Pattern of skin diseases and prescribing practice in dermatology in public and faith based hospitals in three regions of Tanzania

Skin diseases account for a higher proportion of outpatient attendances in Tanzania and they were among the top ten diseases of hospital admissions for children in 2009. Irrational medicine prescribing and use are serious global problems. The study investigated the prevailing skin diseases and the prescribing practice among out patients in public and faith based hospitals in three regions of Tanzania. Types of skin diseases and data for prescribing indicators were collected from patient records for a period of one year; January to December 2014 using WHO-Prescribing Indicator Forms. Structured questionnaires were used to obtain data from 43 OPD prescribers on availability and utilization of National Standard Treatment Guidelines (STG). A total of 2151 medicines were prescribed for 1020 prescriptions with average of 2.1 medicines per encounter. Medicines prescribed by generics constituted 75% of the prescribed medicine 81-90% were from the Essential Medicine List while 72% of prescribers consulted STGs. Furthermore, 68.7% of the patients were treated in accordance with STGs. Types of skin diseases treated included noninfectious dermatoses (63.8%) and infectious dermatoses (36.2%) which included dermatitis variants (40%), pyoderma (19%) and superficial mycosis (12%). The prescribing practice was agreeable with WHO guidelines for most of medicine use indicators except for percentage encounter with antibiotics, generic prescribing and availability of STGs. It was also noted in this study that steroids we irrationally prescribed. There is a need for continuing education on rational prescribing of antibiotics, use of generics and increased access to STGs which will lead to effective management of skin diseases.