual, A., Konaté, M., & Bobin, P. (1995) · Transactions of the Royal Society of Tropical Medicine and Hygiene · doi:10.1016/0035-9203(95)90068-3 · Cited by 89 · see citing works
Walker, S. L., Lebas, E., Sario, V. D., Deyasso, Z., Doni, S. N., Marks, M., Roberts, C. H., & Lambert, S. M. (2017) · PLoS neglected tropical diseases · doi:10.1371/journal.pntd.0005808 · Cited by 87 · see citing works
The spectrum of dermatological disorders among primary school children in Dar es Salaam
Komba, E. V., & Mgonda, Y. M. (2010) · BMC Public Health · doi:10.1186/1471-2458-10-765 · Cited by 86 · see citing works
Yotsu, R. R., Kouadio, K., Vagamon, B., N’guessan, K., Akpa, A. J., Yao, A., Aké, J., Abbet Abbet, R., Tchamba Agbor Agbor, B., Bedimo, R., et al. (2018) · PLOS Neglected Tropical Diseases · doi:10.1371/journal.pntd.0006489 · Cited by 85 · see citing works
Self-citationMulder, A. A., Boerma, R. P., Barogui, Y. T., Zinsou, C., Johnson, R. C., Gbovi, J., van der Werf, T. S., & Stienstra, Y. (2008) · Transactions of the Royal Society of Tropical Medicine and Hygiene · doi:10.1016/j.trstmh.2008.05.026 · Cited by 83 · see citing works
Skin diseases among schoolchildren in Ghana, Gabon, and Rwanda
Hogewoning, A., Amoah, A., Bavinck, J. N. B., Boakye, D., Yazdanbakhsh, M., Adegnika, A., De Smedt, S., Fonteyne, Y., Willemze, R., & Lavrijsen, A. (2013) · International Journal of Dermatology · doi:10.1111/j.1365-4632.2012.05822.x · Cited by 75 · see citing works
Singh, R. K., Singh, B., & Mahato, S. (2019) · PLoS neglected tropical diseases · doi:10.1371/journal.pntd.0007075 · Cited by 70 · see citing works
Expression of antimicrobial peptides in cutaneous infections after skin surgery
Kesting, M. R., Stoeckelhuber, M., Hölzle, F., Mücke, T., Neumann, K., Woermann, K., Jacobsen, F., Steinstraesser, L., Wolff, K.-D., Loeffelbein, D. J., et al. (2010) · British Journal of Dermatology · doi:10.1111/j.1365-2133.2010.09781.x · Cited by 66 · see citing works
Grietens, K. P., Toomer, E., Boock, A. U., Hausmann-Muela, S., Peeters, H., Kanobana, K., Gryseels, C., & Ribera, J. M. (2012) · PLoS ONE · doi:10.1371/journal.pone.0036954 · Cited by 65 · see citing works
Integrated Management of Skin NTDs—Lessons Learned from Existing Practice and Field Research
Yotsu, R. R. (2018) · Tropical Medicine and Infectious Disease · doi:10.3390/tropicalmed3040120 · Cited by 65 · see citing works
Self-citationStrategies to reduce stigma related to visible chronic skin diseases: a systematic review
Topp, J., Andrees, V., Weinberger, N., Schäfer, I., Sommer, R., Mrowietz, U., Luck‐Sikorski, C., & Augustin, M. (2019) · Journal of the European Academy of Dermatology and Venereology · doi:10.1111/jdv.15734 · Cited by 59 · see citing works
Changing stigmatisation of leprosy: an exploratory, qualitative life course study in Western Nigeria
Ebenso, B., Newell, J. N., Emmel, N. D., Adeyemi, G., & Ola, B. A. (2019) · BMJ Global Health · doi:10.1136/bmjgh-2018-001250 · Cited by 53 · see citing works
Tabah, E. N., Nsagha, D. S., Bissek, A. Z., Njamnshi, T. N., Njih, I. N.-N., Pluschke, G., & NJAMNSHI, A. K. (2018) · PLoS neglected tropical diseases · doi:10.1371/journal.pntd.0006233 · Cited by 42 · see citing works
Persisting Social Participation Restrictions among Former Buruli Ulcer Patients in Ghana and Benin
de Zeeuw, J., Omansen, T. F., Douwstra, M., Barogui, Y. T., Agossadou, C., Sopoh, G. E., Phillips, R. O., Johnson, C. R., Abass, K. M., Saunderson, P. R., et al. (2014) · PLoS neglected tropical diseases · doi:10.1371/journal.pntd.0003303 · Cited by 40 · see citing works
Klis, S., Ranchor, A. V., Phillips, R. O., Abass, K. M., Tuah, W., Loth, S., Velding, K., van der Werf, T. S., & Stienstra, Y. (2014) · PLoS neglected tropical diseases · doi:10.1371/journal.pntd.0002964 · Cited by 28 · see citing works
Knowledge, attitudes and practices regarding head lice infestations in rural Nigeria
Heukelbach, J., & Ugbomoiko, U. S. (2011) · The Journal of Infection in Developing Countries · doi:10.3855/jidc.1746 · Cited by 25 · see citing works
Murgia, V., Bilcha, K. D., & Shibeshi, D. (2010) · International Journal of Dermatology · doi:10.1111/j.1365-4632.2009.04284.x · Cited by 24 · see citing works
Mueller, Y. K., Bastard, M., Nkemenang, P., Comte, É., Ehounou, G., Eyangoh, S. I., Rusch, B., Tabah, E. N., Trellu, L. T., & Étard, J.-F. (2016) · PLoS neglected tropical diseases · doi:10.1371/journal.pntd.0004593 · Cited by 16 · see citing works
Children and leprosy in southern Nigeria: burden, challenges and prospects
Ekeke, N., Chukwu, J., Nwafor, C. C., Ogbudebe, C. L., Oshi, D. C., Meka, A., & Madichie, N. O. (2014) · Leprosy Review · doi:10.47276/lr.85.2.111 · Cited by 16 · see citing works
Konan, D. O., Mosi, L., Fokou, G., Dassi, C., Narh, C. A., Quaye, C., Saric, J., Abe, N. N., & Bonfoh, B. (2018) · Journal of Biosocial Science · doi:10.1017/s0021932018000317 · Cited by 14 · see citing works
Effah, A., Ersser, S. J., & Hemingway, A. (2017) · International Journal of Dermatology · doi:10.1111/ijd.13785 · Cited by 11 · see citing works
Flagged first, then by citations
1 of the 39 references couldn’t be matched to a known paper.
