TINEA CAPITIS AMONG SCHOOL CHILDREN IN OKELELE COMMUNITY, KWARA STATE

Abstract

Tinea capitis impacts negatively on the health of children, consequently
affecting their education. Its prevalence is unknown in many African
communities. Tinea capitis is faced with therapeutic challenges as
resistance to all classes of antifungal agents continues to emerge. The
objective of this study was to determine the prevalence of tinea capitis
among primary school children in Okelele community in Kwara State,
highlighting the aetiological agents of the disease and their susceptibility
pattern, as well as the predisposing factors to tinea capitis among the
school children.
Three hundred and one pupils aged 5-14years with scalp lesions clinically
suggestive of tinea capitis attending the seven primary schools in Okelele
community were recruited, using a multistage sampling technique. Their
socio-demographic characteristics along with relevant clinical information
were obtained through a proforma designed for the study. Hair and/or
scalp scrapings and/or swabs were collected as specimens. The
specimens were examined microscopically and then cultured on Mycosel
agar plates. The susceptibility pattern of the isolates was determined by
the disc diffusion method using griseofulvin (25µg), terbinafine (30µg),
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itraconazole (8µg), fluconazole (25µg), ketoconazole (10µg), miconazole
(10µg) and clotrimazole (10µg) discs.
Two hundred and twenty eight of the children, with a mean age of 9.8
years±2.4, had mycologically proven tinea capitis, giving a prevalence of
75.7%. Tinea capitis was more common among males (76.8%) than in
females (69.0%). The identified aetiological agents of tinea capitis in the
study population were Trichophyton rubrum 156(68.4%), Microsporum
ferrugineum 51(22.4%), Trichophyton mentagrophytes 17(7.4%) and
Trichophyton verrucosum 4(1.8%). Following susceptibility testing T.
rubrum showed 78.8% sensitivity to clotrimazole and miconazole. M.
ferrugineum and T. mentagrophytes were 100.0% sensitive to
clotrimazole, miconazole and terbinafine. In addition, T. mentagrophytes
showed 100.0% intermediate susceptibility to fluconazole. T. verrucosum
was 100.0% resistant to all the antifungal drugs tested. Large family size
was found to be significantly associated with the occurrence of tinea
capitis.
The prevalence of tinea capitis among the school pupils with clinically
suggestive disease is high. There is the need for health education, in the
schools and the community on the modes of transmission, with emphasis
on the identified associated factors, and preventive measures. Terbinafine
is recommended for empiric treatment of tinea capitis while clotrimazole or
miconazole is suggested for use as adjunct therapy among the school
children in Okelele community. Further susceptibility studies are desired
on T. rubrum and T. verrucosum to identify the effective drugs for the
treatment of tinea capitis due to these agents.