Abstract
Context:
Risk factors for the persistence of superficial skin infestations are prevalent in humid tropical environments, which are favorable for breeding of the causative vector mite Sarcoptes scabiei (ectoparasite) and dermatophyte fungi.
Aim:
This study aimed at assessing the awareness and knowledge of childhood scabies and ringworm infestations among parents in Calabar, a highly humid rainforest tropical environment.
Settings and Design:
Cross-sectional study design and systematic random sampling were used to recruit school-age children in selected primary schools in Calabar.
Materials and Methods:
Researcher-driven administration of a structured questionnaire was conducted to obtain quantitative data from parents of recruited children.
Statistical Analysis Used:
Chi-square was used to assess factors associated with ever hearing or seeing scabies and ringworm infestations. Statistical significance was set at P < 0.05.
Results:
One hundred and eighty-two (56.7%) and 218 (67.9%) of the respondents had heard of or seen scabies and ringworm infestation. Among respondents that were aware of scabies, 53.3% knew of the cause, 50.5% were aware of the risk factors while 68.1% and 78.0% knew their treatment and prevention, respectively; 98.6%, 60.6%, 76.6%, and 80.7% of respondents knew the cause, risk factors, treatment, and prevention of ringworm infestation, respectively. Fathers with at least secondary school literacy level and sharing beds were significantly associated with awareness of scabies.
Conclusion:
There is a suboptimal level of awareness and knowledge of two of the most common superficial skin infestations among parents of primary school children in the study setting. There is a need to redouble our effort at sensitization of parents toward improved awareness of these common infestations.
Keywords: Knowledge, Nigeria, parents, ringworm, scabies, school-age children, skin infestations
Résumé
Contexte:
Les facteurs de risque de persistance des infestations cutanées superficielles sont prévalents dans les environnements tropicaux humides, favorables à la reproduction du vecteur responsable, la gale Sarcoptes scabiei (ectoparasite), et des champignons dermatophytes.
Objectif :
Cette étude visait à évaluer la sensibilisation et les connaissances des parents de Calabar, un environnement tropical de forêt équatoriale très humide, concernant la gale et les infestations à la teigne chez les enfants. Cadre et conception : Une étude transversale et un échantillonnage systématique ont été utilisés pour recruter des enfants d’âge scolaire dans des écoles primaires sélectionnées à Calabar.
Méthodes et matériel:
Une administration dirigée par le chercheur d’un questionnaire structuré a été réalisée pour obtenir des données quantitatives auprès des parents des enfants recrutés.
Analyse statistique utilisée:
Le test du chi carré a été utilisé pour évaluer les facteurs associés à la connaissance de la gale et des infestations à la teigne. La signification statistique a été fixée à P < 0,05.
Résultats:
Cent quatre-vingt-deux (56,7 %) et 218 (67,9 %) des répondants avaient entendu parler ou vu une infestation de gale et de teigne. Parmi les répondants qui étaient au courant de la gale, 53,3 % connaissaient la cause, 50,5 % étaient conscients des facteurs de risque, tandis que 68,1 % et 78,0 % connaissaient respectivement leur traitement et leur prévention. De même, 98,6 %, 60,6 %, 76,6 % et 80,7 % des répondants connaissaient respectivement la cause, les facteurs de risque, le traitement et la prévention de l’infestation à la teigne. Les pères ayant au moins un niveau d’alphabétisation au niveau secondaire et partageant des lits étaient significativement associés à la connaissance de la gale.
Conclusion:
Il existe un niveau sous-optimal de sensibilisation et de connaissance de deux des infestations cutanées superficielles les plus courantes parmi les parents d’enfants d’école primaire dans le cadre de l’étude. Il est nécessaire de redoubler d’efforts pour sensibiliser les parents afin d’améliorer la connaissance de ces infestations courantes.
