The Study Area and Characteristics

This study was carried out in the Al Mawasi region, situated in the southern Gaza Strip, a pivotal area for analyzing displacement patterns amid the ongoing conflict. The Gaza Strip, a coastal territory, encompasses an area of approximately 365 square kilometers [5]. Although designated by Israeli authorities as a “humanitarian safe zone,” this area has suffered repeated attacks, leading to significant civilian casualties and further displacement. Recent data from early 2025 indicate that approximately 1.9 million individuals—around 90% of Gaza’s population—have been displaced within camps across this region, with many experiencing multiple displacements, some up to 19 times within a single year [16,17]. In addition, the Al-Mawasi area is a narrow, fertile coastal strip located in the southwestern Gaza Strip, spanning parts of the Khan Younis and Rafah governorates. Furthermore, covering approximately 14 square kilometers—about 3% of the Gaza Strip’s total area—this region is characterized by sand dunes, which are a natural extension of those in Egypt’s Sinai Desert. The area experiences a semi-arid climate, with average annual precipitation of approximately 250 mm [18]. Therefore, the current study was conducted on a representative sample of displaced persons residing in the three of the displacement camps in the Mawasi area of Khan Younis during the period from December 2024 to Januarys 2025.

Sample Size and Population

The current study exclusively targeted displaced individuals residing in three displacement camps, excluding any other criteria. To determine the study’s sample size, we adopted the approach used by Taherdost (2017) and Dardona et al. (2023). Employing this identical research model, a sample size of 384 is considered representative of the displaced community in the camps, as illustrated by the following equation: [19,20].

Assuming:

A 95% confidence level (Z=1.96)

A margin of error of 5% (E=0.05)

Maximum variability (p=0.5).

The initial sample size calculation for an infinite population is:

For a finite population of 1.9 million (N=1,900,000 N=1,900,000 N=1,900,000), the finite population correction factor is applied:

Calculating the correction

Therefore, despite a population size of 1.9 million, the calculated minimum sample size required was approximately 384. To enhance the precision of the study’s findings, a sample size of 500 was selected, and accordingly, 500 questionnaires were distributed among the target population.

Ethical Approval

The Scientific Research Ethics Committee at the Islamic University of Gaza provided ethical approval for this research, ensuring strict confidentiality and data protection throughout the study. The study population was fully informed about the research and its objectives, and authorization was granted to the researcher to use the data and findings.

Data Collection

Data collection involved the systematic distribution of a carefully structured questionnaire, administered in Modern Standard Arabic to ensure clarity and accessibility. The instrument comprised multiple sections: demographic and socioeconomic information; epidemiological assessment of skin disease prevalence among internally displaced persons (IDPs) at both individual and familial levels; clinical symptoms; personal and family medical history; knowledge and awareness of skin disease transmission, risk factors, and treatments; and an evaluation of key risk factors influencing disease spread within displacement camps. Following data gathering, rigorous compilation, statistical analysis, and evaluation were performed to ensure robust findings.

Statistical Analysis

The relationship between various factors, including the epidemiological status of the disease, and some socio-demographic variables were assessed using the chi-square test, SPSS Version 15 was used to analyze the data.

Socio-Demographic Distribution of the Displaced Respondents

The study findings indicated a nearly equal gender distribution among participants, with 240 males and 260 females included in the sample. Notably, children under the age of ten represented the largest age group, accounting for just under one-quarter of the total sample of 500 individuals, reflecting a significant presence of young children. In contrast, participants over the age of sixty comprised the smallest age group. Regarding marital status, many respondents (255) reported being single, while 224 were married. As anticipated, 25.4% of participants had attained a university-level education. Additionally, 22.2% of the sample reported having completed only primary education. A more comprehensive overview of these demographic characteristics is presented in Table 1 below.

Table 1: Socio-Demographic distribution of displaced individuals in displacement camps in Mawasi-Khan Younis.

