Prevalence and pattern of infectious dermatoses referrals to clinical microbiologists in a tertiary hospital in Southern Nigeria

Abstract

Background: Infectious dermatoses are rife in low resource tropical countries. The consultative roles of clinical microbiologists in these countries are not portrayed in the literature. Specifically, their role in the management of infectious dermatoses has not been emphasized. The objective of this study is to determine the prevalence and pattern of infectious dermatoses referrals to an out-patient infectious disease clinic run by clinical microbiologists.

Method: A retrospective analysis of all outpatient referrals to the clinical microbiologists in a tertiary hospital in southern Nigeria from October 2016 to September 2018 was conducted. The infectious dermatoses referrals were further analysed for patient demographics and frequency of clinical diagnosis.

Results: A total of 545 consults were received, 82 (15.0%) of which were outpatient referrals. Infectious dermatoses accounted for 67 (81.7%) of the outpatient referrals. The male to female ratio was 0.9:1 and mean age was 39.7 ± 17.9 years. Paediatric referrals accounted for 10.4%. The commonest referral diagnoses were tinea corporis/capitis in 28 (41.8%), onchodermatitis in 15 (22.4%) and onychomycosis in 10 (14.9%). Leprosy was suspected in 5 cases (7.5%), lymphatic filariasis in 5 cases (7.5%), and pityriasis in 2 cases (3.0%). Referral diagnosis in 27 cases (38.8%) was a skin-related neglected tropical disease. Microbiological testing confirmed clinical suspicion in 31.3% of cases.

Conclusion: Infectious dermatoses referrals constitute a substantial proportion of referrals to clinical microbiologists in the study location. Clinical microbiologists must be adept in the diagnosis of mycotic and parasitic dermatoses. The trending global health interest in integrated management of skin NTDs should be exploited to advocate for more sensitive diagnostic testing for infectious dermatoses.

Keywords: Clinical, Microbiology, Infectious dermatoses, Consultation, Nigeria