Research works printed but not linked: 1
- World Health Organization. Global leprosy update, 2018: moving towards a leprosy-free world. Weekly Epidemiological Record. 2019; 94: 501-20.
Cited by
Sorted by citations
Singh, R. K., Singh, B., & Mahato, S. (2019) · PLoS neglected tropical diseases · doi:10.1371/journal.pntd.0007075 · Cited by 70 · see citing works
Quality of life in children and adolescents with alopecia areata—A systematic review
Prendke, M., Kanti, V., Wilborn, D., Hillmann, K., Singh, R., Vogt, A., Kottner, J., & Blume‐Peytavi, U. (2023) · Journal of the European Academy of Dermatology and Venereology · doi:10.1111/jdv.18848 · Cited by 50 · see citing works
Yotsu, R. R., Almamy, D., Vagamon, B., Ugai, K., Itoh, S., Koffi, Y. D., Kaloga, M., Dizoé, L. A. S., Kouadio, K., Aka, N., et al. (2023) · JMIR Dermatology · doi:10.2196/46295 · Cited by 18 · see citing works
Self-citationYotsu, R. R., Itoh, S., Yao, K. A., Kouadio, K., Ugai, K., Koffi, Y. D., Almamy, D., Vagamon, B., & Blanton, R. E. (2022) · JMIR Research Protocols · doi:10.2196/39867 · Cited by 16 · see citing works
Self-citationOwusu, L., Tuwor, R. D., Ackam, N., Loglo, A. D., Agbavor, B., Agbanyo, A., Dornu, O., Antwi, P. B., Oppong, M. N., Adjei, J. K., et al. (2023) · BMC Public Health · doi:10.1186/s12889-023-16015-w · Cited by 13 · see citing works
Okyere, D., Ocloo, E. K., Owusu, L., Amoako, Y. A., Tuwor, R. D., Koka, E., Novignon, J., Asante-Poku, A., Siam, I. M., Afreh, E. K., et al. (2024) · PLOS Global Public Health · doi:10.1371/journal.pgph.0002833 · Cited by 11 · see citing works
Dofitas, B. L., Kalim, S. P., Toledo, C. B., & Richardus, J. H. (2022) · Tropical Medicine and Health · doi:10.1186/s41182-022-00433-4 · Cited by 9 · see citing works
Tchatchouang, S., Basing, L. A., Hugues, K. A., Handley, B. L., González-Beiras, C., Amanor, I., Ndzomo, P., Bakheit, M. A., Becherer, L., Knauf, S., et al. (2024) · PLoS neglected tropical diseases · doi:10.1371/journal.pntd.0011790 · Cited by 7 · see citing works
Leprosy stigma in the healthcare setting: Lived experiences of persons affected by leprosy in Niger
Alio, A. P., Sani, I. M. M., Abdou, Y., Gado, M., Harouna, I., & Celiktemur, B. (2025) · PLoS neglected tropical diseases · doi:10.1371/journal.pntd.0013584 · Cited by 5 · see citing works
Koffi, Y. D., Konan, A. G., Koné, B. V., N’krumah, R. T. A. S., Coulibaly, I. D., Kaloga, M., Kreppel, K. S., Haydon, D. T., Utzinger, J., & Bonfoh, B. (2023) · Journal of Wound Care · doi:10.12968/jowc.2023.32.sup10.cci · Cited by 4 · see citing works
Perceived water-related risk factors of Buruli ulcer in two villages of south-central Côte d’Ivoire
Leuenberger, A., Koné, B. V., N’krumah, R. T. A. S., Koffi, Y. D., Bonfoh, B., Utzinger, J., & Pluschke, G. (2022) · PLoS neglected tropical diseases · doi:10.1371/journal.pntd.0010927 · Cited by 4 · see citing works
Kalaivani, A., & Karpagavalli, S. (2023) · Multimedia Tools and Applications · doi:10.1007/s11042-023-16255-3 · Cited by 3 · see citing works
The screening and management of skin diseases in remote African regions: a narrative review
Mugisha, N., Ghanem, L., Komi, O. A., Manoel, A. Z., Shariff, S., Wojtara, M. S., & Uwishema, O. (2024) · Postgraduate Medical Journal · doi:10.1093/postmj/qgae133 · Cited by 3 · see citing works
Yotsu, R. R., Kouadio, K., Yao, A., Vagamon, B., Takenaka, M., Murota, H., Makimura, K., & NISHIMOTO, K. (2021) · Tropical Medicine and Infectious Disease · doi:10.3390/tropicalmed6010009 · Cited by 2 · see citing works
