{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T03:25:14Z","timestamp":1781839514873,"version":"3.54.5"},"reference-count":41,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T00:00:00Z","timestamp":1665619200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003042","name":"Else Kr\u00f6ner-Fresenius-Stiftung","doi-asserted-by":"publisher","award":["2017_HA19"],"award-info":[{"award-number":["2017_HA19"]}],"id":[{"id":"10.13039\/501100003042","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Data on the burden and clinical epidemiology of skin wounds in rural sub-Saharan Africa is scant. The scale of the problem including preventable progression to chronic wounds, disability and systemic complications is largely unaddressed.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We conducted a cross-sectional study combining active (household-based survey) and passive case finding (health services-based survey) to determine the burden and clinical epidemiology of wounds within the Taabo Health and Demographic Surveillance System (HDSS) in rural C\u00f4te d\u2019Ivoire. Patients identified with wounds received free care and were invited to participate in the wound management study simultaneously carried out in the survey area. The data were analysed for wound prevalence, stratified by wound and patient characteristics.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>3842 HDSS-registered persons were surveyed. Overall wound prevalence derived from combined active and passive case finding was 13.0%. 74.1% (403\/544) of patients were below the age of 15 years. Most frequent aetiologies were mechanical trauma (85.3%), furuncles (5.1%), burns (2.9%) and Buruli ulcer (2.2%). Most wounds were acute and smaller than 5 cm<jats:sup>2<\/jats:sup> in size. 22.0% (176\/799) of wounds showed evidence of secondary bacterial infection. 35.5% (22\/62) of chronic wounds had persisted entirely neglected for years. Buruli ulcer prevalence was 2.3 per 1000 individuals and considerably higher than expected from an annual incidence of 0.01 per 1000 individuals as reported by WHO for C\u00f4te d\u2019Ivoire at the time of the study.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Skin wounds are highly prevalent in rural West Africa, where they represent a widely neglected problem. The HDSS-based survey with combined active and passive case finding adopted in this study provides a better estimate than school- and health institution-based surveys which underestimate the frequency of skin wounds and, particularly, of neglected tropical diseases of the skin, such as Buruli ulcer and yaws. A comparison with country-specific WHO data suggests underreporting of Buruli ulcer cases.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Trial registration<\/jats:title>\n<jats:p>Registration at ClinicalTrials.gov <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT03957447\" xlink:type=\"simple\">NCT03957447<\/jats:ext-link>.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0010608","type":"journal-article","created":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T17:28:53Z","timestamp":1665682133000},"page":"e0010608","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":9,"title":["Skin wounds in a rural setting of C\u00f4te d\u2019Ivoire: Population-based assessment of the burden and clinical epidemiology"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0576-8241","authenticated-orcid":true,"given":"Simone","family":"Toppino","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond T. A. S.","family":"N\u2019Krumah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bognan Valentin","family":"Kone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Didier Yao","family":"Koffi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isma\u00ebl Dognimin","family":"Coulibaly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Tobian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerd","family":"Pluschke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marija","family":"Stojkovic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bassirou","family":"Bonfoh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Junghanss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,10,13]]},"reference":[{"key":"pntd.0010608.ref001","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1111\/j.1524-475X.2009.00543.x","article-title":"Human skin wounds: A major and snowballing threat to public health and the economy: PERSPECTIVE ARTICLE","volume":"17","author":"CK Sen","year":"2009","journal-title":"Wound Repair Regen"},{"key":"pntd.0010608.ref002","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1111\/bjd.19704","article-title":"Putting the burden of skin diseases on the global map","volume":"184","author":"C Flohr","year":"2021","journal-title":"Br J Dermatol"},{"key":"pntd.0010608.ref003","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.1016\/S0140-6736(20)30925-9","article-title":"Global burden of 369 diseases and injuries in 204 countries and territories, 