RESUMO
BACKGROUND: We describe diverse clinical characteristics and course of confirmed mpox cases managed in a Nigerian tertiary health facility. METHODS: Clinical and epidemiologic data were analyzed, highlighting the unusual presentations of polymerase chain reaction (PCR)-confirmed mpox cases observed during the 2022 outbreak. RESULTS: Out of 17 suspected cases, 13 (76.4%) were PCR confirmed for mpox. The mean ± SD age for the participants was 28.62 ± 10.29 years (range, 2-55), of which 9 (64.3%) were male. Of the 13 PCR-confirmed cases, 5 (38.5%) had varicella zoster virus coinfection, 2 (15.4%) had HIV coinfection, and 1 (7.7%) had diabetes mellitus comorbidity. All patients experienced rash, with 6 (46.2%) having significant genital lesions and 1 (7.7%) having a severe perianal lesion. A lack of prodromal symptoms was reported in 3 (23.1%), and a prolonged prodrome (>1 week) occurred in 5 (38.5%). Skin lesions were polymorphic in 6 (46.2%), and solitary skin lesions occurred in 3 (23.1%), which persisted for >120 days in 7.7%. CONCLUSIONS: Clinical recognition, diagnosis, and prevention remain a concern in resource-limited settings. Our findings highlight the need to further evaluate unusual skin lesions and to include mpox screening for genital skin lesions that are presumed to be sexually transmitted infections. Revision of clinical case definition and enhanced surveillance are key to early recognition and prevention of spread.
Assuntos
Coinfecção , Mpox , Humanos , Masculino , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Feminino , Pele , População Negra , Instalações de SaúdeRESUMO
Background: The aim of this study was to educate secondary school students on etiology, risk factors, clinical features, treatment, and prevention of scabies; to evaluate their knowledge base on scabies before and after an educational intervention; and to reassess this knowledge base and behavioral change, 6 months after, on a second visit. Methods: Questionnaires with standard questions on scabies, graded to a maximum score of 10, were administered to students in junior secondary Classes 1 and 2 across 4 states in Nigeria. Information obtained included subjects' demographics, scabies symptomatology, risks, and preventive behaviors. Students with active scabies were diagnosed and treated. Data were analyzed with STATA. Results: The mean test scores for the pretest and posttest at first visit were 2.82 ± 1.38 and 6.30 ± 1.09, respectively. This difference was statistically significant at t = 3.95, P = 0.004. Six months later, when the same schools were re-visited, the mean test scores for the pretest and posttest were 4.63 ± 0.54 and 5.87 ± 0.25, respectively. This difference was also significant at t = 4.13, P = 0.003. The prevalence of scabies was 3.5% at first visit and 4.34% at second visit; t = 0.24, P = 0.41. Conclusions: Secondary school students lack basic education on scabies and exhibit high-risk behaviors for scabies transmission. Knowledge on scabies needs constant reinforcement.
RésuméContexte: Le but de cette étude était d'éduquer les élèves du secondaire sur l'étiologie, les facteurs de risque, les caractéristiques cliniques, le traitement et la prévention de la gale; évaluer leur base de connaissances sur la gale avant et après une intervention éducative; et de réévaluer cette base de connaissances et ce changement de comportement, six mois après, lors d'une deuxième visite. Méthodes: Des questionnaires contenant des questions standard sur la gale, notés à un score maximum de 10, ont été administrés aux élèves des classes 1 et 2 du premier cycle du secondaire dans 4 États du Nigéria. Les informations obtenues comprenaient la démographie des sujets, la symptomatologie de la gale, les risques et les comportements préventifs. Les étudiants atteints de gale active ont été diagnostiqués et traités. Les données ont été analysées avec STATA. Résultats: Les scores moyens aux tests avant et après le test lors de la première visite étaient respectivement de 2,82 ± 1,38 et 6,30 ± 1,09. Cette différence était statistiquement significative à t = 3,95, p = 0,004. Six mois plus tard, lorsque les mêmes écoles ont été revues, les scores moyens aux tests avant et après test étaient respectivement de 4,63 ± 0,54 et 5,87 ± 0,25. Cette différence était également significative à t = 4,13, p = 0,003. La prévalence de la gale était de 3,5% lors de la première visite et de 4,34% lors de la deuxième visite; t = 0,24, p = 0,41. Conclusions: Les élèves du secondaire manquent d'éducation de base sur la gale et présentent des comportements à haut risque de transmission de la gale. Les connaissances sur la gale nécessitent un renforcement constant.
