Impact assessment of IEC intervention on knowledge, attitude and practice (KAP) of community pharmacists / chemists regarding skin dermatophyte infection in Himachal Pradesh.â€

Dermatophyte infections of skin are one of the commonest dermatoses seen in dermatology clinics in India and has become an emerging public health concern. In recent years there is an outbreak of recurrent and chronic dermatophytosis. Today, we are facing an onslaught of chronic and recurrent dermatophytosis in volumes never encountered previously.

What has led to such a catastrophic situation in the Indian scenario is a hot topic of epidemiological and clinical research. Some predisposing factors particularly relevant to India are wide over-the-counter (OTC) availability and rampant use of topical steroid and antifungal combinations by the patients themselves or unrestricted prescription of these products by quacks and general practitioners.(1) Topical and oral antifungals in suboptimum and irrational regimens are the most often misused medications in India, which are prescribed by various medical specialists/pharmacists/chemists who tend to label a majority of skin lesions as “fungal infections.†(1)The availability of such medications OTC is adding to the current situation. Cost of these medications may also be another factor for nonadherence or poor compliance.(1)

On website of centre for disease control (CDC) there is a mention of this problem of recalcitrant dermatphytosis in India. Here people can buy creams containing strong steroids without a prescription. Many of these steroid creams also contain antifungal and antibacterial medicines, and the labels say that the cream can be used to treat fungal infections.(2) Also, healthcare providers in India report seeing more cases of severe dermatophytosis in people who have used these combination medications.(3),(4–6) These infections have been reported to cover large parts of the body, last for months or longer, and spread to family members.(6)

As chemists in India have an important role in dispending OTC drugs, capturing the knowledge, attitudes, and practices (KAP) of pharmacists regarding fungal infection is important for developing future community health action strategies and plans. We plan to conduct a KAP survey among  pharmacists and chemists  across 5 districts of Himachal Pradesh which caters around more than half of himachal population. We will also conduct an education IEC programme post KAP survey and reassess KAP immediately post IEC and  after 6 months. This will further help to intervein an important factor in this emerging menace of chronic and recalcitrant dermatophytosis.