Tinea Capitis In School Children Research Articles

Prevalence and Risk Factors of Tinea Capitis Among Primary School Children in the Grand Lomé Region (Togo), 2021: A Cross-Sectional and Case-Control Study Approach.

Tinea capitis is an infectious dermatosis frequent in children, causative fungi variable over time and space. The risk factors associated with this disease are still poorly understood. The objective of this study was to estimate the prevalence of tinea capitis among schoolchildren in Lomé (Togo), identify the fungal species involved and assess the associated risk factors. It was a cross-sectional and case-control study conducted in primary schools in Lomé from November 2020 to April 2021. All pupils presenting tinea capitis suspected lesions have been sampled, and the scraping and hair were examined by direct microscopy in KOH solution and cultured in Sabouraud dextrose agar with chloramphenicol and cycloheximide. Positive children were matched by age and sex with those without symptoms for case-control study. Out of the 15,087 pupils enrolled, 465 had positive cultures for dermatophytes, corresponding to the tinea capitis prevalence of 3.08% (95% CI [2.59-3.57]). Trichophyton mentagrophytes (81.86%) and Trichophyton soudanense (13.12%) were the majors isolated dermatophytes. The risk factors were mostly living in households with domestic animals, showering less than twice a day, having a history of ringworm, having similar lesions in the same household and sharing personal hygiene items. This study highlights the low prevalence of tinea capitis in schoolchildren in Lomé (Togo), the causative species dominated by T. mentagrophytes and emphasises the importance of environmental and behavioural factors in the mycosis transmission. Implementing preventive measures addressing the identified factors could help to reduce the prevalence of this disease.

Prevalence of Tinea capitis in Schoolchildren in Three Villages of Woleu-Ntem Province Haut Ntem Department, Gabon

Introduction: Tinea capitis is a benign alopecising fungal infection mainly affecting schoolchildren with a tendency to spontaneous healing at puberty, and caused by dermatophytes. Objective: to determine the prevalence of Tinea capitis in schoolchildren in the Haut Ntem department. Materials and Methods: This was a descriptive cross-sectional study conducted from November 11, 2021 to April 7, 2022 in 3 villages in the Haut Ntem department. The ringworm lesions were taken from schoolchildren head using a scalpel and collected in a sterile Petri dish. Each sample was examined directly and cultured on Sabouraud Chloramphenicol Actidione medium. Tinea capitis was diagnosed if either direct examination or culture was positive. Results: Among the 128 children, included, median age was 9 years, Tinea capitis with small plaques (66.4%) were more frequent than those with large plaques (33.6%). The frequency of Tinea capitis was higher on direct examination (23.6%) than on culture (9.4%). The age group most affected by both direct examination and culture was [6-9 years] (p=0.27). After culture, Tinea capitis of the scalp was more frequent in Gabon-Ville (41.7%); whereas its frequency (25.0%) was similar in Akok and Gabon-Ville on direct examination. Endothrix parasitism was significantly more frequent (p<0.0001). Tinea capitis was mainly due to the Trichophyton genus (100%, p<0.0001). Conclusion: Tinea capitis are a public health problem in rural Gabon. They are dominated by small-plate ringworm caused by fungi of the Trichophyton genus.

Antifungal Susceptibility Pattern of Fungi Associated with Tinea capitis in School Children of Morogoro Municipality, Tanzania

