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IntroductionSkin diseases represent a significant public health problem in most low and middle income settings. Nevertheless, there is a relative paucity of high-quality epidemiological data on the prevalence of these conditions.Materials/MethodsWe conducted two cross-sectional population-based skin-surveys of children (6 months to 9 years old) in the Bijagós Archipelago of Guinea-Bissau during the dry season (February-March 2018) and the wet season (June-July 2018). Following a period of training, a nurse performed a standardised examination for communicable dermatoses for each participant. We calculated the prevalence of each skin condition and investigated demographic associations.Results1062 children were enrolled in the dry season survey of whom 318 (29.9%) had at least one skin diseases. The most common diagnosis was tinea capitis (154/1062, 14.5% - 95% CI 12.5–16.8%) followed by tinea corporis (84/1062, 7.9% - 95% CI 6.4–9.7%), pyoderma (82/1062, 7.7% - 95% CI 6.2–9.5%) and scabies (56/1062. 5.2% - 95%CI 4.0–6.8%). 320 children were enrolled in the wet season survey of whom 121 (37.8%) had at least one skin problem. Tinea capitis remained the most common diagnosis (79/320, 24.7% - 95% CI 20.1–29.9%), followed by pyoderma (38/320, 11.9% - 95% CI 8.6–16.1%), tinea corporis (23/320, 7.2% - 95% 4.7–10.7%) and scabies (6/320, 1.9% - 95% CI 0.8–4.2%).ConclusionsOur study, which utilised robust population-based cluster random sampling methodology, demonstrates the substantial disease burden caused by common communicable dermatoses in this setting. Given these findings, there is a need to consider common dermatoses as part of Universal Health Coverage to deliver ‘skin-health for all’.

Soil-transmitted helminths (STH) are endemic and widespread across Sub-Saharan Africa. A community wide soil-transmitted helminth (STH) prevalence survey was performed on the island of Bubaque in Guinea-Bissau using both Kato-katz microscopy and qPCR methodology. Predictors of infection and morbidity indicators were identified using multivariable logistic regression, and diagnostic methods were compared using k statistics. Among 396 participants, prevalence of STH by microscopy was 23.2%, hookworm was the only species identified by this method and the mean infection intensity was 312 eggs per gram. qPCR analysis revealed an overall prevalence of any STH infection of 47.3%, with the majority A. duodenale (32.3%), followed by N. americanus (15.01%) and S. stercoralis (13.2%). A. lumbricoides, and T. trichiura infections were negligible, with a prevalence of 0.25% each. Agreement between diagnostic tests was k = 0.22, interpreted as fair agreement, and infection intensity measured by both methods was only minimally correlated (Rs = -0.03). STH infection overall was more common in females and adults aged 31–40. STH infection was associated with open defaecation, low socio-economic status and further distance to a water-source. The prevalence of anaemia (defined as a binary outcome by the WHO standards for age and sex) was 69.1%, and 44.2% of children were malnourished according to WHO child growth standards. Hookworm infection intensity by faecal egg count showed no statistically significant association with age (Rs 0.06) but S. Stercoralis infection intensity by qPCR cycle threshold was higher in pre-school aged children (Rs = 0.30, p-value 0.03) There was no statistically significant association between STH infection and anaemia (OR 1.0 p = 0.8), stunting (OR 1.9, p-value 0.5) and wasting (OR 2.0, p-value 0.2) in children. This study reveals a persistent reservoir of STH infection across the community, with high rates of anaemia and malnutrition, despite high-coverage of mebendazole mass-drug administration in pre-school children. This reflects the need for a new strategy to soil-transmitted helminth control, to reduce infections and ultimately eliminate transmission.

Introdução: a tuberculose é uma doença milenar, constituindo um problema de saúde pública, desde sua descoberta até hoje em dia. Recentemente, com o surgimento da HIV/AIDS, a doença ganhou outros contornos e dimensões, nos países desenvolvidos e, sobretudo, nos países em desenvolvimento. Objetivo: análise das ações da Luta Contra Tuberculose na República da Guiné-Bissau e do fluxo do sistema de notificação e de informação de dados, dentro do Sistema Nacional de Saúde. Metodologia: trata-se de um estudo exploratório descritivo que consiste no diagnóstico da situação de tuberculose no país, no período de 2000 a 2005, mediante levantamento das informações secundárias dos principais indicadores epidemiológicos e operacionais mais utilizados no país. Foram feitos cálculos de coeficientes e taxas, assim como a padronização pelo método direto de coeficientes de incidência de casos bacilíferos, para comparação. Resultados: no período de estudo, foram registrados 10.623 casos de tuberculose. O menor coeficiente de incidência de tuberculose foi de 116,4/100.000 habitantes, no ano de 2003, e o mais alto foi de 131,3/100.000 habitantes, em 2005. O maior coeficiente de mortalidade registrado foi de 16,8/100.000 habitantes, em 2005. A maior taxa de letalidade foi de 11,8%, em 2005, e a mais baixa, de 5,1%, em 2003. Conclusão: é de notar que a busca ativa de sintomáticos respiratórios ainda é baixa, assim como a cobertura da estratégia DOTS, por possíveis problemas técnicos operacionais. Há necessidade da melhoria do diagnóstico no país, sobretudo da forma clínica extrapulmonar, e de um sistema de notificação e informação eficiente em todos os níveis.

Background: Skin diseases represent a significant public health problem in most low and middle income settings. Nevertheless, there is a relative paucity of high-quality epidemiological data on the prevalence of these conditions. Materials/methods: We conducted two cross-sectional population-based skin-surveys of children (6 months to 9 years old) in the Bijagos Archipelago of Guinea-Bissau during the dry season (February-March 2018) and the wet season (June-July 2018). Following a period of training, a nurse performed a standardised examination for communicable dermatoses for each participant. We calculated the prevalence of each skin condition and investigated demographic associations. Results: 1062 children were enrolled in the dry season survey of whom 318 (29.9%) had at least one skin diseases. The most common diagnosis was tinea capitis (154/1062, 14.5% - 95% CI 12.5-16.8%) followed by tinea corporis (84/1062, 7.9% - 95% CI 6.4-9.7%), pyoderma (82/1062, 7.7% - 95% CI 6.2-9.5%) and scabies (56/1062. 5.2% - 95%CI 4.0 - 6.8%). 320 children were enrolled in the wet season survey of whom 121 (37.8%) had at least one skin problem. Tinea capitis remained the most common diagnosis (79/320, 24.7% - 95% CI 20.1 - 29.9%), followed by pyoderma (38/320, 11.9% - 95% CI 8.6-16.1%), tinea corporis (23/320, 7.2% - 95% 4.7 - 10.7%) and scabies (6/320, 1.9% - 95% CI 0.8-4.2%). Conclusions: Our study, which utilised robust population-based cluster random sampling methodology, demonstrates the substantial disease burden caused by common communicable dermatoses in this setting. Given these findings, there is a need to consider common dermatoses as part of Universal Health Coverage to deliver skin-health for all.