With respect to pre-displacement residence, the study findings showed that many displaced individuals originally resided in the North Gaza Governorate, representing approximately 54.4% of the total sample (n = 272). This was followed by 123 individuals from Gaza Governorate, 69 from Rafah Governorate, and 36 from Khan Younis Governorate. Figure 1 illustrates the geographical distribution of participants’ places of residence prior to displacement to the Muwasi Khan Younis camps.

Figure 1: The distribution of pre-displacement residence among the displaced individuals in the displacement camps of Mawasi Khan Younis.

Evaluation of the Epidemiological Status of Skin Diseases among Displaced Persons

The study unequivocally demonstrated a genuine prevalence of skin diseases among displaced persons, with 28.6% of respondents reporting having a skin disease at the time of the study in addition 42.8% demonstrated of having a skin disease during this war. Moreover, more than half of the respondents (54.5%) indicated that at least one family member had contracted skin disease during the war. Notably, over 37.0% of respondents reported experiencing skin diseases multiple times during the displacement period.

Symptoms of Patients with Dermatological Diseases

The results of this study indicated that the most prevalent symptom among affected individuals was skin itching, reported in 88.1% cases. This was followed by the occurrence of blisters in 76.9% and skin redness in 69.2% of cases. Additionally, pain and skin rash were observed in 58.7% and 57.3% of respondents, respectively. Furthermore, both skin dryness and the presence of ulcers or cracks were documented in 41.9% of cases. The least frequently reported symptoms included swelling and the presence of fluid or pus, which were identified in 30.0% of cases.

Personal and Family Medical History

The findings of this study clearly demonstrate that many respondents do not have a family history of skin diseases. Specifically, only 75 individuals (15.0%) reported a familial history of skin conditions, whereas 425 individuals (85.0%) did not. Regarding personal history, 37.2% (186 individuals) indicated previous occurrences of dermatological conditions, while 62.8% (314 individuals) had not experienced any prior skin issues. In terms of exposure to potential triggers such as stress or allergies, 48.1% (245 individuals) reported experiencing such exposures, whereas 51.9% (255 individuals) did not. Additionally, concerning the current use of skin medications or products, 31.7% (158 individuals) reported using them, while 68.3% (342 individuals) stated that they did not use any.

Assessment of Knowledge and Awareness of Dermatological Diseases

The findings of this study reveal a notable disparity in awareness levels related to dermatological diseases among the surveyed population. A significant portion of respondents demonstrated limited knowledge of these conditions, with only a minority exhibiting familiarity with the most prevalent dermatological diseases in Palestine. Additionally, participants showed inadequate understanding of the risk factors associated with the transmission of these diseases. Table 2 provides a comprehensive analysis of respondents’ knowledge and awareness within the displaced population.

Table 2: An in-depth assessment of the awareness and knowledge of dermatological diseases among the displaced population in the study area.

Identification of Potential Risk Factors for Dermatological Diseases among Displaced Populations in the Displacement Camps

The findings of this study clearly identify the presence of insects and pests within living environments as the most prominent risk factor reported by participants. This was followed by high levels of malnutrition and deficiencies in essential vitamins and minerals, alongside limited access to basic personal hygiene products such as soap and shampoo. Additionally, a notable proportion of respondents reported the communal use of personal items, including clothing and towels, which further increased the risk of skin disease transmission. These results underscore the critical impact of poor sanitary conditions and overcrowded living environments on the health of displaced populations. Figure 2 provides a visual summary of the primary risk factors contributing to the spread of dermatological diseases in the study sample.

Figure 2: The potential risk factors for skin diseases among the displaced population.