Mots-clés: Infestations cutanées, gale, teigne, connaissance, parents, enfants d’âge scolaire, Nigeria
INTRODUCTION
Scabies and ringworm are among the common superficial skin infections reported globally with one in every 4–5 children affected in some settings.[1] Globally, scabies affect more than 130 million people annually.[2] Dermatophyte infections also are the most prevalent fungal infections the world over, accounting for about a billion people involving the keratinized tissues hair, skin, and nail structures of the body.[3] These infections, while not acutely fatal cause morbidity, and disfigurement, create a psychological burden, constitute a chronic nuisance, and may cause potentially fatal secondary bacterial complications including glomerulonephritis and rheumatic heart fever from scabies.[4,5] Although poor hygiene and overcrowding are key factors, these infestations are found among all socioeconomic groups, gender, and ethnic settings.[6,7,8,9]
Scabies is one of the ectoparasites infestations endemic in developing countries which are neglected often ironically by the sufferer. In comparative terms and reckoning, both ectoparasites infestations and the dermatophyte infections of tinea are low as there are of less importance in the scale of immediate needs of the average rural person. In tropical settings, young children and the elderly in resource-poor communities are more susceptible to scabies as well as to the secondary complications of infestation, respectively.[10] School children, immunocompromised, elderly, disabled, and debilitated persons are at risk of scabies infestation.[11] Epidemiological efforts are unfolding in several countries in Africa among different population segments.[12] Tinea dermatophyte fungal infections are majorly caused by the environmental species of Trichophyton and Microsporum. They are most prevalent in tropical regions noted for warm and highly humid weather conditions.[13]
The transmission of scabies and ringworm infestations in schools is a major public health problem.[14,15,16] The problem is aggravated among school-age children in rural areas as a result of poor living conditions and low educational levels of parents.[17] Infections have been known to spread rapidly among school children in close contact and overcrowded classrooms,[18] a common situation in most public schools in Nigeria.[19] In a study conducted in a rural community of Kaduna State, North-western Nigeria, Sambo et al.[20] noted a high prevalence of skin diseases among school-aged children with a quarter of the children in the community having active skin infections. Overcrowding within the class and in homes, sharing of utensils, poor sanitation, poverty, high humidity, and climate, enhance the spread of these infestations in school-age children.[20,21] This makes scabies, ringworm, and other superficial skin infections thrive and become highly prevalent.[1,5] Epidemiological data about scabies and ringworm infestations in schoolchildren provide valuable information about its risk factors and form a basis for methods of prevention and therapy.[22,23] Yet, there is the absence of public health surveillance systems, treatment, and education even among high-risk vulnerable groups,[24] and a low volume of studies on superficial skin infections in the Niger Delta region.[1] To the best of our knowledge, the risk factors of scabies and tinea among school children are not well studied in Calabar, Cross River State.
This phase of the study is therefore aimed at assessing awareness and knowledge of childhood scabies and ringworm as common superficial skin infestations among parents in Calabar.
MATERIALS AND METHODS
Study design
A comparative cross-sectional and quasi-experimental study was conducted in Calabar, Cross River State between September 2019 and February 2020, to assess awareness and knowledge of childhood scabies and ringworm infestations among parents and or guardians. The study population comprised children in schools in Cross River State.
Study setting
The study setting comprised publicly-run primary schools in Calabar, Cross River State. Most of these public schools have overcrowded classrooms, with poor sanitation, ventilation, and little or no source of potable water for regular hand washing. Parents/guardians of most pupils are petty traders, peasant farmers, or fishermen. Some of the pupils are also involved in raising income for the family through trading, farming, and other forms of child labor.
Sample size determination
The sample size for the study was determined by applying the Leslie Kish formula thus:[25]
Where,
n = The desired minimum sample size.
Z = Standard normal deviation for desired significance level = 1.96 (for 95% confidence).
P = Estimated proportion of subjects with superficial skin infections = 28.9%[26]
q = 1– P = 1–0.289 = 0.711
d = margin of error = 0.05
n = 315.75.
Sampling method
Simple random sampling by balloting was used to select the primary schools while systematic random sampling was used to select the school children used in the study. A total of 8 public primary schools in Calabar metropolis were used.
Questionnaire design
The interviewer-administered questionnaire was used to collect data on socio-demographic characteristics of schoolchildren and their parents, household and school characteristics, knowledge, and practice of prevention of superficial skin infections, and personal and environmental hygiene.
Ethical considerations
Approval to conduct the study was sought and obtained from the Health Research Ethics Committee of the Cross River State Ministry of Health. Consent was obtained from school authorities, the respective head teachers, and parents/guardians of selected subjects before data collection.
Data analysis
Data were entered and analyzed using SPSS version 21.0 (IBM Corporation, Armonk, New York, United States). Sociographic characteristics of subjects and other relevant variables were presented using frequency tables. Chi-square was used as an inferential statistic to assess factors associated with ever hearing or seeing scabies and ringworm infestations. Statistical significance was set at P < 0.05.
