Epidemiology of dermatophytoses in a rural community in Eastern Nigeria and review of literature from Africa

A total of 4,287 primary school children, comprising 1,740 males and 2,547 females in Arochukwu local government area of Abia state Nigeria were examined for clinical signs of dermatophytoses. About 873 (20.4%), consisting of 505 males and 368 females had lesions consistent with dermatophytoses. The disease was more prevalent in males (29%) than females (14.4%) in a ratio of approximately 2:1 (P < 0.05). The infection rate increased from 16.8% in the 4–6 year age group to a peak of 28.1% in the 10–12 year age bracket and dropped sharply to 5.6% in the 16–18 year group. The highest prevalence (39%) was observed among males aged 10–12 years while females 16–18 years had the lowest prevalence (2.5%). Tinea capitis was the predominant clinical type of dermatophytoses, and occurred in 13.7% of the total population studied and 67% of lesion positive cases. Trichophyton soudanense and Trichophyton tonsurans the predominant aetiological agents of dermatophytoses with a prevalence of 26.2% and 21.6%, respectively. Others include Trichophyton mentagrophytes (18.8%), Epidermophyton floccosum (8.3%), Microsporum audouinii (6.4%), Microsporum gypseum (6.0%), Trichophyton rubrum (5.5%) and Microsporum ferrugineum (7.3%), which was isolated for the first time in Nigeria.     

Changes of Dermatophytoses in Southwestern Greece: An 18-Year Survey

The isolation and distribution rate of dermatophytes as causative agents of superficial mycoses of skin, hair, and nails during an 18-year period (1991–2008) at a university hospital are presented. A comparative analysis of epidemiological differences within the first (1991–1999) and the second 9-year period (2000–2008) was performed. Skin scrapings, nail, and hair specimens were examined by a direct microscopic examination and culture. Identification of dermatophyte species was based on macroscopic and microscopic characteristics of colonies. During the complete period (18 years), 5,971 patients with suspected dermatophytosis were examined. Seven hundred and sixty-nine patients (12.8%) were found positive. Among them, 495 cases (64.3%) were of skin dermatophytoses, 91(11.8%) of hair, and 183 (23.7%) of nails. The most frequent etiological agents were Microsporum canis (54%), Trichophyton rubrum (38%), and T. mentagrophytes (6%). Epidermophyton floccosum, T. tonsurans, T. violaceum, and M. gypseum were responsible only for 16 cases (2%) of dermatophytoses. The prevalence of dermatophytoses seems to decrease significantly from 16.2% (1991–1999)–9.6% during the last 9-year period. The most frequent dermatophyte, M. canis, shows decreasing trends during the last period (from 58.5 to 45.7%), whereas T. rubrum shows an increasing isolation rate (from 35 to 43.6%), respectively. The most common form of dermatophytosis among children remains tinea capitis due to M. canis. The most frequent etiological agent of tinea unguium (81%) is T. rubrum.     

Favus of the Scalp: An Overview and Update

Tinea capitis favosa, a chronic inflammatory dermatophyte infection of the scalp, affects over 90% of patients with anthropophilic Trichophyton schoenleinii. T. violaceum, T. verrucosum, zoophilic T. mentagrophytes (referred to as ‘var. quinckeanum’), Microsporum canis, and geophilic M. gypseum have also been recovered from favic lesions. Favus is typically a childhood disease, yet adult cases are not uncommon. Interestingly, favus is less contagious than other dermatophytoses, although intrafamilial infections are reported and have been widely discussed in the literature. Clinical presentation of T. schoenleinii infections is variable: this fungus can be isolated from tinea capitis lesions that appear as gray patches, but symptom-free colonization of the scalp also occurs. Although in the past T. schoenleinii was the dominant fungus recovered from dermatophytic scalp lesions, worldwide the incidence has decreased except in China, Nigeria, and Iran. Favus of the glabrous skin and nails are reported less frequently than favus of the scalp. This review discusses the clinical features of favus, as well as the etiological agents, global epidemiology, laboratory diagnosis, and a short history of medical mycology.     

