Health Seeking Behavior and Cost of Care of Chronic Dermatophytosis: A Hospital-Based Cross-Sectional Study

Abstract

Recent trend in onslaught of chronic and recurrent dermatophytosis not amenable to conventional dose and duration of antifungal agents has been observed in Nepal and India. The major factor implicated behind this surge is use of over-the-counter fixed drug combination containing topical steroids. This study aimed to examine the health seeking behavior, pattern of drug use and cost of care of chronic dermatophytosis in Nepalese population. Ninety-one patients with the diagnosis of chronic dermatophytosis of skin willing to participate in the study were recruited in a hospital-based, cross-sectional study. Information regarding demographic profile, health seeking behavior and cost incurred in the treatment of their dermatophytosis were recorded in a preset proforma. Mean age of study population was 30.49±13.50 years with M:F ratio of 2.25:1. Mean duration of illness was 20.68±6.44 months, with groin as the initial site of involvement in nearly half of cases. Commonest diagnoses were extensive dermatophytosis, followed by tinea cruris et corporis and tinea cruris. Nearly three-forth of patients reported seeking advice from local pharmacy and two-third reported using steroid containing topical agents for their skin problem. On an average, patients spent NPR 6,488.70 in a six months period and 3.03% of their income in the treatment of chronic dermatophytosis. This study highlighted the tendency of patients to seek advice from pharmacy dispensers, use of topical steroid containing agents in chronic dermatophytosis and substantial financial burden borne by patients in the treatment of the condition.

Drug utilization pattern evaluation and cost variation analysis of anti-fungal agents in tinea infected patients in dermatology department of a tertiary care teaching hospital

“…Similar findings were reported in a study conducted by Joshi et al in which the majority of the patients belonged to 19 years to 28 years age group (41.6%). 10 Different types of tinea infections were diagnosed in the patients. Amongst these tinea corporis and cruris were responsible for maximum infections (52.7%) whereas tinea faciei, capitis, pedis, versicolor, manuum and incognito were observed comparatively less in our study population and similar results were observed in a study done by Dutta et al 11 Superficial fungal infection can be a chronic condition due to recurrences as was seen in 74 (29.4%) patients who had history of similar infections in past.…”

Atividade in vitro de extratos das variedades Arbequina e Picual de Olea europaea L. frente a Candida sp., Microsporum gypseum e Sporothrix brasiliensis

“…Apesar dos tratamentos disponíveis, o surgimento de novos casos e de recorrência dessa infecção se tornou um problema de saúde pública (Nweze & Eke, 2018;Pereira et al, 2020;Rengasamy et al, 2020). Estudos apontam aumento na incidência de casos de dermatofitose crônica e recorrentes sem resposta ao tratamento pelos antifúngicos, como fluconazol e terbinafina (Dogra & Uprety, 2016;Joshi et al, 2020).…”

Knowledge Attitude And Practice Regarding Superficial Fungal Infections In Dermatology Patients In Eastern Nepal

“…This has been highlighted by studies where majority of patients do not visit dermatologist and purchase medication from local pharmacy. 6 Hence knowledge, attitude, practice surveys are essential to help plan, implement and evaluate patient behaviour. It can identify knowledge gaps, cultural beliefs, or behavioural patterns so that it can facilitate understanding and action.…”