RESULTS
Data were obtained from 321 subjects with a response rate of 92.4%. The mean age of children was 10.2 ± 2.0 ranging from 6 to 17 years, while the female: male ratio was 1:0.9. The mean number of individuals in a household was 5.8 ± 1.9 ranging from 2 to 12, while the mean number of children was 3.7 ± 1.8 ranging from 1 to 9. Most subjects (58.3%) were 10-year-old or younger [Table 1]. Approximately 21% (70/321) of fathers of children had primary or no formal education, while 78.2% (251/321) had at least a secondary level of education. Most mothers (79.8%; 256/321) and fathers (59.5%; 191/321) had business or trading as their occupation [Table 1].
Table 1.
Sociodemographic characteristics of subjects (n=321)
| Variable | Frequency, n (%) |
|---|---|
| Gender | |
| Male | 152 (47.4) |
| Female | 169 (52.6) |
| Total | 321 (100) |
| Age group (years) | |
| <10 | 187 (58.3) |
| 11–15 | 132 (41.1) |
| >15 | 2 (0.6) |
| Total | 321 (100) |
| Mother’s level of education | |
| None/primary | 78 (24.3) |
| At least secondary | 243 (75.7) |
| Total | 321 (100) |
| Father’s level of education | |
| None | 15 (4.7) |
| Primary | 55 (17.1) |
| Secondary | 140 (43.6) |
| Tertiary | 111 (34.6) |
| Total | 321 (100) |
| Mother’s occupation | |
| Civil servant | 39 (12.1) |
| Business/trader | 256 (79.8) |
| Others | 26 (8.1) |
| Total | 321 (100) |
| Father’s occupation | |
| Civil servant | 87 (27.1) |
| Business/trader | 191 (59.5) |
| Others | 43 (13.4) |
| Total | 321 (100) |
Approximately half (48.0%; 154/321) and a quarter (25.9%; 83/321) of respondents lived in single rooms and self-contained apartments, respectively [Table 2]. A little above half (53.6%; 172/321) had 6–10 individuals in a household, while 45.5% (146/321) had 4 or fewer children in the household. Dogs and cats were kept as pets by 30.8% (99/321) and 6.2% (20/321) of respondents, respectively [Table 2].
Table 2.
Residential and exposure characteristics of subjects (n=321)
| Variable | Frequency, n (%) |
|---|---|
| Type of residence | |
| Single room | 154 (48.0) |
| Self-contained | 83 (25.9) |
| Bungalow/flat/duplex | 71 (22.1) |
| Others | 13 (4.0) |
| Total | 321 (100) |
| Number in household | |
| <5 | 146 (45.5) |
| 6–10 | 172 (53.6) |
| >10 | 3 (0.9) |
| Total | 321 (100) |
| Have a dog as a pet in the house/compound | |
| Yes | 99 (30.8) |
| No | 222 (69.2) |
| Total | 321 (100) |
| Have a cat as a pet in the house/compound | |
| Yes | 20 (6.2) |
| No | 301 (93.8) |
| Total | 321 (100) |
| Child shares bed | |
| Yes | 185 (57.6) |
| No | 136 (42.4) |
| Total | 321 (100) |
| Child shares clothes | |
| Yes | 68 (21.1) |
| No | 253 (78.8) |
| Total | 321 (100) |
| Child shares towel | |
| Yes | 84 (26.2) |
| No | 237 (73.8) |
| Total | 321 (100) |
One hundred and eighty-two respondents (182/321 [56.7%]) had heard of or seen scabies infestation [Table 3]. Among these respondents, 53.3% knew of the cause of scabies infestation, and 50.5%, 68.1%, and 78.0% respectively, were aware of the risk factors, treatment, and prevention of scabies infestation. About 35.5% of the respondents reported having had scabies at least once in their lifetime and 23.4% reported currently having a scabies infestation [Table 3].
Table 3.
