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Advice and Services Provided by an Outreach Albino Clinic in Tanzania

Sandy R. McBride, MBBS, MRCP; Barbara J. Leppard, DM, FRCP

Arch Dermatol. 2002;138:629-632.

Objective  To determine an albino population's expectations from an outreach albino clinic, understanding of skin cancer risk, and attitudes toward sun protection behavior.

Design  Survey, June 1, 1997, to September 30, 1997.

Setting  Outreach albino clinics in Tanzania.

Participants  All albinos 13 years and older and accompanying adults of younger children attending clinics. Unaccompanied children younger than 13 years and those too sick to answer questions were excluded. Ninety-four questionnaires were completed in 5 villages, with a 100% response rate.

Interventions  Interview-based questionnaire with scoring system for pictures depicting poorly sun-protected albinos.

Results  The most common reasons for attending the clinic were health education and skin examination. Thirteen respondents (14%) believed albinism was inherited; it was more common to believe in superstitious causes of albinism than inheritance. Seventy-three respondents (78%) believed skin cancer was preventable, and 60 (63%) believed skin cancer was related to the sun. Seventy-two subjects (77%) thought sunscreen provided protection from the sun; 9 (10%) also applied it at night. Reasons for not wearing sun-protective clothing included fashion, culture, and heat. The hats provided were thought to have too soft a brim, to shrink, and to be ridiculed. Suggestions for additional clinic services centered on education and employment. Albinos who had read the educational booklet had no better understanding of sun avoidance than those who had not (P = .49).

Conclusions  There was a reasonable understanding of risks of skin cancer and sun-avoidance methods. Clinical advice was often not followed for cultural reasons. The hats provided were unsuitable, and there was some confusion about the use of sunscreen. A lack of understanding of the cause of albinism led to many superstitions.

From the Regional Dermatology Training Centre, Kilimanjaro Christian Medical Centre, Moshi, Tanzania. Dr McBride is now with the Department of Dermatology, Royal Free Hospital, London, England.

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