Assessment of Skin Infections among Long-Stayed Patients at the Accra Psychiatric Hospital in Ghana

Abstract

Background: The high prevalence rate of skin infections is strongly linked to socioeconomic level whereas the incidence of skin infections is linked to poor hygiene, climatic factors and interpersonal transmission Aim: The main aim of the study was to assess skin infections among long-stayed patients at the Accra Psychiatric hospital. The study also assessed facility based factors, as well as Patient based factors. Methods: This research employed both qualitative and quantitative research design to address the stated objectives and draw conclusions.The study population was made up of 7,803 patients admitted to the hospital for more than one month and were either diagnosed of skin infections or not during their stay at the hospital. A sample size of 380 folders of the patients admitted were drawn for the study.A retrospective review of these folders of the patients admitted for more than a month from the period of 2013 to 2017 were randomly reviewed to document skin infection types. During the analysis inferential statistics were employed. The data was analyzed using descriptive and inferential statistics. Also patients who are still on admission and have been diagnosed of skin infections during their stay were interviewed. The interviews were analyzed using content analysis Results: The types of skin infection recorded at the hospital include Acne, Allergic Dermatitis, Boils, fungal dermatitis, eczema, pruritis, tinea coporis, dermatitis, pityriasis versicolor, scabies, seborrheic dermatitis, dermatomania, diaper rash, foot rot, chicken pox, chronic skin infections, folliculitis, herpes simplex, impetigo, miliary rash, popular urticaria and Cellulitis etc. However out of the (n=380) patients, 63.7% were males, 46.8% had skin infections with cellulitis (19.1%) and fungal dermatitis (18.0%) being the most prevalent of the infections. The results revealed that patients with SHS/ A level/O level are more likely to have skin infection as compared with students with no education. The p-value of 0.026 (which is less than the 0.05 significance level) shows that the relationship is significant. Females are less likely to have skin infection than males. The p-value of 0.03 (which is less than the 0.05 significance level) shows that the relationship is significant. Patients who have stayed in the hospital for 1 to 5 years were more likely to get skin disease than patients who have stayed for less than a year. Patients who are age 46 to 55 years are less likely to get skin disease than patients who were age 25 years and below. When asked about the facility-based factors which may predispose patients to skin infections all the interviewees said the environmental conditions were bad. . One of the male patients elaborated that “there is odor in the bathrooms and the wards since some patients urinate in small gutters inside the ward. There are also feaces in the toilet most of the time because patients do not flush due to water shortage and regular cleaning is not done by the cleaner. The mattress I sleep on is dirty and I suspect that might have caused the skin disease”. CONCLUSION: Some skin infections were recorded in long-stayed patients’ folders at the APH. The most prevalent of these skin infections identified were cellulitis and fungal dermatitis. Younger and male patients on admission at the APH were more likely to have skin infections compared to older and female patients.