Self-citationEmanghe, U. E., Imalele, E. E., Ogban, G. I., Owai, P. A., & Abraka, B. A. (2024) · Annals of African Medicine · doi:10.4103/aam.aam_82_23 · Cited by 2 · see citing works
Mwageni, N., Schoenmakers, A., van Wijk, R., Kamara, D., Kisonga, R. M., Njako, B., Nyakato, P., Mieras, L. F., de Vlas, S. J., Richardus, J. H., et al. (2025) · medRxiv · doi:10.64898/2025.12.02.25341087 · Cited by 1 · see citing works
Owusu, L., Tuwor, R. D., Ackam, N., Loglo, A. D., Agbavor, B., Agbanyo, A., Dornu, O., Antwi, P. B., Oppong, M. N., Adjei, J. K., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26594618
Tchatchouang, S., Basing, L. A., Kouadio-Aboh, H., Handley, B. L., González-Beiras, C., Amanor, I., Ndzomo, P., Bakheit, M. A., Becherer, L., Knauf, S., et al. (2023) · medRxiv · doi:10.1101/2023.11.16.23298508
Aborode, A. T., Otorkpa, O. J., Scott, G. Y., Adesola, R. O., Bhattacharjee, P., Elebesunu, E. E., Khan, M., Abdullahi, A. N., Olorukooba, A. A., Sybile, T. N. L., et al. (2026) · Tropical Diseases Travel Medicine and Vaccines · doi:10.1186/s40794-026-00288-1
Koffi, Y. D., Konan, A. G., Ehouman, E., Koné, B. V., & Bonfoh, B. (2026) · Research Square · doi:10.21203/rs.3.rs-8786462/v1
Bereda, G. (2026) · Public Health Challenges · doi:10.1002/puh2.70389
- Authors
- Yotsu, R. R., Comoé, C. C., Ainyakou, G. T., Konan, N., Akpa, A., Yao, A., Aké, J., Vagamon, B., Abbet Abbet, R., Bedimo, R., & Hay, R.
- Affiliations
- Tulane University (US)
- Université Félix Houphouët-Boigny (CI)
- Université Alassane Ouattara (CI)
- The University of Texas Southwestern Medical Center (US)
- Corresponding author
- Yotsu, Rie Roselyne
- Venue
- PLOS Neglected Tropical Diseases
- Publisher
- Public Library of Science (PLoS)
- Published
- 2020-05-18
- Volume
- 14
- Issue
- 5
- Pages
- e0008291
- ISSN
- 1935-2727 (ISSN-L)
- 1935-2735
- PMC
- PMC7274456
- OpenAlex
- W3024997409
- Cited by
- 21
- References
- 39
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 5 · 2023: 6 · 2022: 3 · 2021: 1 · 2019: 1
- FWCI
- 0.33
- Type
- journal article
- Language
- en
- Update notices
- new_version (2020-06-05)
- Open access
- gold
- doi.org
- Licence
- public-domain
- creativecommons.org/publicdomain/zero/1.0/ (vor)
- Locations
- PLoS neglected tropical diseases (publishedVersion, public-domain)
- PubMed Central (publishedVersion, public-domain)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Institutional Repositories DataBase (IRDB) (submittedVersion, public-domain)
- Nagasaki University's Academic Output SITE (Nagasaki University) (submittedVersion, cc-by-nc-nd)
- Funders
- Japan Agency for Medical Research and Development (20jm0510004h0203)
- National Center for Global Health and Medicine (26‐120)
- Japan Society for the Promotion of Science (16K21656)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Dermatological diseases and infestations
- Health Sciences › Medicine › Infectious Diseases › Leprosy Research and Treatment
- Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
- Keywords
- common skin diseases, neglected tropical diseases, leprosy, Buruli ulcer, children, quality of life, knowledge, attitudes and practices, pruritus, bullying, hygiene, health-seeking behavior
- MeSH terms
- Adolescent, Child, Communicable Disease Control, Female, Humans, Interviews as Topic, Cote d'Ivoire, Health Knowledge, Attitudes, Practice, Leprosy, Male, Rural Population, Prevalence, Endemic Diseases, Buruli Ulcer, Neglected Diseases
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
