Integrating skin of colour into generalist dermatology education: A metacognitive framework.

Pesticides are increasingly used globally to control public health and agricultural pests and diseases, particularly in sub-Saharan Africa (SSA)-. However, pesticide use may turn out to be dangerous to the users through exposure, especially to the most risk populations such as farmers due to lack of knowledge on safe pesticide use, poor pesticide handling behavior for example, not using personal protective equipment (PPE) while handling pesticides. In developing countries, pesticide poisoning has been highly rated as a public health challenge. According to the World Health Organization (WHO), it is estimated that more than 200,000 lives are lost every year in developing countries as a result of pesticide poisoning. In addition, human exposure to pesticides is associated with several health risks including neurological consequences such as chronic and acute neurological symptoms (including headache), and mental health issues (including increased depression). For instance, exposure to glyphosate, a commonly used herbicide in low- and middle-income countries (LMICs) including Uganda, is found to be associated with impaired visual memory, and mancozeb exposure, a fungicide containing manganese, is linked to sleep problems, developmental effects in children, endocrine disruption, Parkinson's disease, and alteration of the immune system response. Coughing, runny nose, dizziness, blurred vision, headache, general body weakness, and itchy skin are some of the common short-term effects of pesticide exposure,. In Uganda, majority of the farmers use pesticides to increase their crop yields. However, most of the pesticides used are classified as hazardous by WHO. Pesticides account for a case fatality rate of 1.4 (per 100 000) in Uganda, with high percentage cases related to intentional self-poisoning. Occupational exposure to pesticides often occurs through skin contact, inhalation, and ingestion during mixing and spraying of pesticides. Additionally, a study done in Uganda demonstrated that smallholder farmers are occupationally exposed to pesticides as they directly mix, and spray pesticides. Notably, households near farms are also likely to be exposed to pesticides due to drift and vaporization of pesticides during application. Moreover, there is limited regulation, monitoring, and control in sale and use of pesticides in many LMICs, like Uganda which always lead to unprotected exposure among users.