Indian Journal of Paediatric Dermatology

ORIGINAL ARTICLE
Year
: 2020  |  Volume : 21  |  Issue : 4  |  Page : 279--282

Prevalence of dermatoses among jenukuruba tribal children


HS Rajani, D Narayanappa, K Jagadish Kumar, VG Manjunath 
 Department of Pediatrics, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India

Correspondence Address:
Dr. H S Rajani
Department of Pediatrics, JSS Hospital, Mahatma Gandhi Road, Mysore - 570 004, Karnataka
India

Abstract

Introduction: Dermatoses are common among schoolgoing children, more so in a tribal area and cause significant morbidity. Objective: The present study was conducted to study the point prevalence and pattern of dermatoses in Jenukuruba tribal children in Mysore district. Materials and Methods: A cross-sectional study was conducted on 4207 Jenukuruba tribal children in Mysore district. Diagnosis of various dermatoses was made on the basis of detailed clinical examination. Results: The point prevalence of dermatoses was 71.5%. Majority had single skin lesion. Nearly 43% had more than one skin lesion. Among skin infections and infestations, pyoderma (33.4%) and scabies (19.8%) were most prevalent. Among the noninfective conditions, xerosis (71.5%), pityriasis alba (16.7%), acne (8.6%), and hyperpigmentation (54.5%) were most prevalent. Conclusions: The point prevalence of dermatoses in tribal schoolchildren in Mysore district is very high. Health education of children and caregivers regarding the signs and symptoms of dermatoses is warranted for early detection, timely intervention, and prevention.



How to cite this article:
Rajani H S, Narayanappa D, Kumar K J, Manjunath V G. Prevalence of dermatoses among jenukuruba tribal children.Indian J Paediatr Dermatol 2020;21:279-282


How to cite this URL:
Rajani H S, Narayanappa D, Kumar K J, Manjunath V G. Prevalence of dermatoses among jenukuruba tribal children. Indian J Paediatr Dermatol [serial online] 2020 [cited 2020 Dec 3 ];21:279-282
Available from: https://www.ijpd.in/text.asp?2020/21/4/279/296844


Full Text



 Introduction



According to the 2001 census,[1] tribal population in India is 74.6 million (8.2% of the total population), with largest number seen in Madhya Pradesh, Odisha, and Jharkhand. There are 573 scheduled tribes in our country and 270 tribal languages have been identified. There are 16 million tribal children (6–14 years) among the total of 193 million children. The total population of tribal is 53 million in Karnataka, which is 5.13% of the Indian population. Almost 6.6% of the total population in Karnataka are scheduled tribes. They are highest in Raichur, Bellary, and Chitradurga. Fifty scheduled tribes have been notified in Karnataka. Jenukuruba and koraga with a population of 29,828 and 16,071 are the two primitive tribal groups. Jenukuruba tribes are mainly seen around Mysore, Kodagu, and Bengaluru. Koraga tribes are mainly seen in Dakshina Kannada and Dharwad. In Mysore district, 2,641,027 tribal populations are there. Among them, 19,246 are Jenukuruba, which is the major tribal group inhabited in and around Nagarhole forest areas, around Hunsur, HD kote, Piriyapatna, and Nanjangud.

Dermatoses constitute one of the important and common health problems in children, leading to significant morbidity.[2],[3] Many studies have been done to study the prevalence and pattern of pediatric dermatoses in the community, hospitals, and schoolchildren. The prevalence of pediatric dermatoses has ranged from 8.7% to 69% in various studies, with higher prevalence among rural and tribal schoolchildren.[2],[3],[4] Dermatoses are one of the common but neglected problems, especially in tribal children. Poverty, illiteracy, lack of safe drinking water and sanitary facilities, and lack of health-care facilities are the main reasons for health-related problems and skin disorders among them. The present study was done to find the point prevalence of pediatric dermatoses in children in Jenukuruba tribal areas in Mysore district.

 Materials and Methods



This study was a part of a community-based, cross-sectional study on nutritional and health status of Jenukuruba tribal children in Mysore district, with a study population of 4207 children between 0 and 15 years of age belonging to Jenukuruba Community in Mysore district. Children were selected by convenience sampling method. A predesigned pro forma for data collection was used. Preliminary site visit and inquiry of local officials and schools were done, and all the Jenukuruba households mainly in H. D. Kote, Hunsur, Nanjangud, and Periyapatna were listed. Explanation regarding collection of information, examination, and purpose of the study was done in simple language, and consent forms were signed by parents for enrollment in the project. Institutional ethical committee clearance was obtained. Information regarding sociodemographic and living conditions was collected by interview method using a pro forma. Clinical examination was done by senior research fellows and research assistants under the supervision of co-investigators. All schoolchildren present in the school were examined for the presence of dermatoses. The diagnosis was made after detailed history taking and clinical examination by research fellows and assistants. The findings of examination were recorded in a pro forma prepared for the study. Appropriate statistical analysis was done. Descriptive statistics was used, and analysis of categorical variables was done by Chi-square test using SPSS version 21.0 (IBM, New York, USA). Criteria of significance used in the study were P < 0.05 (two tailed).

