Introduction:

Dermatological disorders are quite common in paediatric practise. Atopic dermatitis, contact dermatitis, birthmarks, and acne are few of most frequent paediatric skin problems. ¹ Skin diseases particularly in children’s, are frequently accompanied by feelings of low self-esteem and humiliation, having a substantial influence on quality of life. ^{2, 3, 4, 5}

According to the Economic Survey 2022-23, 65% of India's population live in rural areas. In 2021, 25.69% of India's population was between the ages of 0 and 14, and 67.51%. Several studies conducted in metropolitan settings do not accurately represent the real condition of illnesses in community. ⁶

According to estimates, there are 1.42 million blind children worldwide and 17.52 million children with moderate to severe vision impairment. Approximately 75% of these individuals reside in low- to middle-income nations, where the prevalence is as high as 1.5 per 1000 children, as opposed to 0.3 per 1000 in high-income nations. An estimated 500,000 children, or one every minute, lose their vision each year. ^{7, 8}

Most of the current research indicates corneal & lenticular disorders are most common reasons of blindness, but refractive errors are key reasons of blindness as well as visual impairment among children who do not attend blind schools. ^{9, 10}

Using a school survey, researchers aim to assess the prevalence and patterns of skin and eye problems among children aged 5 to 14 in a rural service region. The study seeks to understand the level of health awareness and accessibility to healthcare services within the community. The findings will contribute to the development of healthcare policies tailored to meet the genuine needs of children in the area. The objective was to study prevalence of dermatological and ocular morbidities in school children.

Materials and Methods:

RESULTS

Out of 500 school children screened, 345 (69%) had dermatological morbidities and 38 (7.6%) had ocular morbidities. Our findings revealed prevalence of dermatological morbidities as 42% in age bracket of 5-10 years whereas 27% in age bracket of 11-14 years. Also the study revealed prevalence of ocular morbidities as 3.6% in age bracket of 5-10 years and 4% in age bracket of 11-14 years. Table 1

Our findings revealed prevalence of dermatological morbidities amongst boys as 50.6% whereas 18.4% in girls. Also, the findings revealed prevalence of ocular morbidities amongst boys as 4.2% whereas 3.4% in girls. Table 2

Gender wise type of dermatological manifestations revealed that among boys, infectious & infestation type were 27.7%, non-infectious were 43.5% and nutritional deficiencies were 28.9%. Among girls, infectious type were 29.3%, non-infectious were 16.3% and nutritional deficiency were 54.3%. Table 3

The Figure 1 shows the range of skin conditions identified among school children within the study's sample. Nutritional disorders were the most common, affecting over a third of the cases at 35.65%. The second-highest category was infections and infestations, comprising 28.10% of the findings. Eczema, which is another term for dermatitis, was seen in 8.60% of the children. There were also a moderate number of cases involving the skin's keratinization (6.95%), scaly skin conditions known as papulosquamous disorders (6.08%), and hair disorders (5.21%). Less frequently observed were hypersensitivity reactions, affecting 3.47%, and disorders related to skin pigmentation and reactions to light, both at less than 3%. Sebaceous gland issues and nevi (moles) were the least common, each making up 1% of the total conditions noted.

In boys, the study found refractive error to be the most common ocular manifestation at 33.33%. This was followed by Vitamin A Deficiency at 28.57%, Conjunctivitis at 19.04%, and both ptosis and pterygium at 9.52% each. Among girls, refractive error was also the most common, seen in 35.29%, with Vitamin A Deficiency at 29.41%, Conjunctivitis at 23.52%, and ptosis and pterygium both at 5.88%. Table 4

DISCUSSION

Out of 500 school children screened, 345 (69%) had dermatological morbidities and 38 (7.6%) had ocular morbidities.

In our study prevalence of dermatological morbidities amongst boys were 50.6% whereas 18.4% in girls. Also, the prevalence of ocular morbidities amongst boys was 4.2% followed by 3.4% in girls.

