Acne vulgaris in general population of rural western Kenya: cross-sectional community survey.

Kenya: cross-sectional community survey Acne vulgaris is a common chronic inflammatory condition of the pilosebaceous glands. Acne is estimated to affect 9.4% of the world’s population with the highest prevalence in adolescents. The incidence of acne varies among countries and between ethnic groups. In the general population, the prevalence of acne ranges from 0.1% in northern Tanzania to a high of 17% in Iraq. Other large studies showed a prevalence of 8.1% in China and 3.9% in Germany. The prevalence of acne in developing countries of Africa is reported to be low. However, most studies are either hospital-based or targeted adolescence groups. The socioeconomic status and access to cosmetics in the rural population of Africa is improving. The social and economic changes may have led to changes in disease patterns. The aim of this study was to determine the prevalence, severity, and complication of acne in the general population of rural western Kenya. This research was part of a larger cross-sectional study in a rural area of Kakamega County. A total of 10 villages were selected randomly from 46 villages. A random point on the village map was used as a starting point, and every consecutive household was included in the study. All members of the family were interviewed and examined. One dermatologist and four dermatovenereology officers conducted the interviews and the clinical examination. The research team examined both the face and the trunk of all the participants. Digital pictures of acne were taken and later jointly reviewed by the five researchers to determine the type of acne and acne complications. The Kakamega hospital research and ethics committee approved the study and informed consent obtained from all participants or guardians of children under 16 years. A total of 1185 people were recruited with a median age of 25 years and the male to female ratio of 1 : 1.4. The prevalence of acne was 11.2% (n = 133). The majority of those affected by acne were women (71 of 133). The median age of onset of the disease was 15 years. The youngest person to develop acne was 9 years old, while the oldest was 52 years. Acne was reported to be present in 49.6% of family members of people with acne. Papulopustular acne was the commonest type (60.9%, n = 81) affecting predominantly the face (93.2%, n = 124) as shown in Table 1. A total of 12 persons with acne did not develop complications from the disease while 69.2% (n = 92) had postinflammatory hyperpigmentation. Among the 133 people with acne, 20 (15%) had treatment from herbalists or a local health facility. The prevalence of 11.2% in this study is higher than other general population studies done elsewhere in Africa, which reported a prevalence of 0.1–8.9%. There is a wide variation in the prevalence of acne in Africa. The difference could be attributed to a different ethnicity, use of steroid-based cosmetics, or inconsistencies in clinical diagnosis and methods used in data collection. The most common sequelae of acne in this study are dyspigmentation and scarring as reported in other studies. Postinflammatory hyperpigmentation is reported to affect more than half of acne patients with skin of color. Papulopustular type of acne was the most common type of acne. This kind of acne is associated with severe