Closing Dermatology Research Gaps Will Benefit Africa

Times are changing and African consumers demand more from their beauty products. A growing expectation of high quality and functional products adapted to their needs. The growing demand for products designed for African natural hair exemplifies this movement. In addition, epidemiological reports show an increasing prevalence of 20 to 87% of skin diseases in developing countries, motivating a large proportion of visits and therefore weighing on primary care centers. Investing in research is vital to further spur innovation on the continent, guide the creation of guidelines to demotivate harmful grooming practices such as bleaching, which has been linked to skin cancer, and provide relief to the health system,

There are many gaps in our knowledge about the physiology of Afro hair and skin, especially with regard to disease states as well as the effect of daily habits. For example, a recent study led by Dr. Kwezikazi Molamodi, an expert in the science of Afro hair, looked at the impact of common hair care practices on Afro hair fibers. The study concludes that hair care practices as simple as combing should be accompanied by strengthening or protective hair care routines. Likewise, the age-old myth that black skin is completely protected from the effects of the sun and does not need sun protection measures has been refuted by recent studies involving black participants in South Africa, Nigeria and the United Kingdom. -United. These studies revealed that:

• More than 50% of the 74 study participants based in Africa had suffered sunburn2;
• Sun-induced DNA damage following sun exposure is found in black skin with a significant differential gradient of melanin protection in the black skin epidermis3
• Skin color has no effect on the rate of DNA repair in vivo4

Interestingly, the sunscreen studies by Verschoore et al5,6 showed that for dark skin7, just eight weeks of daily sunscreen application (with high UVA protection) resulted in a significant improvement in texture. skin and dyschromia; the latter being a major beauty problem in Africa. These studies were mostly the first of their kind to include black skin and answer relevant questions that affect the daily grooming habits of black people.

Likewise, the prevalence of atopic dermatitis (AD) is increasing in developing regions, especially in Africa. In sub-Saharan Africa, the following disorders are most common in children: pyoderma (prevalence range 6.9-35%) and scabies (1.3-17%), viral skin conditions (0.4-9%), pediculosis capitis (0-57%), and dermatitis (0-5%) 8. Older people suffer from a burden of disability due to HIV-related skin diseases, fungal skin diseases and dermatitis. There is some evidence that cesarean section increases the risk of AD in some people. In an unpublished Nigerian study, Professor Frances Ajose, University of Lagos, explored newborn skin care practices in rural Nigeria where AD is rare and discovered the benefits of the microbiome derived from vaginal deliveries and the use of acidic pH skin care to provide microbiome coverage that supports the development of life-long lasting immune responses.

There is a high prevalence of diseases without specific diagnosis in Africa. These are fundamentally due to the lack of high quality clinical trials to inform therapeutic approaches, in addition to the very rare clinical practice collaborations in African countries. Without guidelines, healthcare professionals in these resource-constrained settings may be forced to rely on non-validated information, which can; harm patients, considerably lengthen the duration of treatment and reduce the quality of life of those affected. The immediate benefits of increased investment in dermatology research will indirectly reduce functional disturbances in working life and directly benefit patients who, possibly estimated for India, spend up to 73% of their monthly income. per capita in health care.

A local advantage

Africa could benefit even more from its dual patient care practices. There is a widespread custom of traditional community healers who use the incredibly unique flora of plants and animals on the African continent. In a race to offer consumers more natural products, the beauty industry is slowly turning to traditional medicine as a source of bioactive compounds and the pharmaceutical industry as a source of inspiration for the production of synthetic drugs. A better understanding of the chemistry behind the medicinal mixtures used by traditional healers would provide additional information on the effectiveness of these natural herbal products while exposing new ways and uses. This research will propel Africa’s reputation as a research power, providing unique opportunities for Africa-led and funded research, in addition to translating into an empowered workforce and economic benefits to the world. continent. It should be remembered that the growth of highly industrialized economies is attributed to technical innovation and not exclusively to labor and capital9. A more important element supporting investment in traditional medicine research is that in addition to the ease of availability of these remedies, the efficacy and toxicity guidelines will provide empirical evidence to the public and reduce reliance on it. with regard to more expensive Western medicine.

