Pattern of Skin Diseases and their Impact on Quality of Life Among Adults Attending the Dermatology Clinic at Muhimbili National Hospital, Tanzania

Abstract

Background: Skin diseases contribute substantially to morbidity worldwide and are associated with impaired health-related quality of life (HRQoL). In sub-Saharan Africa, clinico-epidemiological data remain scarce despite the high burden of dermatological conditions. Objective: To determine the pattern of skin diseases, associated sociodemographic and clinical factors, and their impact on HRQoL among adults attending the dermatology clinic at Muhimbili National Hospital, Tanzania. Methods: A hospital-based cross-sectional study was conducted at Muhimbili National Hospital, Dar es Salaam, from September 2021 to January 2022. Adults (≥18 years) attending the dermatology clinic were consecutively recruited. Diagnoses were made clinically and supported by laboratory examination (e.g., fungal microscopy, bacterial culture, biopsies) where necessary. Conditions were classified using ICD-10 groupings. Health-related quality of life was assessed using the validated Swahili version of the Dermatology Life Quality Index (DLQI). Data were analysed using SPSS v23. Associations were tested using the chi-square test and odds ratios (95% CI); p<.05 was considered statistically significant. Results: A total of 378 participants were enrolled; 158 (41.8%) were male, with an overall median age of 34 years (IQR 26–49). The most common disease categories were eczemas and urticaria 146 (38.6%), disorders of skin appendages 43 (11.4%), autoimmune diseases 38 (10.1%), fungal infections 30 (7.9%), benign neoplasms 23 (6.1%), bacterial infections 22 (5.8%), and viral infections 18 (4.8%). Skin diseases were significantly associated with sex, age, education level, depression, family history, endocrine disorders, and seasonal variation. The mean DLQI score was 9.7 ± 6.5, indicating moderate impairment. Notably, 43.7% of patients reported a very large or extremely large impact, particularly in domains related to work performance, symptoms, and clothing choices. Conclusion: Eczema and urticaria were the most prevalent conditions and had a substantial negative impact on patients’ health-related quality of life (HRQoL). Integrating routine HRQoL assessments, psychosocial support, and comorbidity screening into dermatology care is therefore recommended. Policymakers should prioritise the prevention and management of skin diseases, and future community-based studies, supported by laboratory confirmation, are needed to improve generalisability and diagnostic accuracy.