Prevalence of trichophyton, microsporum and epidermophyton species causing tinea capitis in children aged 3-14 years in Mathare informal settlement, Nairobi, Kenya

Abstract
Tinea capitis is a worldwide public health problem that affects children below 15 years of age and requires identification of the specific causative fungal agent. The hair and skin of the scalp are associated with symptoms and signs of inflammation and hair loss. Poor hygiene, low standards of living, sharing of hair devices or garment, climate conditions and overcrowding are some of the predisposing factors contributing to frequent transmission of the infection. Several previous studies have concentrated on symptomatic cases of Tinea capitis infection with limited studies in Kenya. However, no such study has been done in Mathare informal settlement despite the existence of predisposing factors such as low standards of living of the people in the area. This study therefore aimed at determining the prevalence of Tinea capitis infection and its significant risk factors in Mathare informal settlement in both symptomatic and asymptomatic cases. The study also aimed at determining the prevalence of Trichophyton, Epidermophyton and Microsporum species causing Tinea capitis infection among school going children in Mathare informal settlement, Nairobi. A total of 150 children were systematically and randomly sampled from five public primary schools in Mathare informal settlement. Skin scrapings specimens were collected and inoculated on potato dextrose agar. Fungal cultural characteristics were observed macroscopically (pigmentation formation), microscopically (microconidia or macroconidia formation) and Trichophyton species differentiated by use of biochemical tests. In addition, a structural questionnaire was administered to consenting children’s guardians and socio-demographic data collected. In a total of one hundred and fifty (150) children aged between 3-14 years consisting of 89 (59.3 %) males and 61 (40.7 %) females, 123 (82 %) were infected with Tinea capitis. The dermatophytes consisted of 61.3 % Trichophyton, 13.3 % Microsporum and 7.3 % Epidermophyton with infections occurring either singly (56 %), duo (38 %) or tripple coinfections (6 %). Males were most affected with socio-economic factors such as employment status of the parents and monthly income levels of the family significantly influencing infections (p<0.001). Other factors that significantly influenced the infection include; knowledge on ways of transmission of Tinea capitis (p<0.001), sharing of combs and towels (p<0.001), place of hair shaving (p = 0.037) and frequency of hair shaving (p = 0.02). The prevalence of the infection was higher in lower age groups than the upper age group of 12-14 years. These findings suggest that prevalence of Tinea capitis infection in the informal settlement of Nairobi is high. There is therefore a need to improve personal and community hygiene including the economic status of people living in the informal settlement.
Description
Master of Science (Microbiology). 77p. October 2014
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