Introduction: Tinea capitis is one of the common skin diseases affecting school-age children in developing countries. However, the susceptibility of fungi associated with this disease against antifungal agents commonly used has not been fully investigated. Aim: The aim of this study was to determine the antifungal susceptibility pattern of fungi associated with tinea capitis amongst children sampled from selected schools in Morogoro Municipality, Tanzania. Methods: A descriptive cross-sectional study was conducted involving 72 school children recruited from 10 primary schools in selected class strata within Morogoro Municipality, Tanzania using a multistage sampling technique. Pure cultures of fungi isolates were obtained from scrappings of head lesions in school children and tested for sensitivity to commonly used antifungal agents using the Kirby Bauer agar disk diffusion method. Results: The identified fungi were Trichoderma longibrachiatum, Cytobasidium minutum, Aspergillus spp, Ectophoma multirostrata, Aureobasidium pullulans, Aspergillus flavus, Cladosporium tenuissimum, Pichia terricola, Penicillium flavigenum and Fusarium solani. Out of 10 fungal isolates, 9 (90%) were sensitive to both amphotericin B and nystatin, 4(40%) sensitive to clotrimazole, 1(10%) sensitive to fluconazole and griseofulvin, 3(30%) sensitive to itraconazole, and no isolate showed sensitivity to ketoconazole. Nystatin and amphotericin B showed best antifungal activity against Trichoderma longibrachiatum, Cytobasidium minutum, Fusarium solani and Aspergillus sp while clotrimazole and ketoconazole had intermediate fungal growth inhibition and best activity against Fusarium solani and Aspergillus sp but were resistant to the other antifungal agents. Fluconazole, griseofulvin, and itraconazole were not effective to any of the isolates. Conclusion: This study revealed that nystatin and amphotericin B were ideal antifungal drugs for the treatment of tinea capitis in the studied population.

Tinea capitis in school children from Mauritania: A comparative study between urban and rural areas

IntroductionIn Mauritania, only an investigation carried out 26 years ago allows to report epidemiological findings about tinea capitis in Nouakchott. The objective of this study was to reactualize the tinea capitis epidemiological, clinical and mycological profile in school children and to compare this profile in urban and rural area. Patients and methodsAll subscribed students in targeted schools and present during the investigation were examined clinically before samples collection. Mycological diagnosis was made by direct examination and culture in Sabouraud Dextrose Agar with chloramphenicol and supplemented with cycloheximide. The results were considered positive when culture with the presence of dermatophytes was obtained. ResultsPrevalence of tinea capitis among school children was 10.50% and it was more important in rural area (12.21%) than in urban area (9.52%). The age group ranged between 6 and 8 years was the most affected (13.58%). According to the gender, male (11.46%) were more affected than female (9.62%). Trichophytic tinea were predominant and Trichophyton soudanense was more isolated followed by Trichophyton rubrum, Trichophyton schoenleinii and Microsporum audouinii.

Hair loss in children in rural population

<p class="abstract"><strong>Background:</strong> Among children worldwide, dermatophyte infections are most common constituting a public health problem. The aim of the study is to determine the prevalence and causative agents of tinea capitis in school children attending primary school located in Hyderabad and to perform an analysis of risk factors associated with tinea capitis as the etiological factor.</p><p class="abstract"><strong>Methods:</strong> This is a school based, cross sectional, prospective study which was conducted in July 2015. This study was conducted in a school located near Hyderabad.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of 600 school children, 298 boys and 302 girls, 100 were diagnosed with a tinea capitis infection after clinical and microbiological examination, with an estimated prevalence rate of 15.0%. The most prevalent dermatophytes isolation in tinea capitis in children were <em>Trichophyton verucosum</em> (90), <em>Trichophyton tonsurans</em> (30), <em>Trichophyton mentagrophytes</em> (28), <em>Microsporum audiouium</em> (15), <em>Trichophyton soudanese</em> (9), <em>Trichophyton violaceum</em> (5), <em>Microsporum ferrugineum</em> (3), <em>Trichophyton schoenleineii</em> (3), <em>Microsporum gallinae</em> (2) and culture negative and KOH positive (10).</p><p class="abstract"><strong>Conclusions:</strong> This study concluded that the findings suggest that the practices resulting in entrenchment of dermatophyte infections and fungal infection. The promotion of public health action plan based on self hygiene education, which aimed to counteract the epidemiological burden specifically, and it should play an pivotal role in reduction of the prevalence in future of this common infection.</p>

The Burden of Serious Fungal Infections in Cameroon.

