Magnitude and Associated Risk Factors of Superficial Skin Fungal Infection Among Primary School Children in Southern Tanzania

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Abstract

Introduction: Superficial skin fungal infections are among the neglected communicable diseases in many developing countries. Schoolchildren are among the most affected groups in Southern Tanzania. The main objective of this study was to determine the magnitude and associated risk factors of superficial skin fungal infections among primary schoolchildren in Southern Tanzania.

Methods: A cross-sectional descriptive community-based study was conducted in October 2017 in a public primary school in Songea Municipal, Southern Tanzania. A sample of 500 pupils was interviewed and a physical examination performed to assess for the presence of clinically suspected skin fungal infections. Data were analyzed by SPSS v21 (IBM Corp., Armonk, NY, US).

Results: A total of 500 pupils (52.40% males) with a mean age of 9.92±1.13 years were recruited. The point-prevalence of skin fungal infections was 35.20%. Tinea capitis was the leading suspected skin fungal disease found in 73 (80.22%) pupils. Age between 10 and 12 years and sharing of a bed with more than three people were significantly associated with the development of superficial skin fungal infections (p<0.05).

Conclusion: Our findings indicate that the magnitude of superficial skin fungal infections among schoolgoing children in this study area is moderately high. We recommend the provision of health education programs for preventing and controlling diseases in schoolchildren, with the aim to reduce long-term morbidity and the socioeconomic impact.

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Most cited references 17

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Skin disease and socioeconomic conditions in rural Africa: Tanzania.

Ronald Gibbs (1996)

Many skin diseases in developing countries are associated with socioeconomic factors. It is generally agreed that a public health approach to dermatology in this setting is particularly appropriate; but, there has been little epidemiologic research done to examine which particular socioeconomic factors are important determinants of the prevalence of skin disease. This is especially true in sub-Saharan Africa. A survey of two villages in Ngara district, North West Tanzania, involved 254 randomly selected households using a questionnaire, measurements of houses and water quality, and examination of the skin of 1114 household members. Significant skin disease was encountered in 300 individuals (26.9%). Transmissible diseases comprised the bulk of skin disease (73.9%) with younger age groups being affected most. Socioeconomic conditions were poor, with low quality, crowded housing, low levels of literacy, unsatisfactory water sources, and few households with a regular cash income. Household density was significantly associated with transmissible skin disease. Other indicators of poverty (e.g., no regular cash income and illiteracy) did not correlate with the prevalence of skin disease. Skin disease as highly prevalent in the villages surveyed, especially transmissible diseases in the younger age groups. Household density was the only socioeconomic factor significantly associated with skin disease. Reduction of household density is an attainable intervention that could reduce the prevalence of skin disease in rural African populations. Simple studies like this one should be the first step in community dermatology, assessing the burden of skin disease in communities and looking for particular factors with which public health interventions could effectively reduce the prevalence of skin disease.

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Quality of life and acne in Scottish adolescent schoolchildren: use of the Children's Dermatology Life Quality Index (CDLQI) and the Cardiff Acne Disability Index (CADI).

Nicole Walker, Roland S. G. Jones (2005)

