Dermatophytosis and the associated risk factors among primary school children in southern and central Côte d'Ivoire.

Abstract

Dermatophytosis, particularly the subtype tinea capitis, is common among African children; however, the risk factors associated with this condition are poorly understood. This study aimed to determine the factors associated with tinea capitis and the prevalence rate of other dermatophytoses among primary school students in the rural and urban areas of the southern and central Côte d'Ivoire. The study was carried out in seven towns of Côte d'Ivoire from October 2008 to July 2009, among 17,745 children aged 4-17 years and attending urban and rural primary schools; a complete physical examination of the skin and appendages, including nails and hair, was performed by the physicians. Direct microscopic examination using 30% potassium hydroxide solution and culture on Sabouraud's dextrose agar supplemented with 0.5 g/L chloramphenicol and 0.4 g/L actidione was performed during sampling. For the 17,745 children clinically examined, 2645 exhibited symptoms suggestive of tinea capitis. Positive cultures for dermatophytes were found in 2635 patients, and the overall prevalence rate of tinea capitis was 14.8%. The following factors, age, sex, pets at home, number of bathing daily, sharing of sponges, combs and towels and hair length, were statistically associated with tinea capitis (p < .001). In addition to tinea capitis, other superficial fungal infections were identified among these children. These included tinea corporis (0.9%), tinea unguium (0.6%) and pityriasis versicolor (0.4%). Tinea capitis is common among pupils in rural southern and central Côte d'Ivoire, especially in young boys.