Fungal infections are frequent in Cameroon, and invasive fungal infections are sometimes detected, usually in HIV-infected patients. For these reasons, we have estimated the burden of fungal infections. Using published literature and population estimates for the at-risk group, we used deterministic modelling to derive national incidence and prevalence estimates for the most serious fungal diseases. HIV infection is common and an estimated 120,000 have CD4 counts <200 × 106/mL and commonly present with opportunistic infection. Oesophageal candidiasis in HIV is common, and in poorly controlled diabetics. We estimate 6720 cases of cryptococcal meningitis, 9000 of Pneumocystis pneumonia, 1800 of disseminated histoplasmosis annually complicating AIDS, and 1200 deaths from invasive aspergillosis in AIDS, but there are no data. We found that 2.4% of adults have chronic obstructive pulmonary disease (COPD) and 2.65% have asthma, with “fungal asthma” affecting 20,000. Chronic pulmonary aspergillosis probably affects about 5000 people, predominantly after tuberculosis but also with COPD and other lung diseases. Also, tinea capitis in schoolchildren is frequent. Overall, an estimated 1,236,332 people are affected by a serious fungal infection. There is an urgent need for government and clinician attention, improved laboratory facilities, fungal diagnostic tests, and competent laboratory technicians, as well as all World Health Organization (WHO)-endorsed essential antifungal drugs to be made available, as only fluconazole is registered and available in the country.

Mycological profile of tinea capitis in schoolchildren in rural southern Ethiopia.

Tinea capitis is a known common infection among schoolchildren in developing countries that is still underreported in Ethiopia. The aim of this study was to examine the epidemiologic and etiologic profile of tinea capitis among school-aged children in a rural area in southern Ethiopia. We collected demographic and clinicodermatological data from school children aged 3-12 years with tinea infections. Pathologic specimens were taken for potassium hydroxide (KOH) mount and mycological culture. Dermatophyte species were identified by macroscopic examination of the colony and microscopic examination of fungal cultures. A total of 634 schoolchildren were screened in the study; 128 cases were suspected for tinea capitis based on clinical examination of which 99 patients (mean age 6.7 years within a range of 4-12 years), who were subsequently positive, either based on KOH examination or showed growth of dermatophytes on culture, were included in our study. The ratio of males to females was 3:1. A total of 88 patients (89.9%) had a culture positive for dermatophytes. The zoophilic species Trichophyton verrucosum was the most prevalent isolate (n = 29 cases), followed by the anthropophilic species T. tonsurans (n = 27). The other Trichophyton species implicated were T. mentagrophytes (n = 14), as well as T. schoenleinii, T. soudanense, and T. violaceum. Only 11 of the isolates belonged to the genus Microsporum: M. audouinii (n = 8), M. ferrugineum (n = 2), and M. gallinae (n = 1). T. verrucosum, followed by T. tonsurans were the most frequent causative agents in this study.

Griseofulvin and Fluconazole Reduce Transmission of Tinea Capitis in Schoolchildren.

We evaluated the efficacy of griseofulvin and fluconazole in reducing the potential for person-to-person transmission of tinea capitis (TC) in children. Children with TC with positive fungal cultures were treated with griseofulvin 25 mg/kg/day (group A) or fluconazole 6 mg/kg/day (group B) for at least 21 days and up to 12 weeks until cure was achieved. Clinical and mycologic examinations occurred before treatment and on days 3, 7, 10, 14, and 21 of treatment. During each visit, mycologic examination was performed from scalp lesions of children and fingertips of medical staff and parents after a brief touch of the patient's scalp lesions. Ninety patients were enrolled: 48 treated with griseofulvin and 42 with fluconazole. The predominant species were Trichophyton violaceum (n = 44) and Microsporum canis (n = 41), followed by Trichophyton mentagrophytes (n = 3) and Trichophyton rubrum (n = 2). Ten days after treatment more than 75% of patients from both treatment groups were noncontagious. At day 21, all patients from group A were noncontagious and two (7%) with positive culture of M. canis from group B were still contagious. No statistically significant differences were found between treatment groups. Griseofulvin and fluconazole reduced the potential for disease transmission in children with TC, with griseofulvin being more effective for M. canis infections, although children with TC may be potentially contagious even after up to 3 weeks of treatment. These data should be considered regarding school attendance of children with TC.

Tinea capitis in schoolchildren in a rural area in southern Ethiopia.