Acne vulgaris is known to adversely affect all aspects of quality of life. However, although acne is thought to occur in the majority of adolescents, there are few data currently available on the impact of acne in this age group. Measurement of the impairment of health-related quality of life (HRQoL) in teenage Scottish schoolchildren in a comparative study using two HRQoL questionnaires. A secondary objective was to collect data on the use and perceived efficacy of medical and over-the-counter (OTC) preparations. An anonymous cross-sectional survey of 200 adolescent (15-18 years) Dundee schoolchildren was conducted by means of two self-reported questionnaires: the Children's Dermatology Life Quality Index (CDLQI) and the Cardiff Acne Disability Index (CADI). Data on demographics and therapeutic modalities and their perceived efficacy were also collected. Statistical analysis was performed using the package Stata 7.0. Self-reported acne was present in 83% of teenagers (147/178), with similar sex distribution (54% male, 46% female). The overall mean CDLQI score (max. 30) was low 1.7 {6% impairment} (CI -1 to 0), range 0-19. Nine pupils scored between 5 and 9 {17-30% impairment} suggesting moderate HRQoL impairment and three scored > 10 {> 33% impairment} indicating severe impairment. The overall mean CADI score (max. 15) of 1.9 {13% impairment}, CI 0 to 1 (range 0-15) was also low, but 12 pupils scored between 5 and 9 {33-60% impairment}, one scoring 10 + {> 67% impairment} and one scoring the maximum, 15 {100% impairment}. There was no significant difference in mean scores between the sexes in either questionnaire (P = 0.5). There was good correlation between the results from the two questionnaires (Spearman's rho = 0.62). Three-quarters (75%) had used OTC products, of which only a third (33%) felt they helped 'a lot'. Fifteen per cent were receiving prescribed treatment from their doctors of which 66% found it helpful. Self-reported acne occurred in 83% (147/178) of the Scottish teenagers involved in this study, which confirms previous reports of a high prevalence of acne in teenagers. Cross-validation of the CLDQI and CADI demonstrated good correlation and both scales were easy to administer and identified 11% (16/147) of teenagers who perceive their lives to be significantly affected by their acne (8% moderately to severely, 3% severely). It is important to identify and treat such teenagers early to reduce the future socio-economic burden of their acne.

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Dermatophytes and dermatophytosis in the eastern and southern parts of Africa.

E I Nweze, I E Eke (2018)

Dermatophytosis is currently a disease of global importance and a public health burden. It is caused by dermatophytes, which attack and grow on dead animal keratin. Dermatophytes belong to three genera, namely, Epidermophyton, Microsporum, and Trichophyton. The predominant clinical forms and causative agents vary from one region of the world to another. Poor socioeconomic status, high population densities, and poor sanitary conditions are some of the factors responsible for the high prevalence of dermatophytosis in many developing countries, which include countries in southern and eastern Africa, the focus of this review. To the best of our knowledge, there is currently no review article on published findings on dermatophytosis in the eastern and southern parts of Africa. This information will be of interest to the medical and research community since the world has become a global village. This review covers published research findings in eastern and southern regions of Africa until this date. The countries covered in the current review include Kenya, Ethiopia, Tanzania, South Africa, Mozambique, Madagascar, Malawi, Rwanda, Burundi, Uganda, Zambia, Zimbabwe, and Botswana. T. violaceum is the most common human etiological agent in all the countries under review with prevalence ranging from 56.7% to 95%, except for Madagascar (M. langeronii, reclassified as M. audouinii), Uganda (M. gypseum) and Malawi (M. audouinii). Tinea capitis was the most clinical type, followed by tinea corporis. Etiological agents of animal dermatophytoses were variable in the countries where they were reported. Major risk factors for dermatophytoses are age, climatic, and socioeconomic factors.

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Author and article information

Journal

Journal ID (nlm-ta): Cureus

Journal ID (iso-abbrev): Cureus

Journal ID (issn): 2168-8184

Title: Cureus

Publisher: Cureus (Palo Alto (CA) )

ISSN (Electronic): 2168-8184

Publication date (Electronic, pub): 18 July 2018

Publication date (Electronic, collection): July 2018

Volume: 10

Issue: 7

Electronic Location Identifier: e2993

Affiliations

[1 ] Department of Community Medicine, Archbishop James University College, Songea, TZA

[2 ] Department of Microbiology and Immunology, Archbishop James University College, Songea, TZA

[3 ] Department of Internal Medicine, Archbishop James University College, Songea, TZA

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Rahel Chikoi rahel.chikoi@ 123456gmail.com

Article

DOI: 10.7759/cureus.2993

PMC ID: 6143372

PubMed ID: 30245947

SO-VID: 00c27b6d-87a9-4fe6-9c44-1f68fc2d7f2b

License:

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Magnitude and Associated Risk Factors of Superficial Skin Fungal Infection Among Primary School Children in Southern Tanzania

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Decoding Infection and Transmission

Most cited references 17

Skin disease and socioeconomic conditions in rural Africa: Tanzania.

Quality of life and acne in Scottish adolescent schoolchildren: use of the Children's Dermatology Life Quality Index (CDLQI) and the Cardiff Acne Disability Index (CADI).

Dermatophytes and dermatophytosis in the eastern and southern parts of Africa.

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