# Prevalence and determinants of impetigo in Ghana: a cross-sectional study

## TL;DR

This study found that impetigo and scabies are common in Ghana, with itchiness and scabies increasing the risk of impetigo.

## Contribution

The study provides new epidemiological data on impetigo and scabies in Ghana and identifies key risk factors.

## Key findings

- Impetigo prevalence was 14% among 1327 participants in Ghana.
- Having an itch, scabies burrows, or clinical scabies increased the risk of impetigo.
- Preschool children had a 4.56 times higher risk of impetigo.

## Abstract

Skin diseases such as impetigo pose a significant public health challenge in low resource settings. Despite this, there is a dearth of epidemiological data on the prevalence of this condition in Ghana.

We conducted a cross sectional study in three settings in Ghana: community members in East Mamprusi district in the North East region, a secondary school in Sekyere East district, and inmates of the Kumasi central prisons both in the Ashanti region. Following a period of training, we performed a standardised skin examination on each participant to assess for scabies and impetigo. We calculated the prevalence of each skin condition and investigated determinants of impetigo.

Of the 1327 participants [males 64.1% and median age 22 (16–29) years], 746 (56.2%) had scabies and 186 (14%) had impetigo which was usually very mild or mild in severity. Most participants with impetigo also had scabies (161/186, 86.6%). Having an itch [RR 6.05 (95% CI 2.53–14.47)], presence of scabies burrows [RR 1.99 (95% CI 1.54–2.59)], clinical scabies [RR 3.15 (2.11–4.72)] or being in preschool [RR 4.56 (1.78–11.67)] increased the risk for impetigo. A combination of the presence of clinical scabies, age, sex and itch most accurately predicted the odds of having impetigo.

There is substantial burden of impetigo and scabies in Ghana. There is a need to institute measures to improve detection and control of these common dermatoses as part of Universal Health Coverage package to reduce the scourge of the diseases in this setting.