Epidemiology Of Tinea Capitis Research Articles

The Epidemiology of Tinea Capitis in Guangxi Province, China.

The aim of this study was to analyze the epidemiological characteristics and pathogen spectrum of tinea capitis in Guangxi, southern China. A multicenter prospective descriptive study was conducted in 8 hospitals across Guangxi. From January 2019 to July 2022, one hundred seventy-one (171) patients diagnosed with tinea capitis were included. Demographic data, risk factors, and fungal data were collected. If necessary, species were further identified by morphological or molecular sequencing in the central laboratory. Of the 171 cases of tinea capitis, 74.3% occurred in patients aged 2-8years. Children with tinea capitis were mainly boys (59.6%) and were more likely than adults to have a history of animal contact (44.2% vs. 33.3%) and zoophilic dermatophyte infection (76.9% vs. 46.7%, P = 0.008). The adults were mainly female (53%) and were more likely than children to have a history of infection with anthropophilic organisms (53.3% vs. 18.9%). The causative agents of tinea capitis in Guangxi were diverse, and the most common pathogen was Microsporum canis (M. cani, n = 98, 62%), followed by Trichophyton mentagrophytes (T. mentagrophytes n = 18, 11.4%) and Trichophyton tonsurans (T. tonsurans n = 12, 7.6%). In addition, tinea capitis caused by Nannizzia incurvata (N. incurvata) and Trichophyton verrucosum (T. verrucosum) was detected in the study. Notably, the proportion of patients with kerion in the study was 41.5% (n = 71), and most of those patients were children (n = 68), especially neglected children living in the rural mountainous areas of Guangxi, where they were unable to receive timely diagnosis and appropriate treatment. In conclusion, the causative agents of tinea capitis in Guangxi, South China, are diverse, and the incidence of kerion is high, indicating that diagnosis and treatment modalities in the region remain grossly inadequate. Clinicians and policy-makers should collaborate to adopt public health strategies to control the disease.

Epidemiology of Tinea Capitis in Children in Beijing and Adjacent Regions, China: A 15-Year Retrospective Study.

Tinea capitis is the most common dermatophytosis in children. Due to many factors, the types of pathogenic fungi of tinea capitis vary all over the world, and the pathogenic fungi of tinea capitis may change over time even in the same region. To investigated the epidemiological characteristics and pathogenic strains distribution of tinea capitis in children in Beijing and adjacent regions. Patients/Methods Through retrospective study and epidemiological analysis, we investigated the epidemiological characteristics of tinea capitis in children in Beijing and adjacent regions over 15years. A total of 1739 children with tinea capitis were retrospectively investigated from January 2006 to December 2020, including 1100 boys and 639 girls. A total of 67.4% of tinea capitis patients were between 1 and 5years of age. A decreasing trend in tinea capitis was observed before 2009, while for the following 12years, the incidence rate of tinea capitis fluctuated little. Zoophilic isolates (primarily Microsporum canis) were responsible for 88.4% of tinea capitis. Males are at greater risk for M. canis infection (p = 0.02). Zoophilic species were responsible for approximately nine-tenth of the tinea capitis cases. The incidence of tinea capitis decreased before 2009.

Epidemiology of Tinea Capitis among Population of Arar City, Northern Saudi Arabia

Epidemiology of Tinea Capitis among Population of Arar City, Northern Saudi Arabia

Epidemiology of Tinea Capitis and Associated Factors among School Age Children in Hawassa Zuria District, Southern Ethiopia, 2016

Introduction: Africa, being the settings mostly affected, the rates of tinea infection ranges between 10 and 30% among school-aged children. For instance in Ethiopia, the prevalence of tinea capitis among school children was 47.5%. The aim of this study was to determine the magnitude of tinea capitis and associated factors among school age children in Dorebafano town, Hawassa Zuria Disrict, Southern Ethiopia. Methods: A community based cross-sectional study design was conducted among 292 children in Dorebafano town from June 30 to July 6, 2016 using systematic random sampling technique. Data was collected using pretested and interviewer administered structured questionnaire. The presence or absence of tinea capitis was confirmed by physical examination and taking samples from scalp scratch and observing under a microscope with potassium hydroxide (KOH). Logistic regression was carried out to identify factors associated with presence of tinea capitits. Model fitness was checked using Hosmer and Lemeshow show. Result: The magnitude of tinea capitis among the study subjects was 32.3% [CI: 27.3%-37.5%]. Age of child (AOR=3.2, 95% CI: 1.40, 7.00), sex of child (AOR=0.10, CI (0.03, 0.40), educational status of the child (AOR=6.9, 95% CI: 1.4, 33.5) and presence of similar illness (AOR=6.49, 95% CI: 2.42, 17.43) were identified to be independent factors for the occurrence of tinea capitis. Conclusion: The magnitude of tinea capitis among the study subjects was found to be high. Age, sex, educational status of children and presence of similar illness were identified factors for occurrence of tinea capitis. Health promotion, health education measures and early identification and treatment of tinea capitis need to be given emphasis.