Parental knowledge and history of prior scabies infestation (n=321)
| Variable | Frequency, n (%) |
|---|---|
| Ever heard of or seen scabies? | |
| Yes | 182 (56.7) |
| No | 139 (43.3) |
| Total | 321 (100) |
| Know the cause of scabies (n=182) | |
| Yes | 97 (53.3) |
| No | 85 (46.7) |
| Total | 182 (100) |
| Know conditions/risk factors for scabies (n=182) | |
| Yes | 92 (50.5) |
| No | 90 (49.5) |
| Total | 182 (100) |
| Know how scabies is treated (n=182) | |
| Yes | 124 (68.1) |
| No | 58 (31.9) |
| Total | 182 (100) |
| Knows how scabies can be prevented (n=182) | |
| Yes | 142 (78.0) |
| No | 40 (22.0) |
| Total | 182 (100) |
| Has your child ever had scabies? | |
| Yes | 114 (35.5) |
| No | 207 (64.5) |
| Total | 321 (100) |
| Does any household sibling have scabies? | |
| Yes | 75 (23.4) |
| No | 246 (76.6) |
| Total | 321 (100) |
Two hundred and eighteen respondents (218/321 [67.9%]) had heard of or seen ringworm infestation [Table 4]. Among these respondents, 98.6% knew of the cause of ringworm infestation, while 60.6%, 76.6%, and 80.7% respectively, were aware of the risk factors, treatment, and prevention of ringworm infestation. Approximately 55.1% of the respondents reported having had ringworm at least once in their lifetime and 26.5% reported currently having ringworm infection [Table 4].
Table 4.
Parental knowledge and history of prior ringworm infestation (n=321)
| Variable | Frequency, n (%) |
|---|---|
| Ever heard of or seen ringworm? | |
| Yes | 218 (67.9) |
| No | 103 (32.1) |
| Total | 321 (100) |
| Know what ringworm is (n=218) | |
| Yes | 215 (98.6) |
| No | 3 (1.4) |
| Total | 218 (100) |
| Know conditions/risk factors for ringworm (n=218) | |
| Yes | 132 (60.6) |
| No | 86 (39.4) |
| Total | 218 (100) |
| Know how ringworm is treated (n=218) | |
| Yes | 167 (76.6) |
| No | 51 (23.4) |
| Total | 218 (100) |
| Knows how ringworm can be prevented (n=218) | |
| Yes | 176 (80.7) |
| No | 42 (19.3) |
| Total | 218 (100) |
| Has your child ever had ringworm? | |
| Yes | 177 (55.1) |
| No | 144 (44.9) |
| Total | 321 (100) |
| Does any household sibling have ringworm? | |
| Yes | 85 (26.5) |
| No | 236 (73.5) |
| Total | 321 (100) |
Fathers with a primary or less level of education had a higher proportion of ever heard of or seen scabies and ringworm, compared with those with a secondary or higher level of education, though statistical significance was found only for scabies (P = 0.02) [Table 5]. Other sociodemographic characteristics including gender, age group, and occupation did not significantly influence awareness of scabies and ringworm [Table 5].
Table 5.
Sociodemographic factors associated with awareness of skin infestations (n=321)
| Variable | Ever heard of or seen scabies? |
Ever heard of or seen ringworm? |
||
|---|---|---|---|---|
| Yes, n (%) | No, n (%) | Yes, n (%) | No, n (%) | |
| Gender | ||||
| Male | 85 (46.7) | 67 (48.2) | 121 (45.3) | 31 (57.4) |
| Female | 97 (53.3) | 72 (51.8) | 146 (54.7) | 23 (42.6) |
| Chi-square (P) | 0.79 | 0.11 | ||
| Age group (years) | ||||
| <10 | 100 (54.9) | 87 (62.6) | 154 (57.7) | 33 (61.1) |
| 11–15 | 81 (44.6) | 51 (36.7) | 111 (41.6) | 21 (38.9) |
| >15 | 1 (0.5) | 1 (0.7) | 2 (0.7) | 0 (0.0) |
| Fisher’s exact (P) | 0.37 | 0.75 | ||
| Mother’s level of education | ||||
| None/primary | 40 (22.0) | 38 (27.3) | 64 (24.0) | 14 (25.9) |
| At least secondary | 142 (78.0) | 101 (72.7) | 203 (76.0) | 40 (74.1) |
| Chi-square (P) | 0.27 | 0.76 | ||
| Father’s level of education | ||||
| None/primary | 48 (26.4) | 22 (15.8) | 63 (23.6) | 7 (13.0) |
| At least secondary | 134 (73.6) | 117 (84.2) | 204 (76.4) | 47 (87.0) |
| Chi-square (P) | 0.02 | 0.08 | ||
| Mother’s occupation | ||||
| Civil servant | 22 (12.1) | 17 (12.2) | 33 (12.4) | 6 (11.1) |
| Business/trader | 146 (80.2) | 110 (79.1) | 210 (78.7) | 46 (85.2) |
| Others | 14 (7.7) | 12 (8.6) | 24 (9.0) | 2 (3.7) |
| Chi-square/Fisher’s exact (P) | 0.95 | 0.4 | ||
| Father’s occupation | ||||
| Civil servant | 52 (28.6) | 35 (25.2) | 76 (28.5) | 11 (20.4) |
| Business/trader | 104 (57.1) | 87 (62.6) | 154 (57.7) | 37 (68.5) |
| Others | 26 (14.3) | 17 (12.2) | 37 (13.9) | 6 (11.1) |
| Chi-square (P) | 0.61 | 0.33 | ||
A significant association was found between the child’s sharing of bed and ever heard of or seen scabies (P = 0.000) [Table 6]. Furthermore, a child’s sharing of a towel was associated with ever heard of or seen ringworm, though this was not statistically significant (P = 0.08) [Table 6].
