Abstract

Background: Vitiligo is a depigmenting skin condition characterized by the selective loss of melanocytes, leading to amelanotic, nonscaly, chalky-white macules with distinct borders. Despite its prevalence, public knowledge and attitudes toward vitiligo remain under-researched, particularly in educational settings. Knowledge Gap: There is limited research assessing the understanding and attitudes of university students toward vitiligo, particularly in Middle Eastern regions. Aims: This study aims to evaluate the knowledge and attitudes of students at Basrah University’s Bab Al-Zubair complex regarding vitiligo, using a cross-sectional descriptive design. Methodology: A random sample of 300 male and female students participated, responding to a closed-ended questionnaire created from a review of relevant literature. The survey, administered in Arabic, consisted of three parts: sociodemographic characteristics, 16 questions on knowledge, and 7 questions on attitudes toward vitiligo. A three-point Likert scale was used to evaluate responses. Results: The majority of participants demonstrated moderate knowledge of vitiligo, with similar findings in their attitudes, as assessed using an arithmetic mean. Expert validation of the questionnaire ensured the clarity and relevance of its content. Novelty: This study provides the first comprehensive evaluation of university students’ knowledge and attitudes toward vitiligo in Basrah, filling a significant gap in dermatological health education research in the region. Implications: Raising public awareness about vitiligo is crucial to improving the psychological well-being, social integration, and self-esteem of those affected by the condition. These findings highlight the need for educational interventions that can foster better understanding and reduce stigma surrounding vitiligo, particularly in academic settings.

Highlights:

1. Students showed moderate knowledge and attitudes toward vitiligo.
2. Validated questionnaire assessed understanding and perceptions.
3. Awareness crucial for social and psychological support of vitiligo sufferers.

Keywords: Vitiligo, Knowledge, Attitudes, University Students, Public Awareness

Introduction

Melanocyte death is a defining feature of vitiligo, an autoimmune disorder that causes skin depigmentation[1].1% of people worldwide are thought to be affected, irrespective of age, sex, or skin tone[2].

It is a chronic condition that mostly affects the hands and face, resulting in white patches of skin that are infrequently accompanied by additional somatic symptoms as itching[3]. The disease can strike at any age, although it usually starts in childhood or early adulthood between the ages of 10 and 30[4].

The pathogenesis is complex and poorly understood; potential causes include oxidative stress, intrinsic melanocyte abnormalities, and autoimmunity [5]. In addition, concordance in monozygotic twins has been seen, and up to 30% of patients have a good family history, suggesting that a genetic component is definitely involved [6].

A significant portion of patients cannot receive the necessary care, or the duration of treatment effectiveness is often brief. Additionally, the longer the sickness persists and the more times the patient sees their doctor, the worse their quality of life gets[7].Therefore, physically deforming looks cause major psychological issues in day-to-day living [8, 9].

Depending on the individual's health, social and professional circumstances, and psychological state, vitiligo can have widely different psychological effects. Darkly pigmented people are more likely to get vitiligo, which can have significant psychological effects on them. Particularly for people with lesions on exposed skin, these consequences might vary from minor humiliation to a significant loss of confidence and social anxiety [10, 11].

There are several myths about vitiligo that differ depending on where you live in the world. The illness is frequently misunderstood to be communicable, incurable, linked to a particular food or drink, a kind of leprosy, always inherited, and potentially fatal for skin cancer [12]

Methods

Design of the study:

In November 2022 and May 2023, a descriptive cross-sectional study on attitudes and knowledge on Vitiligo was carried out.

3.2 Setting of the study:

The present study was conducted in In Basrah University Bab Al-Zubiar complex.

The sample of the study:

probability (stochastic sample) included Three hundred male and female students from the Bab Al-Zubair complex's institutions took part in the survey by responding to questions.The students themselves completed the questionnaire that was used to gather the samples. In order to fulfil the research objective, an Arabic translation of a questionnaire was created with the intention of evaluating students' attitudes and understanding on vitiligo.

The Study Instrument:

A Closed-end questions questionnaire was used for the purpose of data collection.

questionnaire format, was designed and constructed after reviewing related literatures, and previous studies by the researchers.

The questionnaire consist of

Three parts,the first part consists of 7 items related to Sociodemographic characteristics of the nurses and include: age ,gender ,College name, stages, marital status, residency, training course in dermatology.

second part consist of 16 questions related knowledge toward Vitiligo.

third part consist of 7 questions attitude toward Vitiligo

The Format of a typical three-level likert item, for example, could be

Compute of Arithmetic mean (mean score)

1-We find the range= max value - min value

Range= 3-2=1

2-We find the length of the class= Range ÷ Number of Classes

We use three(3) point likert scale which ranged from(1) up to (3), as shown in the next.