The Relationship between Socio- Demographic Variables and the Occurrence of Skin Diseases

The results of the study, analyzed using the Chi-square test, demonstrate a statistically significant association between age and the prevalence of skin diseases, suggesting that susceptibility varies notably across age groups. The highest prevalence was recorded among children under the age of 10, followed by adolescents aged 10 to 20, albeit at a reduced rate. Conversely, individuals aged over 40 showed a markedly lower incidence of skin diseases. These findings underscore the heightened vulnerability of younger age groups to dermatological conditions. Table 3 presents a detailed analysis of the correlation between age and skin disease prevalence.

Table 3: The relationship between socio- demographic variables and the incidence of skin diseases.

The statistical analysis indicates a significant association between the prevalence of skin diseases and key socio-demographic variables, including marital status, educational level, and place of residence prior to displacement, with all corresponding p-values falling below the 0.05 threshold. These findings underscore the relevance of these variables in influencing individuals’ vulnerability to dermatological conditions. In particular, the association between educational attainment and skin disease prevalence points to a potential link between lower health literacy and increased risk. Additionally, the strong correlation between pre-displacement residence and the occurrence of skin diseases highlights the critical role of prior social and environmental conditions in shaping exposure and susceptibility. Table 3 presents a detailed summary of these relations.

Demographic and Socioeconomic Factors

The study sample showed near-equal gender distribution, with a slight female predominance, likely due to males engaging in external duties. Children under ten constituted the most affected age group, aligning with Gaza’s youth-dominated demographics [25]. On the other hand, the study revealed notable educational disparities, with an illiteracy rate of 6.0%-significantly higher than Gaza’s 2020 national average of 2.0% [19]. This elevated rate is likely influenced by the challenging conditions within displacement camps and the large proportion of children in the sample who have been unable to attend school due to the ongoing conflict. Moreover, many respondents were displaced by the North Gaza and Gaza governorates. Among these populations, high unemployment levels have substantially restricted access to essential hygiene products and clean water, further intensifying the risk and spread of infectious diseases [26,27].

Disease Prevalence and Symptoms

Additionally, 28.6% of respondents reported active dermatological conditions at the time of the survey, while 54% noted that at least one family member was similarly affected. Recurrent skin infections were also prevalent, with 37% experiencing multiple episodes. The predominant symptoms-itching, blistering, erythema, and rashes-were clinically consistent with scabies, eczema, and various bacterial skin infections. These diagnoses were based on clinical assessments conducted by the project’s medical team, which included a specialist dermatologist [28,29].

Awareness and Risk Factors

Over half of the respondents (more than 50%) reported no prior knowledge of skin diseases, and 66.0% lacked awareness of preventive measures. This contrasts sharply with findings from Nigeria, where 75.0% of participants demonstrated awareness of dermatological conditions [30]. Only 48.8% of respondents in Gaza demonstrated sufficient awareness of skin diseases. The most frequently reported risk factors included extreme overcrowding, poor sanitation, malnutrition, and the shared use of clothing and personal items. These findings are consistent with a study conducted by Dardona et al. during the ongoing conflict, which similarly highlighted these conditions as key contributors to the spread of infectious diseases [31,32]^. The scarcity and inflated prices of hygiene products further aggravated conditions [33].

Age-Specific Vulnerability

Children under ten were disproportionately affected, likely due to exposure to contaminated environments, inadequate hygiene, and behaviors like nail-biting [34]. This aligns with global data showing higher dermatological disease incidence in young children [35].

Challenges and Limitations

Ongoing security instability and active military operations caused delays in the progression of the study. Furthermore, gaining access to displacement camps located within heavily blockaded areas such as Al-Mawasi presented considerable logistical challenges.

Key Implications

Call to Action: Breaking this cycle requires integrated solutions distributing hygiene kits, deploying mobile clinics, and implementing community-led education backed by international funding and policy coordination. The findings mandate a shift from reactive care to proactive prevention, with accountability for sanitation, nutrition, and health literacy as pillars of crisis response.

“Skin diseases here are not just medical—they are symptoms of systemic collapse. We must treat the environment, the body, and the mind together.”