Skin diseases, especially tinea capitis, represent some of the most frequent causes of morbidity in developing countries. The aim of this study was to examine the prevalences of fungal infections in schoolchildren in a primary school located in a rural area in southern Ethiopia and to perform an analysis of the risk factors associated with tinea capitis. This school-based, prospective cross-sectional study was conducted in October 2012 in Gambo School, Kore, West Arsi, Oromya Region, Ethiopia. Detailed interviews and dermatological examinations were performed. No laboratory examinations were conducted. A total of 647 students were interviewed and examined. The mean age of these children was 10 years (range: 4-14 years). Of the children examined, 236 had some type of dermatophytosis (prevalence: 36.5%, 95% confidence interval [CI] 32.8-40.3), which represented the most frequent type of skin problem. The prevalence of dermatophytoses was more common in males than in females (42.2% and 30.5%, respectively; P = 0.002), and among pupils aged 5-7 years (46.9%; P < 0.001). A total of 159 (prevalence: 24.6%, 95% CI 21.3-28.1) children had tinea capitis, 56 (8.7%) had tinea pedis, 50 (7.7%) had tinea corporis, and six (0.9%) had tinea unguium. In multivariate analysis, the risk factors for tinea capitis were: age (odds ratio [OR] 0.75, 95% CI 0.69-0.84; P < 0.001), and male gender (OR 2.56, 95% CI 1.69-13.39; P = 0.002). Fungal dermatoses, especially tinea capitis, are common in primary schoolchildren in rural areas of southern Ethiopia, especially in young boys.

Tinea capitis in schoolchildren in southern Ivory Coast

Fungal infections of the scalp commonly affect the pediatric population. These infections are caused by dermatophytes that are able to invade the keratinized structures of skin, hair, and nails. This study aimed to analyze the epidemiology of fungal scalp infections in southern Ivory Coast during 2008-2009. From October 2008 to July 2009, 17,745 children ranging in age from 4-16years, attending urban and rural primary schools in seven towns in Ivory Coast, were examined clinically for tinea capitis. Hair stumps and scales were collected from children who showed symptoms suggestive of scalp ringworm. Samples were exposed to direct microscopic examination using 30% potassium hydroxide solution and cultivation on Sabouraud's dextrose agar with or without actidione. Of the 17,745 children who were clinically examined, a total of 2645 exhibited symptoms suggestive of scalp ringworm. Positive cultures for fungi were found in 2458, yielding an overall prevalence of tinea capitis of 13.9%. The majority of infections occurred in males (74.0%). The most commonly affected age group involved children ranging from 9-12years (n=1335, 54.3%), followed by those in the range of 4-8years (n=936, 38.1%). Trichophyton soudanense, Microsporum langeronii, and Trichophyton mentagrophytes were the most prevalent etiologic agents (56.7%, 21.4% and 19.7%, respectively). Other species were occasionally isolated, including Trichophyton violaceum (1.4%) and Trichophyton rubrum (0.8%). Epidemiological surveys are an essential tool for developing strategies for infection control.

Prevalence and causative fungal species of tinea capitis among schoolchildren in Gabon

Tinea capitis is endemic among schoolchildren in tropical Africa. The objective was to determine the prevalence of symptomatic tinea capitis in schoolchildren in Gabon. A cross-sectional study was conducted with 454 children aged 4-17 years, attending a rural school and an urban school. The diagnosis of tinea capitis was based on clinically manifest infection, direct microscopic examination using 20% potassium hydroxide (KOH) solution and fungal culture. Based on clinical examination, 105 (23.1%) of 454 children had tinea capitis. Seventy-four (16.3%) children were positive by direct examination (KOH) and/or fungal culture. The prevalence of tinea capitis depended on the school studied and ranged from 20.4% in the urban school with a higher socioeconomic status to 26.3% in the rural school with a lower socioeconomic status. Similarly, the spectrum of causative species varied between the different schools. Taken the schools together, Trichophyton soudanense (29.4%) was the most prominent species, followed by Trichophyton tonsurans (27.9%) and Microsporum audouinii (25.0%). Clinically manifest tinea capitis is endemic among schoolchildren in the Lambaréné region in Gabon. The prevalence of tinea capitis and the causative species depended on the type of school that was investigated.