Tinea Capitis in Southeastern China: A 16-Year Survey

This survey was a retrospective of a 16-year (1993–2008) study on the incidence, clinical features, and etiological agents of tinea capitis mainly representing the Southeastern China. The diagnosis was confirmed by direct microscopic examination. Eight hundred and sixty-six patients with tinea capitis, 381 males (44%) and 485 females (56%), were enrolled in this study. Patients were between 20 days and 84 years old with an average of 10.5 years and the peak incidence was in the age group of 6–10 (48.5%). Five hundred and sixty-two patients (64.9%) were ectothrix and 303 patients (35.0%) were endothrix with only one patient was favus. The incidence of tinea capitis from 1993 was gradually increasing and reaching to its peak in 2001. Positive cultures of dermatophytes were obtained in 715 patients: Microsporum canis (62.4%) was predominant, followed by Trichophyton violaceum (19.0%), Trichophyton tousurans (9.8%). M. canis was the major pathogen for ectothrix infection, while T. violaceum and T. tousurans contributed to the most endothrix form. M. canis, T. violaceum, and T. rubrum were the major pathogens for kerion.     

Prevalence of Dermatophytoses in the Zarqa District of Jordan

A total of 350 clinically suspected cases of dermatomycoses were examined for causative fungi during July 1997 to September 1998. Mycotic infection was demonstrable by microscopy and culture in 199 (56.8%) cases. The most common superficial mycotic infections were tinea pedis (35.2%) followed by tinea capitis (23.1%), tinea unguium (21.6%) and tinea corporis (10.6%). Most of the infected patients were 1–9, 20–29 and 30–39 years old. Men were mainly infected with tinea cruris and tinea pedis, while women were infected with tinea pedis, tinea unguium and tinea capitis. The frequencies of etiological agents isolated from patients were as follows: Trichophyton mentagrophytes var. interdigitale (32.7%), T. rubrum (28.6%), Epidermophyton floccosum (20.1%), Microsporum canis (11.1%), T.schoenleinii (4%), T.verrucosum (2%), T.violaceum (1%), and M. gypseum (0.5%). The number of infections varied with the seasons. The highest number of cases of tinea pedis and tinea cruris occurred in the summer months, while tinea capitis, tinea corporis and tinea unguium occurred in the spring and winter months. This revised version was published online in June 2006 with corrections to the Cover Date.     

Analysis of Dermatomycoses in Lanzhou District of Northwestern China

The skin mycoses, perticularly dermatophytoses, in Lanzhou district, Northwestern China, was investigated during July 2002–June 2003. The specimens from patients suspected of having dermatomycoses were examined microscopically in KOH preparations and cultured on Sabouraud dextrose agar (SDA). Among 1443 suspected cases, 594 were KOH positive and 221 cultures of fungi were isolated. The most frequently isolated fungi were Trichophyton rubrum (43.9%) Trichophyton mentagrophytes (29.4%) and Candida species (14.0%). The frequency of tinea pedis, onychomycosis and tinea manuum were 38.7, 27.8 and 13.5%, respectively. In Lanzhou district, tinea pedis is the most commonly seen dermatophytoses, and T. rubrum is the most frequent etiologic agent.     

