Position Statement on Atopic Dermatitis in Sub‐Saharan Africa: current status and roadmap

Abstract

Background The first International Society of Atopic Dermatitis (ISAD) global meeting dedicated to atopic dermatitis (AD) in Sub‐Saharan Africa (SSA) was held in Geneva, Switzerland in April 2019. A total of 30 participants were present at the meeting, including those from 17 SSA countries, representatives of the World Health Organization (WHO), the International Foundation for Dermatology (IFD) (a committee of the International League of Dermatological Societies, ILDS http://www.ilds.org), the Fondation pour la Dermatite Atopique, as well as specialists in telemedicine, artificial intelligence and therapeutic patient education (TPE). Results AD is one of the most prevalent chronic inflammatory skin diseases in SSA. Besides neglected tropical diseases (NTDs) with a dermatological presentation, AD requires closer attention from the WHO and national Departments of Health. Conclusions A roadmap has been defined with top priorities such as access to essential medicines and devices for AD care, in particular emollients, better education of primary healthcare workers for adequate triage (e.g. better educational materials for skin diseases in pigmented skin generally and AD in particular, especially targeted to Africa), involvement of traditional healers and to a certain extent also patient education, bearing in mind the barriers to effective healthcare faced in SSA countries such as travel distances to health facilities, limited resources and the lack of dermatological expertise. In addition, several initiatives concerning AD research in SSA were discussed and should be implemented in close collaboration with the WHO and assessed at follow‐up meetings, in particular, at the next ISAD meeting in Seoul, South Korea and African Society of Dermatology and Venereology (ASDV) meeting in Nairobi, Kenya, both in 2020.

Comorbidities and Environmental Factors Associated with Atopic Dermatitis in Children and Adults in Dermatology-Venereology in Cotonou, Benin

“…This pediatric prevalence is significantly higher than that reported in Abidjan (Côte d'Ivoire) in 2017 [ 13 ]. Several studies confirm the increase in AD prevalence over the last 10 years, particularly in developing countries [ 4 – 6 ]. In Africa, the prevalence of AD varies from country to country between 4.7% and 23% [ 14 ].…”

“…There is not only a correlation between temperature and other climatic factors, namely, humidity, exposure to ultraviolet rays but also the pollen concentration in the environment, alteration of barrier function, and skin irritants. This indicates the important role of climate and even climate change, in the increase in flare-ups of AD [ 4 , 8 , 36 , 38 ].…”

“…ese factors influence the prevalence and clinical expression of the disease in different age groups, geographical regions, and races [4][5][6][7][8].…”

“…Several studies show that it is not a simple disease, but a skin condition with many different genetic and immunological mechanisms and underlying environmental factors. These factors influence the prevalence and clinical expression of the disease in different age groups, geographical regions, and races [ 4 – 8 ].…”

Künstliche Intelligenz zur Unterstützung der Telemedizin am Beispiel Afrikas

“…In Afrika weisen Patienten mit atopischer Dermatitis vermehrt follikuläre und lichenoide Läsionen auf, wohingegen in Asien eher Lichen simplex chronicus, Lichenifikationen und Prurigo-nodularis-Formen vorkommen und in Indien und im Iran weniger häufig eine flexurale Beteiligung vorliegt [17]. Anlässlich eines Treffens mit Ärzten aus Afrika südlich der Sahara wurde die atopische Dermatitis als eine der mit Abstand häufigsten entzündlichen Dermatosen in dieser Region identifiziert und digitale Methoden zu deren Erkennung und Beratung als sehr wesentlich postuliert [18].…”