Prevalence of tinea pedis, tinea unguium of toenails and tinea capitis in school children from Barcelona

Objective To evaluate the prevalence of tinea capitis, tinea pedis, and tinea unguium in children from several schools of Barcelona city. Methods During the period of 2003–2004, a prospective cross-sectional study was carried out in 1,305 children (9% immigrant population) between the ages 3 and 15 in 17 schools in Barcelona. A systematic examination of the feet, (including nails and scalp), was performed to identify lesions compatible with tinea. Cultures of scalp and feet samples were done and analysis of environmental samples was performed for dermatophyte isolation. Results Dermatophytes were isolated in 2.9% of the samples with a prevalence of 2.5% in feet, 0.23% in scalp, and 0.15% in nails of the feet. The predominant etiologic agents in feet were Trichophyton mentagrophytes in 45.7% of the cases and Trichophyton rubrum in 31.4%. In the nails, T. rubrum and Trichophyton tonsurans were isolated, while T. mentagrophytes (2 cases) and Trichophyton violaceum (1 case) were identified in scalp samples. Forty-five per cent of dermatophytes were isolated from healthy feet, the majority of cases in children 13–15 years old ( p<0.05). Microsporum gypseum was the only agent identified in the environmental samples, and was also found in one of the cases of tinea pedis. Conclusion The results of this study demonstrate a low prevalence of tinea capitis and tinea unguium in school children of Barcelona. On the contrary, high prevalence of dermatophytes in feet was found. It highlights the high prevalence of healthy carriers of dermatophytes in feet.

Changes in frequency of agents of tinea capitis in school children from Western China suggest slow migration rates in dermatophytes

Tinea capitis is a common dermatophyte infection of the scalp of children in Western China, with the gray-patch from being the most prevalent. Twenty years ago, the most widespread etiologic agent was reported to be Trichophyton violaceum, which was later succeeded by Microsporum ferrugineum and Trichophyton schoenleinii. In the framework of our recent study, 97 isolates were collected from patients with clinically suspected tinea capitis. Identification was performed by conventional methods and by sequencing the ribosomal DNA internal transcribed spacer region. In the case of T. violaceum an additional microsatellite primer set (T1) was used. Five species (in order of frequency, Trichophyton violaceum, T. schoenleinii, Microsporum ferrugineum, zoophilic strains of Arthroderma vanbreuseghemii, and Trichophyton tonsurans) were identified. Results of molecular and phenotypic ID of the same strains showed good correspondence. Comparison with earlier data showed that dermatophytes species in former rural societies must have migrated extremely slowly. Preponderance of local transmission from domesticated animals was proven by the occurrence of zoophilic strains of Arthroderma vanbreuseghemii. Etiologic agents in the rural communities of Western China tend to be different from those of the other regions in the country, despite modern communication and traffic.

Aetiology of tinea capitis in school children.

Tinea capitis is a superficial fungal infection of the scalp and hair of the head which is common in children aged between two and eleven years. An endothrix infection is best treated using parenteral antifungal drugs while an ectothrix one may be treated by parenteral or topical antifungal drugs. The organism that commonly causes tinea capitis in the Western world is Trichophyton tonsurans while there is inadequate information on the actual causative agent in Kenya. To determine the prevalence and the aetiology of tinea capitis and the fungal agents responsible for it and; to recommend the correct mode of treatment in school children attending a primary school near Eldoret. Prospective and descriptive study. Private primary school near Eldoret town. Sixty eight primary school children aged between six and 14 years in classes 1 to 5. Of the 68 pupils included in the study, 60.9% and 39.1% were males and females, respectively. Prevalence of tinea capitis in the school was 33.3%. Peak age of infection was 10 years. Ratio of infected males to females was 2:1. There was a growth on culture in 76.1% of the cases all of which were endothrix. T. tonsurans was isolated in 77.8%, T. rubrum in four per cent of the cases. The prevalence of tinea capitis in this school was high. The most common cause of tinea capitis was T. tonsurans. Males were more infected than the females. Oral antifungal drugs with griseofulvin being the first line of treatment should be adopted. Health education on the aetiology, treatment and prevention of tinea capitis should be given.

