Abstract
BackgroundOnychomycosis is an infection of the nail unit by a fungus. This is a very common infection amongst diabetics. Its occurrence among diabetics in Fako division is unknown. In this study we provide information on the characteristics of onychomycosis in diabetics in Fako division, Cameroon.MethodsA cross-sectional descriptive and analytical hospital-based study was conducted in two diabetic clinics in the Buea and Limbe regional hospitals. We recruited 152 consenting diabetics into the study. Demographic, behavioural, and clinical data of patients were obtained through the use of structured questionnaires. Toenail, finger nail, skin scrapings and nail clippings were collected from participants, KOH mounts were prepared and observed under the microscope and cultured on Sabouraud Dextrose Agar supplemented with chloramphenicol to isolate causative fungi. Identification of isolates was done to species level using the cello tape flag method and slide culture. The presence of a dermatophyte by either microscopy or culture or both methods was considered positive for onychomycosis. Antifungal susceptibility testing was carried out using selected antifungals by the Kirby–Bauer disk diffusion method on Sabouraud Dextrose Agar.ResultsClinical onychomycosis was found in 77 of the 152 diabetics tested giving a prevalence of 50.7% (95% CI 42.4–58.9) in diabetics in Fako. No socio-demographic or clinical factor studied was significantly associated with onychomycosis. Trichophyton rubrum was the most common isolate (62%). Other isolates included Trichophyton metagraphyte (22%) and Trichophyton tonsurans (16%). Dermatophytes were sensitive to miconazole (66%), amphotericin B (19%) and ketoconazole (14%).ConclusionOnychomycosis is common in diabetics in Fako signifying the need for regular screening by either microscopy or culture. Infected nails could be treated with miconazole.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-016-2302-1) contains supplementary material, which is available to authorized users.
Highlights
Onychomycosis is an infection of the nail unit by a fungus
Onychomycosis refers to fungal infection of the nail unit which occurs in every part of the world
To the best of our knowledge, this is the first study to be performed among diabetics in Cameroon; studies performed in the general population have revealed lower prevalence (8.8%)
Summary
Onychomycosis is an infection of the nail unit by a fungus. This is a very common infection amongst diabetics. In this study we provide information on the characteristics of onychomycosis in diabetics in Fako division, Cameroon. Onychomycosis refers to fungal infection of the nail unit which occurs in every part of the world. Nails with fungal infection may become thick and distorted, sometimes with sharp edges. Such nails can abrade or ulcerate adjacent skin leading to severe outcomes. Diabetic patients with onychomycosis have a higher percentage of gangrene and/or foot ulcer (12.2%) compared to those without onychomycosis (3.8%), that is a threefold higher risk [4]. Nail infections represent a risk factor in diabetic patients because of possible sequels
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