Jose G et al. into their research observed, rate of skin ailments was noticed to be higher in boys (34.7%) than in girls (33.5%), although this was not statistically significant. ¹¹

Gender wise type of dermatological manifestations revealed that among boys, infectious and infestation type was 27.7%, non-infectious were 43.5% and nutritional deficiencies were 28.9%. Among girls, infectious and infestation type was 29.3%, non-infectious were 16.3% and nutritional deficiencies were 54.3%.

In the Jose G et al.’s study ¹¹ , there were 346 (50.73%) infectious dermatoses, 253 (37.10%) non-infectious dermatoses and 83 (12.17%) nutritional deficient dermatoses. Almost 53 different forms of skin lesions were found amongst children, with 15 being infectious, 35 being non-infectious, and three being nutritional dermatoses. 54 children have many types of skin disorders, including Infections (28.1%), Eczema (dermatitis) (8.6%), Papulosquamous disorders (6.08%), Pigmentary disorders (2.6%), Hypersensitivity disorders (3.47%), Keratinization disorders (6.95%), Hair disorders (5.21%), Nutritional disorders (35.65%), Nevi (0.86%), Sebaceous gland disorders (0.86%), and Photo-dermatoses (1.44%).

Chitapur UG et al. ¹² reported that commonest occurrence of dermatoses observed were infections & infestations constituting 40.5% (223 cases), followed by eczema/dermatitis constituting 14.4% (79 cases). Of the total of 223 (40.5%) children having infections and infestations, fungal infections were predominant affecting 77 children (14%) closely, followed by parasitic infestations seen in 76 children (13.8%).

Contrasting findings were observed in the studies by Baskaran et al. ¹³ , Sangameshwara et al. ¹⁴ , Poudyal Y et al. ¹⁵ , Reddy and Narasimha Rao ¹⁶ , Gupta AK et al. ¹⁷ . In all these studies, most prevalent infection was fungal infection. Parasitic was second most common in studies conducted by Baskaran et al. ¹³ , Poudyal et al. ¹⁵ , Reddy and Narasimha Rao ¹⁶ , and Gupta et al. ¹⁷ as noted into our research. Increased frequency of fungal infection in the elderly might be one of the explanations for the comparable increased incidence in youngsters.

Gender wise type of ocular manifestations revealed that among boys, refractive error was seen commonly in 33.33%, followed by Vitamin A Deficiency in 28.57%, Conjunctivitis in 19.04%, ptosis in 9.52% and pterygium in 9.52% cases. Among girls, refractive error was seen commonly in 35.29%, followed by Vitamin A Deficiency in 29.41%, Conjunctivitis in 23.52%, ptosis in 5.88% and pterygium in 5.88% cases.

Singh V et al. as per their study, the total rate of ocular morbidity was 29.35%. A total of 4838 pupils were tested. There were 2271 men and 2567 women. The overall incidence of ocular morbidity was 29.35%, with men accounting for 29.33% and females accounting for 29.37%. ¹⁸

These findings were comparable to those of research done in Delhi by Kumar et al., as he observed 22.7% prevalence. ¹⁹ Gupta M et al. ²⁰ and Chaturvedi et al. ²¹ found prevalence as 31.6% and 40% respectively. International investigations in Tibet by Lu et al. and Shrestha et al. found an overall prevalence of ocular morbidity as 18.36% and 34.2%, correspondingly, similar to our findings. ^{22, 23}

CONCLUSION:

The study's findings stress the importance of early detection and intervention for skin and eye conditions among school children in rural Maharashtra. Boys often face non-infectious skin issues, while girls commonly experience nutritional deficiencies. Eye problems like refractive errors and conjunctivitis are prevalent, indicating a need for regular screening. This underscores the necessity for broader public health initiatives to prevent and manage these issues, ultimately contributing to stronger communities.