Skin diseases and their impact on quality of life among patients at Muhimbili national hospital and Muhas academic medical center

Abstract

Background: Skin diseases are a common cause of ill health in developing countries like Tanzania. The effect of a skin disorder on quality of life of a patient which is ignored many times is often of more importance than the presence of skin lesions. To adequately meet the dermatologic needs of the growing population, it is necessary to have a better knowledge of local skin disease spectrum and their impact on quality of life. This will inform on better clinical practice and health planning. Objectives: To describe types of skin diseases, their distribution and impact on quality of life among medical patients at Muhimbili National Hospital and Muhas Academic Medical Center (MAMC) in Dar es Salaam, Tanzania. Methodology: A descriptive hospital based cross-sectional study was conducted from July 2018 to December 2018. All patients admitted to the tertiary dermatology units on account of skin disease and those attending skin clinic for the first time at the two hospitals were recruited. A total of 608 patients aged ≥14 years were enrolled. Socio-demographic and clinical data was collected using a questionnaire. Diagnosis was made on clinical grounds and laboratory investigations were done whenever necessary. Dermatology life quality index questionnaire was used to assess the impact of skin disease on quality of life. Data was analyzed using SPSS version 20.0 and a p-value of ≤ 0.05 with 95% Confidence interval were considered to be significant. Ethical clearance was sought from MUHAS ethical committee of research and communication. Results: There were 580 (95.4%) outpatients of which 56.4% (327/580) were females. The common diseases among outpatients were atopic dermatitis 31.2%, acne 13.6%, pityriasis versicolor 8.3% and tinea 7.4%. There were 28 (4.6%) admitted patients of which 82.1% (23/28) were females and autoimmune disorders (32.1%) was the commonest diagnosis. The most common reason for admission was severity and extent of illness (65.4%). The mean length of hospital stay days (SD) was highest in autoimmune disorders 22.18(9.7). Females had significantly high mean dermatology life quality index scores (SD) than males among outpatients (11.05(6.8) vs 9.58(6.7), p=0.023) as compared to inpatients (17.9(8.4) vs 15.8 (4.1), p=0.594). Highest mean dermatology life quality index scores (SD) were seen in inflammatory dermatoses and autoimmune disorders among both vii outpatients and inpatients. The proportion of dermatology life quality index scores (SD)>10 was high among inpatients than outpatients (67.9% vs 47.1%, p=0.012). Conclusion: Eczematous dermatitis and autoimmune disorders were most common skin diseases seen among outpatients and inpatients respectively. Different types of skin diseases varied on effect of quality of life. Further studies are needed to pinpoint root causes of the disease spectrum and to widen up knowledge on inpatient dermatology.