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Prevalence, exposure and the public knowledge of keloids on four continents

  • Guy H M Stanley
    Correspondence
    Corresponding author: Dr Guy H M Stanley, Burn Injury Research Unit, The University of Western Australia, 35 Stirling Hwy, Crawley, WA 6009, Australia
    Affiliations
    State Adult Burns Unit, Fiona Stanley Hospital, SMHS, Western Australia

    Burns Injury Research Unit, University of Western Australia, Crawley, Western Australia
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  • Elizabeth R Pitt
    Affiliations
    Department of Mathematical Sciences, The University of Bath, England
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  • Diana Lim
    Affiliations
    School of Medicine, The University of Nottingham, England
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  • Jonathon Pleat
    Affiliations
    Restore-Research

    Department of Plastic and Reconstructive Surgery, North Bristol NHS Trust, England
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  • The Keloid Survey Collaborative
    Author Footnotes
    ⁎ The Keloid Survey Collaborative (all names citable in PubMed author field): Research librarian: Rina Rukmini. Manuscript revisers and (in alphabetical order): Emma Gregory, Lisa Martin, Aaron Wernham. Singapore collaborators (in alphabetical order): Grace Tan, Bien Keem Tan. China collaborators (in alphabetical order): Jianlan Liu, Ningwen Zhu. Malaysia collaborator: Ahmad Zaudi.
  • Author Footnotes
    ⁎ The Keloid Survey Collaborative (all names citable in PubMed author field): Research librarian: Rina Rukmini. Manuscript revisers and (in alphabetical order): Emma Gregory, Lisa Martin, Aaron Wernham. Singapore collaborators (in alphabetical order): Grace Tan, Bien Keem Tan. China collaborators (in alphabetical order): Jianlan Liu, Ningwen Zhu. Malaysia collaborator: Ahmad Zaudi.
Published:November 21, 2022DOI:https://doi.org/10.1016/j.bjps.2022.11.017

      Summary

      Introduction

      Keloid scars are associated with physical and psychological sequelae. No studies have investigated the general public's understanding of keloids. Targeted, short educational interventions in susceptible individuals may aid understanding of the condition and compliance with treatment. We aimed to identify the population with the highest prevalence and lowest knowledge.

      Methods

      We surveyed four countries to determine the public understanding of keloids. A quantitative, subjective, cross-sectional street survey was designed using the Knowledge, Attitudes and Practice Model principles. Target populations were cities in Ghana, Australia, Canada and England. Surveyors used a hybrid stratified/convenience sampling method. Primary outcomes were prevalence, exposure to keloids as an entity and overall keloid knowledge score compared across demographic groups. Study data has been made available in full for reproducibility and education (https://doi.org/10.17605/OSF.IO/3KZ5E)

      Results

      There were 402 respondents, median age 32 (interquartile range 25-45.25) years, of which 193 were females. The survey was carried out between June 2015 - October 2017. The prevalence of self-identified keloids was 11% in Ghana, Australia 6%, Canada 2%, and England 7%. Prevalence, exposure and knowledge were higher in the Ghanaian population.

      Conclusions

      There was association between knowledge, prevalence and the exposure to keloids as an entity. Findings may suggest targeting public health campaigns towards populations where knowledge is lowest, and exposure to and prevalence of keloids is highest.

      Keywords

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