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A charity founded mainly by German dermatologists has provided funding for 30 community health workers who examine about 30 000 children a year in rural Kenya, looking for skin diseases and providing cheap or free treatment (British Journal of Dermatology2001;144:118–24). They provide 1% hydrocortisone cream for dermatitis, 1% gentian violet for bacterial infections, Whitfield's ointment for fungal infections, and 25% benzylbenzoate emulsion for scabies. Disappointingly, surveys carried out 1 year and 5 years after the start of the project showed little change in prevalence of dermatoses, in fact the prevalence of all dermatoses increased from 32% to 40%. Only tropical ulcers became significantly less common (1.2% in 1993, 0.1% in 1999). Flooding, cholera, and a teachers' strike all interrupted the project in 1998. As the authors point out, treatment schemes in rural Africa are very vulnerable to socioeconomic change.
General practice researchers in Australia (British Journal of General Practice 2001;51:112–6) and England (Ibid: 117–20) used a computer questionnaire (Australia) and a postal questionnaire (England) to identify children with asthma. The computerised system was found to give reliable results and the postal questionnaire identified asthma in 23% of children and more severe asthma in 16%, of whom 35% and 25% had no indication of asthma in their general practice records. Nevertheless, an editorialist (Ibid: 92–3) commenting on active case-finding in childhood asthma writes, “On the currently available evidence, it is difficult to …
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