Table 3.1 : three(3) points likert scale

Evaluation

3.7 Validity of the questionnaire:

The instrument's capacity to collect the necessary data in unison determines its validity. In order to assess the clarity, relevance, and sufficiency of the questions designed to gauge the study's focus concepts, a panel of experts with more than five years of experience in related fields is used to determine the validity of the content of the early-stage instrument.

The instrument's validity was established by means of an expert panel. They were faculty members from College of Nursing / University of Basrah. We respectfully requested the experts' assessment and feedback on the questionnaire's substance and structure. Certain issues were changed based on the feedback and recommendations provided by the experts listed above, and the views of all experts were taken into account.

Result and Discussion

4-1 Distribute on of the Variables Related Demographic Characters N=300

Table (4-1) displays the percentage of students who completed the questionnaire: 48.5% are enrolled in medical schools and 51.2% are in human institutions. According to the phases, fourth-year students made up the majority of those who participated in the questionnaire. Regarding to the sex reveal the female student involvement the questionnaire were (73.8%) greater than male student (25.9 %).In terms of age, 94.7 percent of the sample fell between the 18 and 25 year age range, while just 5% fell between the 26 and 33 year age range.In reference to marital status, ninety percent of students who completed the questionnaire reported being single, and nine percent reported being married.In terms of residence, the bulk of samples lived in rural areas (57.5%) and in urban areas (42.2%).In reference to dermatological training courses, the majority of samples (99.3%) did not have any, and 3%

4-2 Result of the Variables Related Knowledge Characteristics N=300 student

The table displayed the responses from students who participated in the questionnaire on their understanding of Vitiligo, with the majority of students answering this question. Not contagious by air transfer (74.1%)Not communicable by contact (71.4%); not communicable by eating (688.8)(64.8%) are aware that sharing items does not make one contagious (59.1%).Of them, more than half (52.8%) believe that vitiligo is not a hazardous disease and that poor hygiene is not the cause of the condition.(49.2%) Are aware that exposure to sunlight aggravates vitiligo?Of those who know the disease's cause, 45.8% are aware it is unknown, yet 48.8% believe it is curable.(36.9%) It is not connected to the regular consumption of a particular meal. (36.9%) are aware that it has nothing to do with an internal organ malfunction. Only 31.9% of people are aware that vitiligo is not an inherited condition, whereas 36.2% are aware that surgery is an option for treating the condition.(31.6%) are aware that it is an illness.

table shown The majority of participants (66.1%) expressed willingness to hire a patient with vitiligo as an employer; more than half (60.1%) expressed sympathy for patients with vitiligo; and more than half (52.2%) did not look at vitiligo.(35.5%) would enquire about the condition from vitiligo patients, (34.6%) would accept food made by vitiligo patients, (26.2%) would have to shake hands with vitiligo patients, and 12.3% would not be married to a vitiligo patient.

4-4 Mean Score for Acknowledge Question

Discussion

The vitiligo patient is the person most exposed to bullying, and society views skin diseases in general, and vitiligo disease in particular, as a view that contains fear and anxiety about the idea of infection and lack of contact, and this is a very wrong idea.

Most skin diseases are not contagious, and the worst thing that a vitiligo patient encounters is that people are afraid to greet him.

While vitiligo is a non-communicable disease, it does not need any precautions other than protection from the sun, and it does not need any infectious precautions for those in contact with the house, not even from friends.

Discussion knowledge of the student:

In this study, 54% showed that vitiligo is a non-dangerous disease, which is almost convergent with the study conducted in India in 2021 (17,13,14), which showed 79%, also that vitiligo affects the immune system, 36%, and this percentage is not consistent with the study. conducted in India (18,15) by 85%, in contrast to the study conducted in Ethiopia, which showed 12% (22), and 45% indicated that the causes of vitiligo are unknown or unknown, and this does not correspond to the study conducted in India (16) is 86%, while the study of Ethiopia showed 32%. Treatment for vitiligo was 99% On the complete opposite with the study of Ethiopia (18), where it showed 16%, and this percentage is very low and does not correspond to our study, unlike the study of India 68%, there is a cure for vitiligo (17)...

Conclusion

comprehensive evaluation of the information of the Vitiligo medium. The general evaluation of attitudes towards Vitiligo was deemed moderate

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