Changing in the Epidemiology of Tinea Capitis among School Children in Egypt.

BackgroundTinea capitis remains a prevalent health problem among school-aged children.ObjectiveTo estimate the prevalence of tinea capitis among primary school students, in Fayoum, Egypt with identification of etiological agents in both public and private primary schools.MethodsA cross-sectional study was conducted in twelve primary schools. The students were selected from different grades with a total number of 12,128 students. Hair and scalp were clinically examined for any lesions that may suspect tinea capitis and mycological samples were collected for direct microscopy and culture.ResultsThe prevalence of tinea capitis in the study group was 0.4% and higher in public than private schools (73.5% versus 26.5% respectively). Boys were more affected than girls with boy to girls' ratio 5:1. Intrafamily history of infection was present in 40.8% of tested group while 51% showed low social standard profile. Mycological culture revealed that Microsporum canis was the predominant isolated organism followed by M. audouinii (52% and 36% respectively).ConclusionM. canis is replacing Trichophyton violaceum as an etiology for tinea capitis in Egypt with lower prevalence rate than reported previously.

Continuous increase of Trichophyton tonsurans as a cause of tinea capitis in the urban area of Paris, France: a 5-year-long study.

Tinea capitis (TC) is a highly contagious fungal infection of the scalp due to dermatophytes in children. To obtain information on the epidemiology of TC in the urban area of Paris, we analysed the microbiological results of 3090 patients seen with suspected TC from October 2010 to September 2015 at Saint Louis hospital, Paris, France. A peak of TC was observed in 3-6 year-old children, followed by a progressive decrease until 16 years of age. Of the 1311 positive cultures, 95% (1246) yielded one of the three anthropophilic species [Trichophyton tonsurans (33.5%), Trichophyton soudanense (38.3%), or Microsporum audouinii (28.2%)]. When considering one TC case per family, we observed a significant increase of T. tonsurans (P = .018) during these 5 years. The increase was more pronounced (P = .0047) in patients of West-African descent (n = 666), and was at the expense of M. audouinii and T. soudanense. On the other hand, the Caribbean patients (n = 85) remained predominantly (72.9%) infected by T. tonsurans. Our results show a better virulence of T. tonsurans over other species as already reported. Since T. tonsurans has not been reported in Africa, the infection of patients of West-African descent probably took place in the Paris area by exchanges with Caribbean patients. This increase of TC due to T. tonsurans was observed in the context of griseofulvin being the only licensed paediatric treatment for TC in France, which should deserve reappraisal because terbinafine may be more efficacious.

Continuous increase of Trichophyton tonsurans at the expense of Microsporum audouinii var. langeronii as a cause of tinea capitis in the urban area of Paris: A five-year long study

Tinea capitis (TC) remains a public health in pediatric population in urban areas. The dermatophytes responsible can be divided into three major groups: anthropophilic, zoophilic, and geophilic species. Our objective was to analyze the recent epidemiology of TC in our hospital in Paris, France. We included all the patients seen from October 2010 to September 2015 in our laboratory for suspicion of TC. Suspected lesions were sampled and epidemiological data were recorded. After a direct microscopic examination, hair samples were seeded on Sabouraud medium agar slant and kept 3 weeks at 26 °C. The species identification was based on macroscopic and microscopic examination. We obtained 3372 samples from 3090 patients (sex ratio 0.93; median age: 8 years, range: 1 month-89 years). We observed 36% of infections, with an overrepresentation of young boys (71%) and 7.5% of patients were defined as carriers. Three anthropophilic species were predominant (96%): Trichophyton soudanense, Trichophyton tonsurans, and Microsporum langeronii. For a given family (n = 233.2 to 6 members), the same species was identified when several TCs were diagnosed except for five. Therefore, we counted one family as one case to analyze the evolution over time. Globally, the incidence of T. tonsurans increased over time and it was the first species isolated in 2014. When considering the geographical origin, we observed a continuous increase of T. tonsurans in the sub-Saharan African patients, mainly at the expense of M. langeronii, T. soudanense remaining quite stable ( Fig. 1 ). In the Caribbean patients, T. tonsurans remained majority, although T. soudanense was present, suggesting transmission between communities. This increase of T. tonsurans could be due to a better fitness of this species for transmission between individuals through community contacts or by common hairdressers. Another explanation could be the less susceptibility of T. tonsurans to griseofulvin, the main agent used in the pediatric population to treat TC. This study showed that T. tonsurans became in 2014 the major agent of TC in the urban area of Paris, as already reported in London. Although British and American guidelines supporting terbinafine as the first choice to treat Trichophyton TCs, the French recommendation is griseofulvin since terbinafine does not have governmental approval in children. These recommendations could be challenged in case of continuous increase of T. tonsurans in TC.