 Results



A total of 4207 Jenukuruba children were examined, out of which 2130 (50.6%) were boys and 2077 (49.4%) were girls. A total of 1846 (43.8%) children were from primary schools (age: 4–10), while 1521 (36.1%) children were from high schools (age: >10–15 years) [Table 1].{Table 1}

A total of 1393 (33.1%) children were stunted with height less than the 3rd centile using WHO growth charts, 1588 (35.7%) children were underweight with weight below the 3rd centile on WHO growth charts, 1175 (27.9%) children were having BMI less than the 5th centile of WHO charts, 127 (3.3%) children were overweight with BMI between the 85th and 95th centiles and 9 (0.2%) children were obese with BMI greater than the 95th centile, 1103 (62.9%) children less than 6 years were malnourished, with 0.9% falling under Grade IV PEM according to the IAP classification of PEM,[5] and 3474 (82.6%) children were anemic, with 17.2% of them having varying grades of Vitamin A deficiency.

Drainage and sanitary facilities were very poor, with 92.8% practicing open-air defecation and 24.9% staying in an area with lack of drainage facilities. Nearly 95.7% were home- delivered babies and 9.4% were low-birth weight babies, with 89.3% of parents not knowing the birth weight of the baby. Almost 99.2% of them belong to upper lower class according to modified BG Prasad's classification.[6]

The prevalence of dermatoses among the schoolchildren was 71.5% (3008). Majority had single skin lesion and 43% had more than one skin lesion. Among infections and infestations, pyoderma (1424 [33.4%] and scabies (834 [19.8%] were most prevalent. Among the noninfective conditions, xerosis (71.5%), pityriasis alba (16.7%), acne (8.6%), and hyperpigmentation (54.5%) were most prevalent [Table 2].{Table 2}

Pyoderma (n = 1424, 33.4%) was the most common among infections, while among infestations, scabies, and pediculosis capitis were common with a prevalence of 19.8% and 12.6%, respectively. Among noninfective conditions, xerosis (n = 3008, 71.5%), pityriasis alba (n = 702, 16.7%), acne (n = 356, 8.5%), and hyperpigmentation (n = 2293, 54.5%) had higher prevalence. The prevalence of other dermatoses found in the study was as follows: tinea and other fungal infections (n = 117, 2.8%), seborrheic dermatitis (n = 33, 0.8%), and angular stomatitis and cheilitis (n = 1758, 41.8%) [Table 2].

The total prevalence of dermatoses was similar across both sexes, and the difference was statistically nonsignificant. There was no statistical difference in the total prevalence of dermatoses between primary schoolchildren (age: 4–10) and high schoolchildren (age: 10–15) [Figure 1].{Figure 1}

 Discussion



The high prevalence of dermatoses in the studied schoolchildren could be due to poor socioeconomic status; environmental conditions; hygiene; cultural factors, genetic factors, and education status of parents; low awareness level among caregivers regarding basic dermatological signs and symptoms; remote location; and poor health-care delivery system.

The present study has revealed the point prevalence of dermatoses to be 71.5% among the 4207 Jenukuruba tribal schoolchildren, which is similar with earlier studies on rural or tribal schoolchildren.[2],[3],[4],[7],[8]

Pyoderma was the most common infection in our study affecting 33.4% of the schoolchildren with no significant difference between primary and high schoolchildren and between girls and boys, which is in concordance with previous studies conducted on rural children.[9],[10],[11] Nearly 19.8% of the children had scabies.