Epidemiological study of tinea capitis in schoolchildren in the Nablus area (West Bank).

A study of tinea capitis was carried out during the period January-June 1996 in 7525 primary schoolchildren aged 6-14 years comprising 4050 boys and 3475 girls in the Nablus district in the Palestinian area. Fourteen primary schools located in rural, urban and refugee camp areas were surveyed in this study. Seventy-five (1.0%) mycologically proven cases of tinea capitis were detected. The incidence was higher in schools in rural areas (1.9%) than in refugee camps (1.1%) or urban areas (0.4%). Also, the incidence was higher in young children (1.4%) aged 6-10 years than in older children (0.5%) aged 10-14 years. Boys 52 (1.3%) were more commonly affected than girls 23 (0.7%). Higher disease incidence was found to be correlated with larger family and class sizes. Trichophyton violaceum was the most common aetiological agent (82.7%) followed by Microsporum canis (16%) and Trichophyton schoenleinii (1.3%). The findings are discussed in relation to the children's different socioeconomic and hygienic backgrounds. A mycological investigation carried out on 117 tinea capitis cases at a clinic in the area under study showed similar results to those of the school survey.

Tinea capitis in school children in Eastern Nigeria.

Summary: A survey of tinea capitis was carried out during the period 1974–1977 in 3, 478 primary school children aged 4–13 years and comprising 1, 868 males and 1610 females in Anambra State in Eastern Nigeria. A total of 303 (8.7%) mycologicaliy proven cases of tinea capitis were detected. Incidence was significantly higher in young children (10.5%) aged 4–8 years than in older children (6.0%) aged 9–13 years. Males (9.0%) were more commonly affected than the females (73%).Microsporum audouinii was the commonest etiological agent (483%) followed next by Trichophyton soudanense (26.6%) and T. tonsurans (15.2%). Other dermatophytes occasionally represented were M. ferrugineum (3.4%), T. violaceum (3.7%), T. yaoundei (1.2%), T. mentagrophytes (0.9%) and T. schoenleinii (0.6%). Investigation of scalp carriage of dermatophytes showed that approximately 9% of children without any clinical signs of tinea capitis harbour dermatophytes in their scalp hair. The significance of these findings is discussed in relation to relative distribution of different species of dermatophytes in Nigeria and other countries in Africa. A detailed study of the morphological characters of the isolates showed considerable variation in microscopical features of M. audouinii and T. soudanense.Zusammenfassung: In den Jahren 1974 bis 1977 wurden im Staat Anambra in Ost‐Nigeria 3478 Schulkinder im Alter von 4 bis 13 Jahren, darunter 1868 männliche und 1610 weibliche Kinder, untersucht Insgesamt wurden 303 (8,7%) einer nachgewiesenen Tinea capitis entdeckt. Bei jungen Kindern im Alter von 4–8 Jahren war die Inzidenz mit 10,5% höher als bei älteren Kindern im Alter von 9–13 Jahren mit 6%. Männliche Kinder waren mit 9,0% häufiger betroffen als weibliche Kinder (73%). Der häufigste Erreger war Microsporum audouinii (483%). Es folgten Trichophyton soudanense (26,6%) und T. tonsurans (15,2%). Andere Dermatophyten traten nur gelegentlich auf: M. ferrugineum (3,4%), T. violaceum (3,7%), T. yaoundei (1,2%), T. mentagrophytes (0,9%) und T. schoenleinii (0,6%). Die Untersuchung der Kopfhaut von klinisch erscheinungsfreien Kindern zeigte, daß bei etwa 9% dieser Kinder Dermatophyten von der Kopfhaut isoliert werden konnten. Die Bedeutung dieser Ergebnisse wird auch unter dem Gesichtspunkt der unterschiedlichen Verteilung der verschiedenen Dermatophyten in Nigeria und in anderen afrikanischen Ländern diskutiert. Eine eingehende Untersuchung der morphologischen Charakteristika der isolierten Pilze zeigte beträchtliche Variationen in der Mikromorphologie von M. audouinii and T. soudanense.