Hair and scalp mycobiota in school children in Nablus area

Hair and scalp mycobiota of 1389 clinically normal children aged 6–12 years attending 12 schools in the Nablus District, Palestinian Authority, was assessed on three occasions over 8-month period (October 1998–May 1999) using the hair brush technique. One hundred and one fungal species belonging to 33 genera were recovered: 6 dermatophytes, 16 dermatophyte-like keratinophilic fungi, and 79 other keratinophilic fungal species. Species varied considerably in their frequency of occurrence and abundance based on their relative importance values (RIVs). The most frequent and abundant species were: Cladosporium cladosporioides, Cl. herbarum, Penicillium chrysogenum and Aspergillus flavus. Microsporum canis, Aphanoascus fulvescence and Chrysosporum sulfureum were the most frequent and abundant species of all dermatophytes and dermatophyte-like keratinophilic fungi recovered. The most frequent and abundant dermatophytes in different communities were M. canis in rural (RIV 0.87) and urban children (0.45), and Trichophyton violaceum (1.41) in refugee camp children. Chrysosporium species were the most frequent and abundant dermatophyte-like keratinophilic fungus in children from all localities followed by Aphanoascus fulvescence. Comparable results on the frequency and abundance of human hair and scalp mycobiota component fungi were obtained based on age group and sex of children. Higher number of species was recovered in spring months (73 species) than in autumn (57) and winter (44) months. Similar occurrence pattern was also noted for dermatophyte-like keratinophilic species and dermatophytes. Higher percentages of children with moderate (11–50) and heavy (≤ 50) spore loads (7.54 and 0.73, respectively) were found in urban school children community than in rural and refugee camp school children (4.7 and 0.1, respectively). Also significantly higher light (1–10) spore load percentages were found in rural (63.67) and refugee camp (62.9) than in urban children (52.6). Of all localities, school children with light spore load comprised the highest percentage of the children examined (37.4), followed by moderate (6.13), and heavy (0.41) spore load categories. However, children with undetected spore load comprised 36.05% of all children. Spore load distribution did not show clear seasonal variations in the study period. Higher percentages of moderate and heavy spore loads were found in male children (8.72 and 0.69, respectively) than in female children (3.4 and 0.1, respectively). However, higher percentages of undetected (38.3) or light spore loads (58.4) were found in females than in males (34.04 and 56.53, respectively). This revised version was published online in June 2006 with corrections to the Cover Date.     

Dermatophyte Infections in Cairo,Egypt

In this study, we examined dermatophyte infections in patients referred to the Department of Dermatology, EL-Houd El-Marsoud Hospital, Cairo, during March 2004 to June 2005. Of 506 patients enrolled in this investigation, 403 (79.6%) were clinically diagnosed as having dermatophytoses (age range 6–70 years; males 240; females 163). Species identification determined by observation of their macroscopic and microscopic characteristics was complemented with sequencing of the internal transcribed spacer ITS1-5.8S-ITS2 rDNA region. The most common dermatophyte infection diagnosed was tinea capitis (76.4%), followed by tinea corporis (22.3%) and tinea unguium (1.2%). The most frequently isolated dermatophyte species was Trichophyton violaceum, which accounted for most (71.1%) of all the recovered dermatophytes, followed by Microsporum canis (21.09%), Trichophyton rubrum (6.2%), and Microsporum boullardii (0.49%); both Epidermophyton floccosum and Trichophyton tonsurans were each only rarely isolated (0.24%).     

Epidemiologic study of dermatophyte infections in Nigeria (clinical survey and laboratory investigations)

The commonest dermatophyte infection among the referred dermatology cases in Nigeria is tinea pedis, whereas among the surveyed population of school children, the commonest fungal infection was tinea capitis.It was found that the most ubiquitcus causative organism for tinea pedis was E. fluccosum, that for tinea capitis was M. audouinii, while that for tinea corporis was T. soudanese.The source of infection of tinea capitis among the school children was found to be most likely the local barber who serviced the schools in all the villages, and this might explain the high incidence rate of T. soudanese in tinea capitis. Tinea pedis infection is believed to be highly favoured by the wearing of shoes among the senior students. Animals were not a major source of transmission of dermatophytes in Nigeria.No new species of dermatophytes has been identified among the cultured organisms.     

Scalp Dermatophyte Carriage in Pregnant,Pre-, and Postmenopausal Women: A Comparative Study Using the Hairbrush and Cytobrush Methods of Sample Collection

Tinea capitis is a dermatophyte infection of the scalp that is most often seen in prepubescent children. In this investigation, we examined the prevalence of tinea capitis and symptom-free colonization of the scalp with dermatophytes in 786 pre- and postmenopausal women aged 12–84 years. Scalp samples were collected from all participants by cytobrush or hairbrush, and cultures were then grown from these samples on Sabouraud glucose agar. No participant was diagnosed with tinea capitis; however, one 43-year-old patient (0.1%) was positive for a “scalp carriage” related to anthropophilic Trichophyton rubrum, as detected using a hairbrush. The internal transcribed spacer (ITS) regions of the isolate were sequenced, and the assembled DNA sequences were examined using the basic BLAST (nucleotide–nucleotide) software of the National Center for Biotechnology Information Web database. This patient was followed up without any antimycotic treatment, and after 4 weeks, mycological clearance was documented. In addition, the contacts and environment at home were screened, where all fungal cultures were sterile. To the best of our knowledge, this study is the first report of a “scalp carriage” related to a cosmopolitan fungus, T. rubrum.     