Table 6.
Residential and exposure factors associated with awareness of skin infestations (n=321)
| Variable | Ever heard of or seen scabies? |
Ever heard of or seen ringworm? |
||
|---|---|---|---|---|
| Yes, n (%) | No, n (%) | Yes, n (%) | No, n (%) | |
| Type of residence | ||||
| Single room | 85 (46.7) | 69 (49.6) | 125 (46.8) | 29 (53.7) |
| Self-contained | 49 (26.9) | 34 (24.5) | 70 (26.2) | 13 (24.1) |
| Bungalow/flat/duplex | 41 (22.5) | 30 (21.6) | 61 (22.8) | 10 (18.5) |
| Others | 7 (3.8) | 6 (4.3) | 11 (4.1) | 2 (3.7) |
| Chi-square/Fisher’s exact (P) | 0.94 | 0.82 | ||
| Number in household | ||||
| <5 | 88 (48.4) | 58 (41.7) | 119 (44.6) | 27 (50.0) |
| 6–10 | 93 (51.1) | 79 (56.8) | 145 (54.3) | 27 (50.0) |
| >10 | 1 (0.5) | 2 (1.4) | 3 (1.1) | 0 |
| Fisher’s exact (P) | 0.39 | 0.59 | ||
| Number of children in a household | ||||
| <4 | 128 (70.3) | 97 (69.8) | 186 (69.7) | 39 (72.2) |
| 5–6 | 42 (23.1) | 30 (21.6) | 60 (22.5) | 12 (22.2) |
| >6 | 12 (6.6) | 12 (8.6) | 21 (7.9) | 3 (5.6) |
| Chi-square/Fisher’s exact (P) | 0.77 | 0.83 | ||
| Have a dog as a pet in the house/compound | ||||
| Yes | 56 (30.8) | 43 (30.9) | 83 (31.1) | 16 (29.6) |
| No | 126 (69.2) | 96 (69.1) | 184 (68.9) | 38 (70.4) |
| Chi-square (P) | 0.98 | 0.83 | ||
| Have a cat as a pet in the house/compound | ||||
| Yes | 11 (6.0) | 9 (6.5) | 16 (6.0) | 4 (7.4) |
| No | 171 (94.0) | 130 (93.5) | 251 (94.0) | 50 (92.6) |
| Chi-square/Fisher’s exact (P) | 0.87 | 0.70 | ||
| Child shares bed | ||||
| Yes | 118 (64.8) | 67 (48.2) | 157 (58.8) | 28 (51.9) |
| No | 64 (35.2) | 72 (51.8) | 110 (41.2) | 26 (48.1) |
| Chi-square (P) | 0.00 | 0.35 | ||
| Child shares clothes | ||||
| Yes | 39 (21.4) | 29 (20.9) | 61 (22.8) | 7 (13.0) |
| No | 143 (78.6) | 110 (79.1) | 206 (77.2) | 47 (87.0) |
| Chi-square (P) | 0.90 | 0.11 | ||
| Child shares towel | ||||
| Yes | 44 (24.2) | 40 (28.8) | 75 (28.1) | 9 (16.7) |
| No | 138 (75.8) | 99 (71.2) | 192 (71.9) | 45 (83.3) |
| Chi-square (P) | 0.35 | 0.08 | ||
DISCUSSION
Infectious skin diseases and infestations have been reported as major health problems in Nigeria.[27] While these are recognized in Nigeria, there are yet limited published data on the knowledge and awareness of these forms of skin diseases among parents in the Niger Delta part of the country.[1] This survey was done to assess the level of awareness of scabies and ringworm infestations among parents and or guardians of school-age children concerning seeking treatment and disease prevention.