Epidemiology of tinea capitis in northeast Iran: a retrospective analysis from 1998 to 2012.

Tinea capitis is a common disease of the pediatric population. This disease typically follows one of several clinical patterns, i.e., scaling, hair loss, and/or inflammatory lesions, which are usually caused predominantly by two dermatophytic genera: Microsporum and Trichophyton. The aim of this study was to investigate tinea capitis and its etiological agents in Sari city of Mazandaran province, Iran. We studied the spectrum of tinea capitis by means of a retrospective analysis involving 1745 patients referred to both the Reference Laboratory of Medical Mycology (RLMM) and Bo Ali Sina Hospital at Sari, Iran (1998-2012). Specimens were assessed by standard mycological techniques based on macroscopic and microscopic morphology. Among the patients, 480 (27.5%; 61 males and 39% females) were confirmed through a mycological examination. The peak incidence was in the 5-14 years age group. Endothrix (263 cases; 54.8%) was the most frequent clinical feature by direct exam. The predominant causative agents of tinea capitis were T. tonsurans (186 cases; 38.8%) and T. violaceum (119 cases; 24.8%), followed by T. mentagrophytes (46 cases; 9.6%), T. schoenleinii (28; 5.8%), T. rubrum (20 cases; 4.2%), M. gypseum (15 cases; 3.1%), T. verrucosum (14 cases; 2.9%), and Epidermophyton floccosum (1 cases; 0.2%). The present study showed that tinea capitis is mainly due to the anthropophilic species, and the most common species were T. tonsurans and T. violaceum. Owing to the high frequency of anthropophilic species, future studies may be useful in the development of preventive and educational strategies to reduce healthcare expenditure.

Updating the epidemiology of dermatophyte infections in Palestine with special reference to concomitant dermatophytosis

To determine the epidemiology of dermatophytosis in Palestinian patients, detect changes in the etiological agents during the last three decades, and to correlate between concomitant tinea pedis infections, and other cutaneous lesions. 220 suspected dermatophytosis patients were involved in this study. In an additional 38 cases, where consultation was prompted by tinea pedis, the presence of other lesions of concomitant dermatophytosis was studied, to further investigate the diagnosis. Clinical specimens were collected and identification of dermatophyte species was based on gross and microscopic morphology. Epidemiology of tinea capitis has gone the most radical changes in Palestine in the last three decades, with the zoophilic dermatophyte Microsporum canis replacing Trichophyton violaceum, becoming the predominant causative agent. During this study, 21.6% (38/176) patients with tinea pedis and concomitant lesions caused by the same dermatophytes at sites distant from the primary lesions in the foot were prospectively identified. About 63.2% of patients with tinea pedis have a concomitant toenail onychomycosis infection. The epidemiology of dermatophytosis, especially tinea capitis, has gone the most radical changes in Palestine in the last three decades, with M.canis replacing T.violaceum, and becoming the predominant causative agent of all cases of infections. The coexistence of tinea pedis with other types of fungal skin infections is a frequent phenomenon; we believe that the infected foot may be a site of primary infection. Thus, the effective therapy for tinea pedis is essential to prevent spreading the infection to other sites of the skin.

Epidemiology of Tinea Capitis among Children at a Suburban Primary School in Blantyre, Malawi

Epidemiology of Tinea Capitis among Children at a Suburban Primary School in Blantyre, Malawi

Epidemiology of tinea capitis among school-age children in Meiganga, Cameroon

Tinea capitis (TC) commonly called scalp ringworm is a worldwide concern and a public health problem in Africa. This study aimed at determining the epidemiologic profile of TC among school-aged children in the savanna zone of Cameroon. All children present at school during this study period, August 2011-July 2012, were examined for signs suggestive of TC. Children not registered at school were excluded from the study. Pathologic specimens were taken from suspected head lesions and cultured. Amongst the 4601 children, average age 10.7±0.16 years, 377 presented with suggestive TC lesions giving a prevalence of 8.1%. The proportion of boys with TC was (63.7%) higher than in girls (36.3%) (P≤0.05). TC manifestations varied; small plaques of alopecia 59.26% were the most frequent. Communal living was the most incriminated risk factor. Three hundred and thirty six isolates were obtained in culture. The prevalence was significantly higher (P<0.05) in age range between 8 and 12 years, followed by that between 13 and 15. The most prevalent isolate was T. soudannense 56.8%, followed by T. rubrum 29.2%. Only 6.0% of the isolates belonged to the genus Microsporum.