Concentration of IgE in children during ragweed pollination season

Genetic and environmental factors are responsible for running allergic diseases. The aim of this study was to compare the values of total- (t-IgE) and allergen-specific IgE (s-IgE) to Ambrosia artemisiifolia L. (Amb a) in children with sensitization to Amb a during ragweed pollination season, who experienced seasonal symptoms of allergic rhinitis (rhinorrhea, post-nasal drip, nasal congestion, itching, sneezing) and asthma (coughing, especially at night, wheezing, shortness of breath, chest tightness). Ragweed pollen grains were collected in Virovitica (rural area) and Zagreb (urban area)—cities with the same geographical width and elevation—during ragweed pollination seasons (July–October in 2006 and 2007), and their count was estimated. Concentration of t-IgE and s-IgE in pollination season was determined in serum of children with symptoms of allergic diseases. The total count of ragweed pollen grains (PG) differed significantly between Virovitica and Zagreb in both years, 2006. and 2007. In Virovitica it was significantly greater than in Zagreb. There was no statistically significant seasonal difference in both, t-IgE and s-IgE, respectively. No correlation was found between pollen grain count and the concentration of IgE’s. To clarify the induction of IgE synthesis in children with sensitization to Amb a, further studies are needed.     

A study of dermatophytoses in Esfahan (Iran)

The present study determined the extent and causative agents of dermatophytoses in Esfahan, a large city of Iran. Specimens from patients were examined for etiologic agents by direct microscopic procedure and by culture. Out of 12000 patients with skin diseases, 10.8% were affected with dermatophytoses. Among the 10.8% group, lesions of tinea capitis were most common (72.1%) and Trichophyton verrucosum was the most frequent (43.8%) dermatophyte isolated from the patients.We found a relationship between the spread of dermatophytoses and live-stock infected with dermatophytoses.     

Epidemiology of the dermatophytoses in the Florence area of Italy: 1985–1990

Between 1985 and 1990 we observed 2085 cases of dermatophytoses in the Florence area of Italy.Trichophyton rubrum andMicrosporum canis were the major etiological agents. 126 cases of dermatophytoses observed during this period were caused byTrichophyton mentagrophytes. Most of the patients came from rural areas or they kept pets.Epidermophyton floccosum ranked fourth in frequency (95 cases). The patients were adults and mainly males, most of whom engaged in sports or lived in group environments.Microsporum gypseum was isolated in 31 cases. Infections occurred directly from contact with soil or domestic animals. We report the principal clinical data concerning these last three dermatophyte infections.     

Long-term change in limnology and invertebrates in Alaskan boreal wetlands

Climate change is more pronounced at high northern latitudes, and may be affecting the physical, chemical, and biological attributes of the abundant wetlands in boreal forests. On the Yukon Flats, located in the boreal forest of northeast Alaska, wetlands originally sampled during 1985–1989 were re-sampled for water chemistry and macroinvertebrates in summer 2001–2003. Wetlands sampled lost on average 19% surface water area between these periods. Total nitrogen and most metal cations (Na, Mg, and Ca, but not K) increased between these periods, whereas total phosphorus and chlorophyll a (Chl a) declined. These changes were greater in wetlands that had experienced more drying (decreased surface area). Compared with 1985–1989, densities of cladocerans, copepods, and ostracods in both June and August were much higher in 2002–2003, whereas densities of amphipods, gastropods, and chironomid larvae were generally lower. In comparisons among wetlands in 2002–2003 only, amphipod biomass was lower in wetlands with lower Chl a, which might help explain the decline of amphipods since the late 1980s when Chl a was higher. The decline in Chl a corresponded to greatly increased zooplankton density in June, suggesting a shift in carbon flow from scrapers and deposit-feeders to water-column grazers. Declines in benthic and epibenthic deposit-feeding invertebrates suggest important food web effects of climate change in otherwise pristine wetlands of the boreal forest. Handling editor: R. Bailey     