1990\u20132019: a systematic analysis for the Global Burden of Disease Study 2019","volume":"396","author":"T Vos","year":"2020","journal-title":"Lancet"},{"key":"pntd.0010608.ref004","unstructured":"Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2019 (GBD 2019) Results. [cited 24 Oct 2020]. Available: http:\/\/ghdx.healthdata.org\/gbd-results-tool"},{"key":"pntd.0010608.ref005","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1136\/injuryprev-2016-042254","article-title":"Prevalence and risk factor for injury in sub-Saharan Africa: a multicountry study","volume":"24","author":"MB Diamond","year":"2018","journal-title":"Inj Prev J Int Soc Child Adolesc Inj Prev"},{"key":"pntd.0010608.ref006","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/j.burns.2015.04.006","article-title":"Burns in sub-Saharan Africa: A review","volume":"42","author":"PM Nthumba","year":"2016","journal-title":"Burns"},{"key":"pntd.0010608.ref007","doi-asserted-by":"crossref","first-page":"e0005136","DOI":"10.1371\/journal.pntd.0005136","article-title":"Integrated Control and Management of Neglected Tropical Skin Diseases","volume":"11","author":"O Mitj\u00e0","year":"2017","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0010608.ref008","author":"WHO","year":"2018","journal-title":"Recognizing Neglected Tropical Diseases Through Changes on the Skin"},{"key":"pntd.0010608.ref009","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.actatropica.2016.12.023","article-title":"Characteristics and epidemiological profile of Buruli ulcer in the district of Tiassal\u00e9, south C\u00f4te d\u2019Ivoire","volume":"175","author":"RTAS N\u2019krumah","year":"2017","journal-title":"Acta Trop"},{"key":"pntd.0010608.ref010","author":"World Health Organization","year":"2021","journal-title":"Number of new reported cases of Buruli ulcer"},{"key":"pntd.0010608.ref011","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pntd.0004385","article-title":"Differential Diagnosis of Skin Ulcers in a Mycobacterium ulcerans Endemic Area: Data from a Prospective Study in Cameroon","volume":"10","author":"L Toutous Trellu","year":"2016","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0010608.ref012","doi-asserted-by":"crossref","first-page":"e0005557","DOI":"10.1371\/journal.pntd.0005557","article-title":"Yaws resurgence in Bankim, Cameroon: The relative effectiveness of different means of detection in rural communities","volume":"11","author":"AU Boock","year":"2017","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0010608.ref013","author":"World Health Organization (WHO)","year":"2019","journal-title":"WHO Meeting on Buruli ulcer and other skin NTDs (25-27th March 2019)"},{"key":"pntd.0010608.ref014","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pntd.0006489","article-title":"Skin disease prevalence study in schoolchildren in rural C\u00f4te d\u2019Ivoire: Implications for integration of neglected skin diseases (skin NTDs)","volume":"12","author":"RR Yotsu","year":"2018","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0010608.ref015","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1111\/j.1365-4632.2012.05822.x","article-title":"Skin diseases among school children in Ghana, Gabon, and Rwanda","volume":"52","author":"A Hogewoning","year":"2013","journal-title":"Int J Dermatol"},{"key":"pntd.0010608.ref016","doi-asserted-by":"crossref","DOI":"10.3402\/gha.v8.27271","article-title":"Causes of death in the Taabo health and demographic surveillance system, C\u01d2te d\u2019Ivoire, from 2009 to 2011","volume":"8","author":"S Kon\u00e9","year":"2015","journal-title":"Glob Health Action"},{"key":"pntd.0010608.ref017","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1093\/ije\/dyu221","article-title":"Health & demographic surveillance system profile: The taabo health and demographic surveillance system, c\u00f4te d\u2019ivoire","volume":"44","author":"S Kon\u00e9","year":"2015","journal-title":"Int J Epidemiol"},{"key":"pntd.0010608.ref018","article-title":"Community-based wound management in a rural setting of C\u00f4te d\u2019Ivoire","author":"S Toppino","journal-title":"Linked submission to PLoS Neglected Tropical Diseases"},{"key":"pntd.0010608.ref019","first-page":"40","article-title":"A Cross-sectional Validation Study of Using NERDS and STONEES to Assess Bacterial Burden","volume":"55","author":"KY Woo","year":"2009","journal-title":"Ostomy Wound Manag"},{"key":"pntd.0010608.ref020","doi-asserted-by":"crossref","first-page":"103208","DOI":"10.1016\/j.jbi.2019.103208","article-title":"The REDCap consortium: Building an international community of software platform partners","volume":"95","author":"PA Harris","year":"2019","journal-title":"J Biomed Inform"},{"key":"pntd.0010608.ref021","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)-A metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"PA Harris","year":"2009","journal-title":"J Biomed Inform"},{"key":"pntd.0010608.ref022","doi-asserted-by":"crossref","first-page":"660","DOI":"10.2471\/BLT.07.043497","article-title":"Development