Prevalence and risk factors of inflammatory acne vulgaris in rural and urban Ghanaian schoolchildren

Conflicts of interest: none declared. Sir, Acne vulgaris is a common skin condition in children and adolescents between the age of 10 and 18 years. The prevalence of acne depends strongly on its definition and the age categories of the studied populations. In industrialized countries this condition affects between 30% and 100% of the adolescent population.1 The prevalence of acne is considerably lower in developing countries.2 Community‐based studies are scarce; hospital‐based studies have been reported more frequently. Hospital‐based studies in Africa showed prevalences of around 5%3 with the exception of a South African study which showed a prevalence of 16%.4 Only few studies compared prevalences of acne in schoolchildren living in rural and urban areas and these showed conflicting results.5, 6 In order to provide information about acne vulgaris, a cross‐sectional study was conducted by two dermatologists (A.A.H, A.P.M.L) in February 2007 with 1394 schoolchildren from six rural schools and five urban schools in the Greater Accra region of Ghana. The schools were categorized as public, private and private rich to reflect the average socioeconomic level of the children, respectively low, middle to high and high (Table 1). This cross‐sectional study is part of a project studying the association of helminth infection with allergic sensitization and atopic eczema among schoolchildren in Ghana. The parents of the children consented by signing or thumb printing an informed consent form and ethical approval was granted by the Institutional Review Board of the Noguchi Memorial Institute for Medical Research in Ghana. The skin of each child was fully examined for inflammatory acne vulgaris, atopic eczema and other skin diseases. The diagnosis of inflammatory acne was defined by the presence of at least six pustules or papulopustules on the face.