Tinea Capitis in Primary and Middle School Students in South-East of Iran

Abstract

Tinea capitis is a common infection among school children, still raising public health importance in many countries. There are unpublished reports of head fungal infections, particularly Tinea capitis, in school children of Sistan and Baluchestan province, at South-East of Iran. However, the reports are only based on the clinical evidences and there is no information about the prevalence and the agents of the infection. The present study was designed to determine the prevalence of Tinea capitis based on demographic information as well as laboratory determination of the causative fungal species in primary and middle school students of seven districts in Sistan and Baluchestan in 2011. During this cross-sectional study, 2060 children from urban and rural primary and middle schools were randomly selected and subjected to the survey by informed consents. Their demographic information was recorded in questionnaire and specimens from suspicious students were taken by scraping the scalp and removing hair stubs. Microscopic examination and culture and subculture of the specimens were performed using Sabouraud’s Dextrose Agar (S) and S + Chloramphenicol + Cyclohexamide (SCC) media and slide culture for identification of fungal agents. The surveyed children contained 56.7% female and 43.3% male. A number of 110 students (5.8%) were suspected to have Tinea capitis. Thirty-seven cases of Tinea capitis were confirmed by demonstration of dermatophytes spores or mycelium in direct smears, consisting of 25 (22.73%) ectothrix, 8 (7.27%) endothrix and 4 cases (3.63%) of favus. The dermatophytes isolated by in in vitro cultures, included 17 anthropophilic, 9 zoophilic and 3 geophilic species. The other 7 isolates were only characterised as Trichophyton mentagrophytes but remained unidentified at the level of subspecies. The prevalence of Tinea capitis in the rural school students was significantly more than that in the urban students. The infection rate in male was also significantly more than that in female. The results implied that control program with concern to the sources of infections is of great importance. Health education and development of knowledge among school children are recommended to be taken into account. It was resulted that all three sources of dermatophyte infections are involved with the incidence of Tinea capitis in children at South-East of Iran, although the anthropophilic and zoophilic reservoirs are predominant.