of a WHO growth reference for school-aged children and adolescents","volume":"85","author":"M De Onis","year":"2007","journal-title":"Bull World Health Organ"},{"key":"pntd.0010608.ref023","volume-title":"Recommendations for data collection, analysis and reporting on anthropometric indicators in children under 5 years old","author":"UNICEF WHO","year":"2019"},{"key":"pntd.0010608.ref024","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pntd.0005331","article-title":"Assessing and managing wounds of Buruli ulcer patients at the primary and secondary health care levels in Ghana","volume":"11","author":"NO Addison","year":"2017","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0010608.ref025","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pntd.0006584","article-title":"Integrated approach in the control and management of skin neglected tropical diseases in Lalo, Benin","volume":"12","author":"YT Barogui","year":"2018","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0010608.ref026","article-title":"Epidemiology and disease burden of Buruli ulcer: a review","author":"G Pluschke","year":"2015","journal-title":"Res Rep Trop Med"},{"key":"pntd.0010608.ref027","author":"WHO","year":"2018","journal-title":"Country Data for Buruli Ulcer"},{"key":"pntd.0010608.ref028","author":"WHO","year":"2021","journal-title":"Number of confirmed yaws cases reported"},{"key":"pntd.0010608.ref029","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1007\/s00268-015-3369-x","article-title":"Surgical management of chronic wounds in a Buruli ulcer endemic area in Central Africa","volume":"40","author":"ML Guifo","year":"2016","journal-title":"World J Surg"},{"key":"pntd.0010608.ref030","doi-asserted-by":"crossref","first-page":"e1751","DOI":"10.1371\/journal.pntd.0001751","article-title":"A Case of Cutaneous Tuberculosis in a Buruli Ulcer\u2013Endemic Area","volume":"6","author":"MW Bratschi","year":"2012","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0010608.ref031","doi-asserted-by":"crossref","first-page":"i53","DOI":"10.1093\/inthealth\/ihv071","article-title":"Social stigma towards neglected tropical diseases: A systematic review","volume":"8","author":"K Hofstraat","year":"2015","journal-title":"Int Health"},{"key":"pntd.0010608.ref032","article-title":"Wound and lymphoedema management","author":"WHO","year":"2010","journal-title":"WHO\/HTM\/NTD\/GBUI\/20101 I"},{"key":"pntd.0010608.ref033","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.pmedr.2017.02.024","article-title":"The global burden of child burn injuries in light of country level economic development and income inequality","volume":"6","author":"M Sengoelge","year":"2017","journal-title":"Prev Med Reports"},{"key":"pntd.0010608.ref034","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1016\/j.burns.2005.12.004","article-title":"Paediatric burn injuries in Sub Saharan Africa-an overview","volume":"32","author":"R Albertyn","year":"2006","journal-title":"Burns"},{"key":"pntd.0010608.ref035","author":"World Health Organization","year":"2011","journal-title":"Burn prevention: success stories and lessons learned"},{"key":"pntd.0010608.ref036","volume-title":"World health statistics 2021: monitoring health for the SDGs, sustainable development goals","author":"World Health Organization","year":"2021"},{"key":"pntd.0010608.ref037","doi-asserted-by":"crossref","first-page":"e422","DOI":"10.1016\/S2214-109X(14)70223-2","article-title":"Clinical epidemiology of laboratory-confirmed Buruli ulcer in Benin: A cohort study","volume":"2","author":"QB Vincent","year":"2014","journal-title":"Lancet Glob Heal"},{"key":"pntd.0010608.ref038","volume-title":"Treatment of mycobacterium ulcerans disease (buruli ulcer): guidance for health workers","author":"World Health Organization","year":"2012"},{"key":"pntd.0010608.ref039","doi-asserted-by":"crossref","first-page":"309","DOI":"10.2147\/IJWH.S182362","article-title":"Burden of surgical site infection following cesarean section in sub-Saharan Africa: a narrative review","volume":"11","author":"A Sway","year":"2019","journal-title":"Int J Womens Health"},{"key":"pntd.0010608.ref040","author":"UNICEF","year":"2016","journal-title":"Percentage of girls who have undergone FGM (as reported by their mothers, by place of residence and household wealth quintile)"},{"key":"pntd.0010608.ref041","volume-title":"WHO | Care of girls and women living with female genital mutilation","author":"WHO","year":"2018"}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0010608","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T17:29:39Z","timestamp":1665682179000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0010608"}},"subtitle":[],"editor":[{"given":"Eric H. Y.","family":"Lau","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,10,13]]},"references-count":41,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,10,13]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0010608","relation":{},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,13]]}}}