It is known that most scabies infestations and ringworm infections do not present as acute diseases. This fact in addition to a poor health-seeking attitude prevalent in most developing countries puts scabies and ringworm as low-priority diseases. Determining the awareness, knowledge, and related determinants among parents and guardians of children in public primary schools is proposed to be more representative of their prevalence than a clinic-/hospital-based survey. Studies have shown that community studies in both urban and rural areas reveal a higher burden than hospital-based studies.[28] There is a marked difference in the prevalence of skin diseases between community- and hospital-based studies.[29,30,31,32] There appears a deliberate shift to the community for care and awareness which may drastically reduce the prevalence of skin infestations.[33]
Interrogation of parents and guardians was to ensure an adequate understanding of skin diseases and infestations. This was reinforced using colored photographs of the clinical lesions from the common body sites. Information on demography, occupation, level of education, and living environment family size all paint a vivid picture of the socioeconomic status of the school children as represented by the respondents. Trading/business represents low-scale buying and selling of essentials for daily subsistence living in which most of the mothers are engaged in. The average age of children below 10 years fell within the vulnerable group.[34] These children are part of the average 6 people in each household housed in single-room accommodation of 48% of the respondents.
From this study, 56.7% and 67.9% of respondents had heard of or seen scabies and ringworm infestations, respectively. Approximately 53.3% knew of the cause of scabies infestation, while 50.5%, 68.1%, and 78.0% knew of risk factors, treatment, and prevention of scabies infestation, respectively. Similarly, 98.6% of parents knew the cause of ringworm, while 60.6%, 76.6%, and 80.7%, knew the risk factors for the disease, treatment, and prevention of ringworm infestation, respectively. This reflects a good knowledge among respondents regarding scabies and ringworm infestations. It has been shown that families who know of these infestations take appropriate measures to prevent infection and seek treatment immediately in the case of infection.[35] While a high knowledge should be advantageous, the relatively significant trader/business occupation of mothers detracts from adequate time for the transfer of knowledge in the care of the children either in preventing the disease or having the economic strength for better living conditions.
The study notes that 35.5% and 23.4% of respondents reported the ever presence of scabies in the child and household siblings of the child, respectively. A higher percentage of 55.1% and 26.5% reported ringworm in children and household siblings of the child. This implies that although the respondents have fairly good knowledge regarding scabies and ringworm infestations, they were still predisposed to external factors that increased the risk of these infections. This can be seen in the fact that of the respondents who reported having heard of or seen scabies, 64.8% reported sharing beds at home (P = 0.000), showing a poor attitude toward disease prevention. Tefera et al.[36] reported that if there was a family history of scabies infestation, the transmission rate might be high as there is a probability of contact among members of the family. A similar result has been reported by Hegab et al.[11] and Dagne et al.[18] in Egypt and Ethiopia, respectively.
Fathers with at least a secondary school literacy level had a higher proportion of ever heard of or seen scabies and ringworm, compared with those with primary or with no level of education, though statistical significance was found only for scabies. Despite the high level of education among mothers and fathers, children still had a high incidence of scabies and ringworm infestation. Parents with a high level of education would likely spend the least amount of time with their wards exposing them to various factors which might lead to scabies/ringworm infestation. Gunathilaka et al.[37] reported the prevalence of skin infections to be higher among children having mothers with a higher level of education. This was linked to the employment status of mothers as uneducated mothers were mostly unemployed and had more time to attend to the health requirements of their children. However, studies have shown that the educational levels of parents were not significantly associated with skin disorders.[38,39]
A significant association was found between a child’s sharing of bed and ever heard of or seen scabies. There is a likelihood that children who shared personal belongings had in the past contracted scabies infection, hence knowing the infection. Furthermore, a child’s sharing of a towel was associated with ever heard of or seen ringworm, though this was not statistically significant. This shows a poor attitude toward the prevention of skin infestations. Children living in houses with a lesser number of rooms[39] and sharing personal items such as towels at home have been identified to be significant in the spread of skin disorders among school children.[40]
CONCLUSION
There is a suboptimal level of awareness and knowledge of common superficial childhood skin infestations among parents of children in the study setting. This may be contributing to the persistence of these scabies and ringworm infestations in humid tropical regions. Health officers and school teachers should collaborate and create awareness of the possible causes, prevention, and control of scabies and ringworm infestations among school children and parents/guardians. Furthermore, research in similar and dissimilar settings is also recommended.
Limitations
Limited financial resources limited the scope of the research, as well as the number of participants that were included. Accessibility to school-age children and their parents was limited due to transportation and geographic barriers. Furthermore, language barriers prevented some participants from understanding the questions or responding accurately. There was also difficulty in obtaining accurate information from parents due to illiteracy.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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