[Risk factors associated with leg erysipelas (cellulitis) in sub-Saharan Africa: A multicentre case-control study].

Abstract

BACKGROUND:

Acute bacterial cellulitis of the leg (erysipelas) is a common problem involving considerable morbidity in dermatology practice in Africa. Previous studies conducted in Europe and North Africa have highlighted lymphoedema and toe-web intertrigo as independent factors associated with leg erysipelas. The aim of this case-control study was to identify risk factors associated with leg erysipelas in sub-Saharan Africa, within a different socio-economic and culture context.

PATIENTS AND METHODS:

We conducted a prospective case-control study in hospital dermatology departments in 8 sub-Saharan African countries over a 12-month period (October 2013 to September 2014). Each case of acute leg cellulitis was matched with 2 controls for age (±5 years) and sex. We analysed the general and local factors.

RESULTS:

During the study period, 364 cases (223 female, 141 male) were matched with 728 controls. The mean age was 42.15±15.15 years for patients and 42.11±36 years for controls. Multivariate analysis showed the following to be independent risk factors associated with leg erysipelas in our study: obesity (odds ratio [OR]=2.82 ; 95% confidence interval: 2.11-3.76), lymphoedema (OR=3.87, 95%CI: 2.17-6.89), voluntary cosmetic depigmentation (OR=4.29, 95%CI: 2.35-7.83), neglected traumatic wound (OR=37.2, 95%CI: 24.9-57.72) and toe-web intertrigo (OR=37.86, 95%CI: 22.27-64.5).

CONCLUSION:

The results of this study confirms the major role of local risk factors (toe-web intertrigo, lymphoedema) previously identified in other geographical settings. However, the originality of our study consists of the identification of voluntary cosmetic depigmentation as a risk factor for leg erysipelas in sub-Saharan Africa.

• Authors: P Pitché, B Diatta, O Faye, B-F Diané, A Sangaré, P Niamba, C Mandengue, L Kobengue, B Saka, A Diop, F Ly, M-T Dieng, A Dicko, M-M Soumah, M Cissé, S-H Kourouma, Y-I Kouassi, T Boukari, S Akakpo, K Tchangaï-Walla
• Journal: Annales de dermatologie et de venereologie (Ann Dermatol Venereol) Vol. 142 Issue 11 Pg. 633-8 (Nov 2015) ISSN: 0151-9638 [Print] France
• Vernacular Title: Facteurs de risque associés à l'érysipèle de jambe en Afrique subsaharienne: étude multicentrique cas-témoins.
• PMID: 26364000 (Publication Type: English Abstract, Journal Article, Multicenter Study)
• Copyright: Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Topics

• Adult
• Africa South of the Sahara (epidemiology)
• Aged
• Body Mass Index
• Case-Control Studies
• Erysipelas (diagnosis, epidemiology, etiology, microbiology)
• Female
• Hospitals
• Humans
• Intertrigo (complications)
• Leg (pathology)
• Leg Ulcer (complications)
• Lymphedema (complications)
• Male
• Middle Aged
• Obesity (complications)
• Poverty (statistics & numerical data)
• Pressure Ulcer (complications)
• Prospective Studies
• Risk Factors