Prevalence Of Pityriasis Alba Disease Among Primary Schools Children In Al-Kufa City.

This is a cross-sectional study was conducted in Al-Kufa city/ Al-najaf Al-Ashraff province to determine the prevalence of pityriasis alba in the children of primary school. Study aims to determine the prevalence of Pityriasis alba in the children of primary schools. The setting of study: The study was conducted in Al-Kufa city /Al-Najaf Al-Ashraff province. Data collection : During the period from 1/4/2011 to 31\4\2012 . The study sample: The total number of primary school submit ة ted was 38 and the number of total pupil were 18356, and founded the number of infected pupil with pityriasis alba was 1935 with percentage (10.54%), number of male was 1067 (55.14%) and number of female was 868(44.86%). Data analysis : The data was analyzed through the application of descriptive statistical analysis that include(Chi-square) , and application of inferential statistical analysis that include (chi-square , P value) . Results: The results of this study showed that the prevalence of pityriasis alba in the male is more than in the female, the more exposed infected age group was between (6-8 year). The white patches were more clear in dark color, appearance of patches in the face was more clear than other parts of the body. The number of pupil who suffered from anemia was 232 (12%), and 242 (12.5%) suffered from infected with Oxyuris vermicularis, Giardia lamblia, Entamoeba histolytic and other parasites. Conclusion: We conclude in this study that the prevalence of pityriasis alba was acceptable in comparison with other similar studies in many countries, this may reflect some negligence, poor personal hygiene and nutrition in primary schoolchildren, care health provided was inadequate. Recommendation: Based on the above results , this study recommended that the primary health care sector must examine the children in beginning of study. Periodic skin examination is of a high value. Health education for teachers and parents on sound personal hygiene and clean environment are recommended.


INTRODUCTION:
Skin is a mirror of the body (1).Skin diseases are common in children, and considered a major health problem in the pediatric age group.They are associated with significant morbidity (2).Skin disorders are among the most frequent ailments of schoolchildren in both developing and industrialized countries (3).Pityriasis alba is a common Coetaneous disorders characterized by asymptomatic, hypopigmented patches on the face, neck ,trunk and proximal extremities of children (4) .The cause of PA is still unknown, but the condition is widely considered as a mild form of atopic dermatitis (5).Pityriasis alba disease in children are more influenced by socio-economic status, climatic exposure, dietary habits and external environment as compared to adults, cutaneous dermatoses are common in children during school going years (6), Poverty, malnutrition, overcrowding, poor hygiene, illiteracy and social, backwardness (7), helminthes (8), iron deficiency ( 9), soaps and Cutaneous xerosis (10).Recent studies have found direct relations between the incidence of PA disease and atopy, the amount of the sun exposure, the lack of sunscreen use, and frequency of bathing (11).PA disease is found all over the world.It is quite common, affecting between 1.9 and 5.25% of all children , the peak of incidence is between 6-12 years (6).
There is a relationship between the prevalence of PA associated with other diseases affected the same patient due to increase the prevalence, Al-Rubaiy KK (2004) from Iraq, was demonstrated, that in the thalassimia disease the prevalence of PA increased to 38.5% (30), also in Egypt was 13.5% in deaf and mute (1) , in Suadia Arabia, Mostafa A (2000) found the prevalence of pityriasis alba in the blind was 21.9 % (31) .

OBJECTIVES OF THE STUDY :
1-To determine the prevalence of Pityriasis alba in the children of primary schools.2-To determine the measures that due to decrease Pityriasis alba .

MATERIALS AND METHODOLOGY
Administrative Arrangement: Prior to actual collection of data, formal administrative approval was to conduct the study from the ministry of education(primary schools) conducted in Al-Kufa city/ Al-najaf Al-Ashraff province to order to conduct the study .

Setting of the study:
The study was conducted in Al-Kufa city/ Al-Najaf Al-ashraff during the period from ( 1/10/2011 to 31\4\2012).The study was established by data collected from primary schools.Design of the study: The cross-sectional study was carried out to determined the prevalence of Pityriasis alb.
The sample of the study: The study involved 38 primary schools with 18356 schoolchildren, the number of male pupil was 10010, while female was 8346.

Tools of the study:
1-All the pupils were examined clinically directly under the sun light to diagnose the PA in the schoolchildren.2-General stool examination .3-Hemoglobin percentage.Data collection: The data, which were collected in 38 schools from period ( 1/10/2011 to 31\4\2012).Statistical analysis: Descriptive and analytical statistics were carried out by utilizing the statistical package for social science (SPSS).Chi-squire was applied for categorical variables to obtain any statistical differences.

Results:
The study was showed that the prevalence of pityriasis alba among schoolchildren was 10.5%.The most age group affected was between 6 and 8 year, also the percentage in the male it was higher than female, the main affected age group was between 6-8 years, the patches were more apparent in pupil with dark color skin than white, and the commonest site of lesion which affected was the face, neck, less common trunk and exterminates .The study shows many pupils were suffering from anemia, which was common in the female than in male, and intestinal parasites, which were versus anemia, in the male was more than in the female.Table (5) shows difference between male and female in relation to presence of anemia among infected pupils, and the females were more affected than males.Table (7) shows that the face was the most site of lesion than other sites .Table (8) shows that the lesions were clear in pupils with dark color more than the white color.

DISCUSSION:
In this study, table (1) showed that the prevalence of pityriasis alba was 10.55% ,it was clearly the percentage of PA in male was 10.7 %, it is more than female 10.4%, because it is proportional with number of male 10010 (54.53%) to the female 8346 ( 44,47%), this result was less the results of many studies, as Blessman which was (58.25%) (2002)( 8 (35 ).Table (2) showed that the common affected group of schoolchildren was 6-8 years, but Soudabe Tirgar (2010) in his study, found the common age group was 10 years but in study of the site of lesion in this study was higher in the face (91%) table (3), as in the study of Sicherer SH, Sampson (35).

CONCLUSION:
We conclude in this study that the prevalence of pityriasis alba was acceptable in comparison with other similar studies in many countries that have the same conditions , this may reflect some negligence, poor personal hygiene and nutrition in primary schoolchildren, care health provided was inadequate.

RECOMMENDATIONS:
According to the results of the study, primary health care sector must examine the children in beginning of study.Periodic skin examination is of a high value.Health education for teachers and parents on sound personal hygiene and clean environment is recommended.

Table ( 2
) shows that the age group of 6-8 years was more than other groups

Table ( 3): Distribution of infected pupils according to total number and gender
(3)le(3)shows that males infected pupils are more than females infected pupils.

Female 288 12 -more Male 326 607 31.4 Female 281 Total Male 1067 1935 100 Female 868 There is no significant difference between age group in relation to infection Χ 2 =o.423 P=o.809 (No significant) p value >0.05 Table
(4)shows that the more age group affected of pupils was between 6-8 years.

Table ( 6
) shows that the males were more infected by parasites than females.