Assessment of Tinea Infections Among Primary School Children in Aninri Local Government Area of Enugu State, Nigeria

Abstract Tinea infection is a common fungal infection that affects the superficial keratinized tissues of the body (skin, hair and nails). This study assessed tinea infections among primary school children in Aninri Local Government Area of Enugu State, Nigeria. Seven primary schools were selected for the study. Ethical approval was obtained from the Education and Health Departments of Aninri Local Government and informed consent also obtained from the parents of the pupils. A researcher-developed questionnaire was used to obtain information on demography, hygienic practices and clinical picture. The pupils were randomly selected based on those with tinea (ringworm) lesions. Samples of nail clippings, hair and skin scrapings were collected from the affected sites after sterilizing with 70% ethanol unto sterile wide containers and transported to the Medical laboratory at the Department of Medical Laboratory Sciences, University of Nigeria, Enugu Campus. The samples were analyzed by microscopy using 10% KOH followed by mycological cultures using Sabourand dextrose agar, Potatoe dextrose agar and Corn meal agar. The isolates were identified based on their colonial morphology using lactophenol cotton blue stain. Statistical analysis was by Chi-square and student`s t-test. Of the 1544 pupils examined, 186 had various tinea infections; Tinea capitis was the commonest infection with a prevalence of 72.5%. Tinea corporis, Tinea unguim and Tinea mannum had a prevalence of 16.18%, 3.8% and 2.2% respectively. The males had higher isolates of dermatophytes (55.1%) than the females (44.9%). The age group of 6 to 10 years had the highest fungal isolates of 55.4% with the least isolates seen in those below 6 years; 11.8%. The mean age for the pupils was 8.70 + 2.66. There was no significant difference (p> 0.05) between the age groups. Trichophyton mentagrophtes was the leading dermatophye isolated; 56.1% and the least was Trichophyton soudanese with a yield of 0.5%. The non dermatophyte species isolated were Aspergillus flavus(0.5%) and Candida albicans(1.6%). Risk factors assessed such as poor personal hygiene, overcrowding, intimate association with household pets among the children and poor infrastructure play roles in the dissemination of tinea infection among these children. Consequently, proper health education, personal and environmental sanitation, provision of infrastructure, primary health care and regular clinical studies are recommended for these primary school pupils.

TABLE OF CONTENTS

Title Page- - - - - - - - - - - i

Certification- - - - - - - - - - - ii

Dedication- - - - - - - - - - - iii

Acknowledgement- - - - - - - - - - iv

Table of Contents- - - - - - - - - - v

List of Tables-- - - - - - - - - - viii

List of Figures- - - - - - - - - - ix

Abstract- - - - - - - - - - - x

CHAPTER ONE: INTRODUCTION

1.1 Statement of Problem- - - - - - - - 3

1.2 Justification- - - - - - - - - - 4

1.3 Aims and Objectives- - - - - - - - - 4

1.3.1 General Objective- - - - - - - - - 4

1.3.2 Specific Objectives- - - - - - - - - 4

CHAPTER TWO: LITERATURE REVIEW

2.1 Classification of Tinea Infections- - - - - - - 5

2.1.1 Tinea Capitis-- - - - - - - - - 5

2.1.2 Tinea Corporis- - - - - - - - - 6

2.1.3 Tinea imbricata- - - - - - - - - 7

2.1.4 Tinea faciei - - - - - - - - - 8

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2.1.5 Tinea pedis - - - - - - - - 8

2.1.6 Onychomycosis- - - - - - - - - 9

2.1.7 Tinea Manuum - - - - - - - - 11

2.1.8 Tinea Barbae - -- - - - - - - 11

2.1.9 Tinea Cruris- - - - - - - - - - 11

2.2 Ecological Groups of Dermatophytes- - - - - - 12

2.2.1 Anthropophilic dermatophytes- - - - - - - 12

2.2.2 Zoophilic dermatophytes- - - - - - - - 12

2.2.3 Geophilic dermatophytes- - - - - - - - 12

2.3 Groups of Dermatophytes - - - - - - - 12

2.3.1 Microsporum species - - - - - - - - 12

2.3.2 Epidermophyton species - - - - - - - 13

2.3.3 Trichophyton species - - - - - - - - 13

2.4 Epidemiology of Tinea Infections - - - - - - - 14

CHAPTER THREE: MATERIALS AND METHODS

3.1 Study Area- - - - - - - - - - 19

3.2 Study Design- - - - - -- - - - 19

3.2.1 Study Population- - - - - - - - - 19

3.2.2 Sample Size- - - - - - - - - - 19

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3.2.3 Inclusion Criteria- - - - - - - - - 20

3.2.4 Exclusion Criteria- - - - - - - - - 20

3.2.5 Ethical Issues- - - - - - - - - - 20

3.2.6 Sampling Method/ Techniques- - -- - - - - 20

3.2.7 Selection of Pupils- - - - - - - - - 21

3.2.8 Sample Collection- - - - - - - - - 23

3.3 Mycological Procedure- - - - - - - - 23

3.3.1 Direct Microscopic Examination- - - - - - - 23

3.3.2 Fungal Culture- - - - - - - - - 24

3.3.3 Identification of Isolates- - - - - - - - 25

3.3.4 Data Analysis-- - - -- - - - - - 25

CHAPTER FOUR: RESULTS

4.1 Results- - - - - - - - - - 26

CHAPTER FIVE: DISCUSSION, CONCLUSION AND RECOMMENDATION

5.1 Discussion- - - - - - - - - - 33

5.2 Conclusion and Recommendation- - - - - - - 39

5.3 Limitations - - - - - - - - - 39

References

Appendices