Superficial Fungal Infections

Superficial Fungal Infections

Etiological agents of tinea capitis in Erzurum, Turkey

Summary Tinea capitis is the most common dermatophyte infection of the scalp affecting mainly children and rarely adults. The epidemiology of tinea capitis varies within different geographical areas throughout the world. In the present study, the incidence of tinea capitis agents in samples sent to our laboratory over the past 2 years was investigated and evaluated. A prospective study was conducted in Erzurum district between 2006 and 2008, of 48 children presenting with tinea capitis at the dermatological outpatient clinic of the university hospital. Thirty (62.5%) were male and 18 (37.5%) were female, with an average age at presentation of 6.3 years (age range 3–14 years). Only one case of tinea capitis was 17 years of age. Specimens were obtained from pus, hairs, and skin scrapings from suspected lesions of tinea capitis. Mycological analyses were conducted by direct microscopic examination using 30% potassium hydroxide solution and by fungal culture on Sabouraud glucose agar, with chloramphenicol and Mycobiotic agar. The culture tubes were incubated at 25 °C and examined daily for 1 month. Species were identified according to the macroscopic and microscopic phenotypic features of the cultures. Direct microscopy of samples was positive in all of patients while culture positive was found in 28 (58.3%) of patients. All patients had inflammatory type (kerion). Species identification revealed that Microsporum canis (28.5%) was the most causative agent, followed by Trichophyton tonsurans (25.0%), M. audouinii (17.8%), T. verrucosum (17.8%), T. violaceum (7.1%). From one patient (17 years old), the isolate was T. schoenleinii. Our data show that M. canis is the main etiologic agents of tinea capitis in this area.

Epidemiology of tinea capitis in Ceyhan district, Adana in Çukurova region, Turkey

This study was conducted on the primary school students in Ceyhan district of Adana, Turkey between May and June 2002 to determine the clinical form, causative agents and prevalence of tinea capitis. A total of 9576 students, with a male-to-female ratio of 50.6-49.4% were screened in 24 primary schools. Tinea capitis superficialis was diagnosed in seven cases, and kerion Celsi in one. Among eight cases, there were seven boys and one girl. Trichophyton violaceum was the most frequent causative agent, followed by T. tonsurans, T. mentagrophytes, Microsporum canis and M. gypseum.

Tinea capitis update: a continuing conflict with an old adversary

Infection with tinea capitis in childhood is a common, age-old problem that continues to plague patients and their families. As is true for most infectious diseases, the epidemiology of tinea capitis is in a constant state of flux and varies considerably with respect to geography and specific patient populations. Trichophyton tonsurans is now the most common cause of tinea capitis in the United States. A recent epidemiologic observation is a striking increase in the incidence of tinea capitis, particularly among African-Americans. Clinical studies over the past decade that have investigated the response of tinea capitis to griseofulvin, the mainstay treatment for this condition, suggest a decrease in sensitivity to this pharmacologic agent, in association with this new epidemiology. Important advances in the diagnosis and treatment of tinea capitis include a renewed interest in the use of the cotton swab method of diagnosing fungal cultures in children, and the ongoing investigation of promising new medications for the treatment of tinea capitis, including terbinafine, itraconazole, and fluconazole in this era of resistant organisms.

Prevalence of Undetected Tinea Capitis in Household Members of Children with Disease

The epidemiology of tinea capitis has changed over the past 40 years. The major organism responsible for tinea capitis today is Trichophyton tonsurans. This dermatophyte accounts for more than 90% of ringworm infections of the scalp in the United States and replaces Microsporum audouinii and to a lesser extent Microsporum canis, which were associated with the ringworm epidemics of the 1940s.1-4 Trichophyton tonsurans is an anthropophilic organism producing endothrix invasion of the hair shaft that does not fluoresce on Wood's light examination.5 Tinea capitis is epidemic in black school-age children, but only rarely in whites. The reason for this racial predilection is not known.1

The rise and fall of fluorescent tinea capitis.

The epidemiology of tinea capitis has had a remarkable change in the past 20 years. It is important for physicians to realize that most tinea capitis in the United States is caused by Trichophyton tonsurans and that these lesions cannot be diagnosed by the Wood's lamp. Trichophyton tonsurans tinea capitis is frequently misdiagnosed because the lesions mimic such common scalp conditions as dandruff and seborrhea. Further, this organism can cause chronic tinea capitis in women that may become a infectious reservoir for other family members. A negative potassium hydroxide preparation will not rule out infection with T tonsurans and cultures are necessary. Scalp lesions in children should be considered tinea capitis until culturally proved otherwise.