International Society of Dermatology - Palm Coast, FL - USA

Author: Morrone Aldo^2,5, Padovese Valeska^2,5, Margherita Terranova^2,5, Augusto Cosulich³, Gardellin Andrea³, Kidanu Estifanos¹, Tesfalem Hagos¹, Yohannes Tsegay⁴, Gebre Ab Barnabas^4
1TMA (Tigray Medical Association),
² IISMAS onlus (International Institute of Medical, Anthropological and Social Science),
³Italian Cooperation- HSDP,
⁴Tigray Regional Health Bureau,
⁵S. Gallicano Dermatological Institute (IRCCS) Rome

ABSTRACT

Introduction As for most developing countries, basic health services in As for most developing countries, basic health services in Ethiopia are not available particularly to the large part of the population living in rural areas. Limited availability of qualified staff, poor diagnostic capability, scarcity of equipment and medicines is a common situation in the country. These shortcomings are even more dramatically evident at peripheral level where a minimum health service package is still not yet
available to the population. Moreover, the problem is worsened and aggravated by the escalating HIV/AIDS epidemic and its consequences.
The Operational Research (OR) scheme therefore deals with the establishment of a basic health service to address the emerging skin diseases related to HIV/AIDS and to other systemic illnesses in Tigray region.
Objectives: This OR aims to improve the diagnostic and therapeutic capacity of health facilities in three selected study-weredas of Tigray and compare the impact of the interventions in three control-weredas. Specific objectives are the establishment of a database on dermatological diseases and STIs related with systemic conditions and
the early detection of systemic illnesses through the skin manifestations.
Methods The Italian Cooperation in Ethiopia is the prominent fund givers for the project. The IISMAS Onlus- San Gallicano Dermatological Institute in Rome together with the TMA and the Tigray Health Bureau are the implementing agencies. The project duration is two years from January 2006 to December 2007.
Six weredas of Tigray region have been included in this OR, three intervention and three in the control group. Both the intervention and control weredas have been purposefully selected and matched for the following criteria: climate and altitude, population size, number of health institution and health personnel, urbanity. In addition, the intervention and control weredas have been set apart to avoid contamination.
The methodology of intervention includes training of health workers (Health Officers, nurses and laboratory technicians) on skin diseases and STIs related with systemic conditions, provision of low cost and sustainable laboratory reagents and equipments, provision of basic medical supplies for the treatment of skin diseases and STI, supportive supervision, data collection and analysis. Base line cross sectional
survey have been collected from the intervention and control weredas on knowledge and skill of health workers on skin diseases and STIs related with systemic conditions, health facility’s infrastructure, services and supplies.
Ongoing report from the intervention and control weredas will be collected on a structured data collection format and analyzed at the time of initial survey, interim period and conclusion of the research. The intervention and control groups will be compared for impact using outcome measures such as knowledge and skill of health workers, number of patients with STIs, skin diseases related with systemic conditions treated, cured and referred at the health facilities.
Results During the first phase of the project we collected data on the top ten diseases burdens, the health workers’ skills and the health furniture’s availability in the study and control weredas. After the training of the health workers of the study weredas we’ve already registered some expected outcomes of the research such as an
increased access to the health facilities in the intervention areas and the early detection of the commonest communicable disease. Moreover, through the support-supervision of health facilities and the organization of campaigns for community sensitisation and participation we’ve spread the knowledge on dermatology and STIs at the community level and improved the population’s hygienic conditions.
Discussion Communicable diseases, and mostly HIV/AIDS, are the major
health problems of the region. These diseases are preventable through approaches such as educating the people to bring behavioural changes. This operational research represents an attempt to improve the implementation capacity of the health system and the health status of people in the Tigray region through the access to new services like dermatology and the prevention of communicable diseases such as HIV/AIDS.
Hence, the dermatologists have a central role in the detection of these conditions and in the training of the local health staff.

References

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   Brockmeyer NH., Dermatological diseases and signs of HIV infection., Eur J Med Res. 2002 Feb 21;7(2):57-62
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   patients with HIV/AIDS in Ethiopia, Ethiop Med J. 2003 Apr;41(2):189-203.