In our study, the prevalence of pediculosis capitis was found to be lower (12.6%) compared to earlier studies.[2],[4],[8],[12] The prevalence of fungal infections such as tinea corporis, tinea capitis, and pityriasis versicolor was about 2.8%, which is similar to previous studies on rural children.[13],[14]

Among noninfective dermatoses, xerosis had the highest prevalence of 71.5% compared to results seen earlier. Pityriasis alba too had a high prevalence of 16.7%, which is similar to previous studies.[9],[15] The prevalence of acne was about 8.5% and was similar in both the sexes with higher occurrence in high schoolchildren compared to primary schoolchildren, as shown in earlier studies.[16],[17]

The prevalence of other noninfective dermatoses such as atopic dermatitis, seborrheic dermatitis, nevus, pityriasis rosea, and juvenile plantar dermatoses was low (0.3%–4.6%), similar to other studies.[2],[3],[4],[8],[16]

The prevalence of nutritional disorders in our study (41.8%) was higher compared to that of earlier studies.[18],[19]

Lack of drainage and sanitary facilities with 92.8% practicing open-air defecation reflects the poor living conditions and thereby its impact on the health status of tribal population, similar to other studies.[20]

 Conclusions



The point prevalence of dermatoses was high in Jenukuruba tribal children of Mysore district. Xerosis, infestations (scabies), and infections (pyoderma) are the common problems noted. Most of the conditions are preventable and can be cured. Health education, improving living conditions, and regular periodical examination of the children are warranted for early detection, timely intervention, and prevention.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

This study was financially supported by the Indian Council of Medical Research.

Conflicts of interest

There are no conflicts of interest.

References

1Government of India Census. Website. Available from: http:/www.censusindia.gov.in. [Last accessed on 2009 Mar 12].
2Upendra Y, Sendur S, Keswani N, Pallava A. Prevalence of dermatoses among the tribal children studying in residential schools of Naxal infested South Chhattisgarh, India. Indian J Paediatr Dermatol 2018;19:15-20.
3Bhatia V. Extent and pattern of paediatric dermatoses in rural areas of central India. Indian J Dermatol Venereol Leprol 1997;63:22-5.
4Sharma NK, Garg BK, Goel M. Pattern of skin diseases in Urban school children. Indian J Dermatol Venereol Leprol 1986;52:330-1.
5Suryakantha AH. Community Medicine with Recent Advances. Vol. 2. New Delhi: Jaypee Brothers Medical Publishers (P) Ltd.; 2009. p. 659-60.
6Proceedings of the workshop on protein calorie malnutrition. Ecology and management. Indian Pediatr 1975;12:57-117.
7Basti BD, Radhakrishnan S. Prevalence of dermatological manifestations among the tribal school children of South India. Int J Community Med Public Health 2016;3:1957-62.
8Saurabh S, Sahu SK, Sadishkumar A, Kakkanattu JC, Prapath I, Ralte IL, et al. Screening for skin diseases among primary school children in a rural area of Puducherry. Indian J Dermatol Venereol Leprol 2013;79:268.
9Valia RA, Pandey SS, Kaur P, Singh G. Prevalence of skin diseases in Varanasi school children. Indian J Dermatol Venereol Leprol 1991;57:141-3.
10Negi KS, Kandpal SD, Parsad D. Pattern of skin diseases in children in Garhwal region of Uttar Pradesh. Indian Pediatr 2001;38:77-80.
11Ghosh SK, Saha DK, Roy AK. A clinico-aetiological study of dermatoses in paediatric age group. Indian J Dermatol 1995;40:29-31.
12Dongre AR, Deshmukh PR, Garg BS. The impact of school health education programme on personal hygiene and related morbidities in tribal school children of Wardha district. Indian J Community Med 2006;31:81-2.
13Rao GS, Kumar SS, Sandhya. Pattern of skin diseases in an Indian village. Indian J Med Sci 2003;57:108-10.
14Patel JK, Vyas AP, Berman B, Vierra M. Incidence of childhood dermatosis in India. Skinmed 2010;8:136-42.
15Sharma NL, Sharma RC. Prevalence of dermatological diseases in school children of a high altitude tribunal area of Himachal Pradesh. Indian J Dermatol Venereol Leprol 1990;56:375-6.
16Sharma S, Bassi R, Sodhi MK. Epidemiology of dermatoses in children and adolescent in Punjab, India. J Pak Assoc Dermatol 2012;22:224-9.
17Tamer E, Ilhan MN, Polat M, Lenk N, Alli N. Prevalence of skin diseases among pediatric patients in Turkey. J Dermatol 2008;35:413-8.
18Vora R, Bodiwala N, Patel S. Prevalence of various dermatoses in school children of Anand district. Natl J Community Med 2012;3:100-3.
19Shakya SR, Bhandary S, Pokharel PK. Nutritional status and morbidity pattern among governmental primary school children in the Eastern Nepal. Kathmandu Univ Med J (KUMJ) 2004;2:307-14.
20Rao VG, Yadav R, Dolla CK, Kumar S, Bhondeley MK, Ukey M. Undernutrition childhood morbidities among tribal preschool children. Indian J Med Res 2005;122:43-7.