Pet ownership and associated respiratory diseases

Background Studies have shown that pets are very important sensitizing agents in patients with asthma. Respiratory disorders and allergic diseases are common in the State of Qatar. Objective The aim of the present study was to determine whether exposure to pets and domestic animals plays a significant role in the development of asthma and allergic rhinitis among Qatari school children aged 6–14 years. Design A cross-sectional prospective study. Setting Public schools for boys and girls in urban and semi-urban areas. Subjects A total of 3,500 Qatari school boys and girls aged 6–14 years were approached. After exclusion of those who did not give consent for the study and incomplete questionnaires, 3,283 (98.3%) participants were included in the data analysis. Methods A multistage sampling technique was used and different schools from urban and semi-urban areas were selected. A standard questionnaire was distributed to parents of randomly selected school children aged 6–14 years between February 2003 and February 2004. Results The overall prevalence of asthma was 19.8% and the mean age of the children was 9.0 ± 2.0 years. The male and female percentages were 52.3% and 47.7% respectively. Nine hundred and ninety-six families out of 3,283 (30.3%) owned pets. It was found that among children with no family history of asthma, the relative risk (RR) of asthma with pets at home was 1.19 and the 95% confidence interval (CI) was 1.0–1.4 (P = 0.025). The RR of having allergic rhinitis was 1.60 (95% CI = 1.4–1.8; P < 0.001) and risk of having eczema was also significantly higher in participants with pets at home (RR = 1.28; 95% CI = 1.1–1.5; P < 0.001). Conclusion In the present study, the prevalence of asthma, allergic rhinitis, and eczema was significantly more common in families with domestic animals than in those without.     

Occurrences of harmful algal blooms (HABs) associated with ocean environments in the South China Sea

Harmful algal blooms (HABs) occur frequently in the South China Sea (SCS), causing enormous economic losses in aquaculture. We analyzed historical HAB records during the period from 1980 to 2003 in SCS. We found that HABs-affected areas have expanded and the frequency of HABs varied during this period. The seasonal and annual variations, as well as causative algal species of HABs are different among the four regions. Areas with frequent HABs include the Pearl River Estuary (China), the Manila Bay (the Philippines), the Masinloc Bay (the Philippines), and the western coast of Sabah (Malaysia). HABs occurred frequently during March–May in the northern region of SCS, May–July in the eastern region, July in the western region, and year-round in the southern region. Among the species that cause HABs, Noctiluca scintillans dominated in the northern region, and Pyrodinium bahamense in the southern and eastern regions. Causative species also varied in different years for the entire SCS. Both P. bahamense and N. scintillans were the dominant species during 1980–2003. Some species not previously recorded formed blooms during 1991–2003, including Phaeocystis globosa, Scrippsiella trochoidea, Heterosigma akashiwo, and Mesodinium rubrum. Variations in HABs are related to various regional conditions, such as a reversed monsoon wind in the entire SCS, river discharges in the northern area, upwelling in Vietnam coastal waters during southwest winds and near Malaysia coastal waters during northeast winds, and eutrophication from coastal aquaculture in the Pearl River estuary, Manila Bay, and Masinloc Bay. Handling editor: D. Hamilton     

Dermatophytosis among children of Fulani/Hausa herdsmen living in southeastern Nigeria

BackgroundDermatophytic infections are a worldwide public health problem. In Nigeria, children of nomadic herdsmen are thought to be more at risk because of their early and continuous exposure to different kinds of animals. However, little is known about the level of infection in these children in southeastern Nigeria or elsewhere within the West African sub-region.ObjectiveThis study investigated dermatophytic infections among children of nomadic herdsmen living in isolated camps in southeastern Nigeria from October 2008 to May 2009.Methods390 children aged between 4 and 17 years with clinically suggestive lesions were sampled. Isolates were identified by microscopy, culture or both. Biochemical tests and sequencing of the ITS2 region of the ribosomal DNA were used to identify isolates with atypical morphology.Results162 children were confirmed to be infected. Ten different species of dermatophytes were recovered with Trichophyton mentagrophytes showing the highest incidence. There was a significant difference (P < 0.05) in the frequency of isolates recovered among the different age groups screened. No significant (P > 0.05) observations were found according to gender or location of the two camps investigated.ConclusionThis study suggests that tinea capitis is the predominant clinical type of dermatophytosis among children exposed to different kinds of animals based on parental nomadic lifestyle. It also dominated in children with mixed infections in different anatomical sites. The high prevalence of 41.25% suggests that animal to child transmission may be very common.     