Public governance in medical laboratory research

The COVID-19 pandemic highlights the importance of investing in strengthening medical laboratories, research and innovation in Africa. Medical laboratory research is vital for the survival of mankind as it ensures public health, product safety and the detection of toxins in various fields. Medical laboratory research and innovation has undergone a transformation in Africa over the past two decades with increased investment from the public and private sectors. Although compared to other continents, Africa lags behind, both in terms of capital and the quality of infrastructure investments and the ratio of available staff. Africa represents less than 1% of global research. In 2020, the African countries with the most innovations according to the World Health Organization (WHO) were South Africa (13%), Kenya (10%), Nigeria (8%) and Rwanda (6%) 10. The World Bank Group also notes that African countries invest less in innovation than any other continent at around 0.01% per capita. In 2018, low-income countries received only 0.2% of all direct grants for biomedical research from major donors. The investment of African governments in health care requires deliberate will. There is also a need for these investments to be accompanied by a patient-centered approach, where medical research should improve the clinical experience and patient outcomes. The aim is to help solve relevant health problems by facilitating collaboration between laboratory specialists and clinical professionals so that they can share their expertise in the research process and provide a high quality service that respects the innovation, data communication, results in fast and accurate data delivery. , and ensures that patients receive the best possible care.

Reference

1. Molamodi K, Fajuyigbe D, Sewraj P, Gichuri J, Sijako B, Galliano A, Laurent A. Quantifying the impact of braiding and combing on the integrity of natural African hair. Int J Cosmet Sci. Jun 2021; 43 (3): 321-331.
2. Diffey BL, Fajuyigbe D, Wright CY. Sunburns and sun protection for black skin. Int J Dermatol. 2019 Sep; 58 (9): 1053-1055.
3. Fajuyigbe D, Lwin SM, Diffey BL, Baker R, Tobin DJ, Sarkany RPE, Young AR. The distribution of melanin in the human epidermis provides localized protection against DNA damage and is consistent with the differences in skin cancer incidence in extreme phototypes. FASEB J. 2018 Jul; 32 (7): 3700-3706.
4. Fajuyigbe D, Douki T, van Dijk A, Sarkany RP, Young AR. Dark dimers of cyclobutane pyrimidine form in the epidermis of Fitzpatrick I / II and VI skin types in vivo after exposure to simulated solar radiation. Pigment Cell Melanoma Res. May; 34 (3): 575-584.
5. Sarkar R, Garg VK, Jain A, Agarwal D, Wagle A, Flament F, Verschoore M. A randomized study to evaluate the efficacy and effectiveness of two sunscreen formulations on Indian skin types IV and V with pigmentation irregularities. Indian J Dermatol Venereol Leprol. 2019 March-April; 85 (2): 160-168.
6. Grimes P, Halder R, Verschoore M, Wangari-Talbot J, Pillai K, Foltis P, Bouez C, Galdi A, Abdelhalim D, Liao IC, Zheng Q. Long term benefits of daily sunscreen with broad spectrum sunscreen in the Hispanic female population of the United States. J Drugs Dermatol. 2020 Mar 1; 19 (3): 236-242.
7. Effectiveness of using sunscreen for uniform skin pigmentation in colored skin. Halder R, Rodney I, Munhutu M, Foltis P, Nielson M, Verschoore M, Oresajo C. JAAD. May 2015; 72 (5 supplement 1): AB215
8. World Health Organization. (2005). Epidemiology and management of common skin diseases in children in developing countries. World Health Organization.
9. Rosenberg N (2004) Innovation and economic growth. OECD, Paris
10. Collins Boakye-Agyemang, Saya Oka, WHO Africa Health Emergencies Program https://www.afro.who.int/news/covid-19-spurs-health-innovation-africa
11. World Health Statistics Report 2021, World Health Organization. https://www.who.int/data/gho/publications/world-health-statistics