Current management of skin conditions in Kenya: exploring teledermatology preferences and perspectives among providers

Abstract

Background: Teledermatology programs may help expand access to care for skin conditions in areas that are underserved by dermatologists such as sub-Saharan Africa, but their success requires input from participating providers.

Objective: This study assesses teledermatology preferences among healthcare providers in Kenya.

Methods: An anonymous cross-sectional survey of nondermatology providers was conducted in Kenya from January to March 2024 at Aga Khan University Hospital-Nairobi and Kijabe Hospital.

Results: Among the 38 providers, 81.6% were physicians. Patient population was primarily Fitzpatrick skin types V and VI. Almost all (97.4%) regularly encountered patients with skin disorders, yet only 5.3% felt comfortable diagnosing and treating 80 to 100% of these disorders independently. Providers anticipated referring cases of rashes (76.3%), unclear diagnoses (63.2%), and infectious diseases (50%), among others, for teledermatology consultation. Only 10.5% reported utilizing teledermatology, although the majority believed it would be useful (91.9%) and improve patient care (89.5%). Preferred response time was <24 hours (81.6%). Most favored submitting cases via personal cell phones (86.8%), with 87.9% preferring submission through WhatsApp.

Limitations: Participants owned smartphones. The survey was distributed via WhatsApp.

Conclusion: Nearly all providers in Kenya see patients with skin conditions, but few utilize teledermatology services. Teledermatology could be extremely beneficial for patients and providers seeking dermatologic expertise.

Keywords: Africa; Kenya; dermatopathology; global health; practice patterns; skin conditions; teledermatology.

Fig. 1.

Types of skin conditions seen regularly and types of skin conditions providers anticipate referring to teledermatology. Percentages are calculated based on n = 38 as all 38 providers responded to both questions. Additional response options not listed above: For types of skin conditions seen regularly, one provider selected “other” with a free-text response indicating that this was breast cancer with skin involvement. There were no “other” responses for types of skin conditions providers anticipated referring to teledermatology. One provider, an imaging and diagnostic radiologist, indicated that none of their patients had skin conditions. For types of skin condition providers anticipated referring to teledermatology, 3 (7.9%) selected that they would not use a teledermatology service. On the survey, the following categories were listed as follows: infectious diseases: “Infectious diseases (such as bacterial, fungal, or viral infections)”; skin lesions: “Skin lesions or suspected malignancies”; HIV-related skin conditions: “HIV-related skin conditions (such as Kaposi sarcoma)”; and Hair disorders: “Hair disorders and alopecia.” Figure created via Fiverr. HIV, human immunodeficiency virus.