Genetic mapping of monoterpene composition in an interspecific eucalypt hybrid

Genetic control of foliar oil composition was investigated amongst half-sib progeny of an interspecific eucalypt hybrid. The oil was found to be largely composed of the monoterpenes, limonene, α−pinene, γ−terpinene, 1,8 cineole and p-cymene. Due to difficulties in the interpretation of the compositional data based on raw proportions, further analysis was conducted using log-ratio variables. A high degree of intercorrelation amongst log-ratios was thought to be a consequence of commonality in the biosynthetic origins of the monoterpenes. Quantitative trait locus (QTL) analysis of log-ratio variables indicated that a significant (68–81%) proportion of the variation in four out of the ten possible log-ratios were controlled by a single genomic region of the maternal Eucalyptus grandis parent. The impact of this genomic region upon oil composition was thought to be a consequence of a gene, or genes, controlling the production of limonene, as limonene was the predominant oil constituent in many hybrid individuals and was common to all log-ratios associated with the identified genomic region. Received: 20 November 1998 / Accepted: 16 June 1999     

Effects of Age and Region on Fecal Microflora in Elderly Subjects Living in Bama,Guangxi, China

Intestinal microflora analysis was performed on 52 healthy elderly subjects of different ages and in different regions in Bama County, Guangxi, China. The participants were assigned to three groups depending on their age and location: longevous (group M; mean age = 98 years; n = 21); rural younger elderly (group S; mean age = 70 years; n = 18); and urban elderly (group C; mean age = 82 years; n = 13). Ten groups of bacteria were quantified using real-time PCR. Age-related differences were observed in the number of Clostridium coccoides–Eubacterium rectale—there were more in longevous participants. Region affected the numbers of Bacteroides—Prevotella and Clostridium perfringens subgroup, and longevous participants had significantly more of the two bacterial groups than urban elderly participants. Region-related effects were also observed for the relative abundance of E. coli, and rural elderly participants had a lower proportion. Both age and regional effects were observed in the amount of total bacteria, and longevous participants had higher numbers than urban elderly participants. A significantly higher proportion of lactobacilli was observed in rural younger elderly participants than urban elderly participants, but independent age or regional effects did not contribute to this difference. This study suggests that age and region can affect the intestinal microflora of elderly people.     

Rural-urban differences in maternal responses to childhood fever in South East Nigeria

Background

Childhood fevers due to malaria remain a major cause of morbidity and mortality among under-five children in Nigeria. The degree of vulnerability perceived by mothers will affect their perception of the severity and threat of their child''s fever and the patterns of health care use. This study was undertaken to compare maternal responses to childhood fever in urban and rural areas of Enugu, south east Nigeria.

Methodology/Principal Findings

Data was collected with pre-tested interviewer-administered questionnaires from 276 and 124 urban and rural households respectively. In each household, only one woman aged 15–49 years who had lived in each of the urban and rural communities for at least one year and had at least one child less than 5 years old was interviewed. Malaria was mentioned as the commonest cause of childhood fevers. Rural mothers were more likely to recognize danger signs and symptoms than urban mothers. Rural mothers use more of informal than formal health services, and there is more home management of the fever with urban than rural mothers. Chloroquine, ACT, SP and Paracetamol are the main drugs given at home for childhood fevers, but the rural mothers were more likely to use leftover drugs from previous treatment to treat the fevers than urban mothers. The urban respondents were also more likely to use a preventive measure. Urban mothers sought actions faster than rural mothers and the total cost of treatment was also higher in urban areas.

Conclusions/Significance

Both urban and rural mothers are aware that malaria is the major cause of childhood fevers. Although rural mothers recognize childhood fever and danger signs better than urban mothers, the urban mothers'' responses to fever seem to be better than that for rural mothers. These responses and differences may be important for geographical targeting by policy makers for malaria interventions.