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A COMPARATIVE STUDY OF SUPERFICIAL FUNGAL INFECTIONS AMONG PRIMARY SCHOOL CHILDREN IN RURAL AND URBAN COMMUNITIES IN ENUGU STATE, NIGERIA.

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Supervisor: Prof Ibe, Prof Ikefuna, and Dr Onyekonwu,
Faculty: PAEDIATRICS
Month: 11
Year: 2019

Abstract

Superficial fungal infections (SFIs) are some of the common cutaneous infections that affect children worldwide. They may lead to school absenteeism or school drop-out and hence cause setback in the education of the child. Community-based studies in any locality are good reflections of the health conditions within that area. There is a dearth of information in the literature about SFI among primary school children in Enugu. This study aimed to determine the prevalence and pattern of SFIs among primary school children in rural and urban communities in Enugu. It was a comparative descriptive cross-sectional study among primary school children in Awgu (rural) and Enugu North (urban) Local Government Areas (LGAs). Subjects' selection was done over 6 months using a multi-stage sampling method. Information such as age, sex, parental education, and occupation were collected using questionnaires. Socioeconomic classes of the children were determined using the classification proposed by Oyedeji et al. Equal numbers of children were recruited from the two LGAs, and a total of 1662 pupils were studied. The mean ages of the study subjects were 9.03 ± 2.10years in rural and 10.46 ± 2.33years in urban communities. The male to female ratio were 1.6:1 in rural and 1:1.1 in urban communities. Samples were collected from subjects with SFIs. Hydroxide tests were done on the samples. The samples that tested positive were cultured for SFI by inoculation onto Sabouraud's dextrose chloramphenicol actidione agar. The characteristics of the isolates were identified according to their morphological features using Mycology Online, Atlas 2000 and Mycology Review 2003. The overall prevalence of SFIs among the study participants was 45%. In the rural community, the prevalence was 29.6% and in the urban prevalence was 60.4%. The types of SFIs were tinea capitis (the commonest), tinea corporis, pityriasis versicolor, tinea unguium, and tinea manuum with prevalence lower in rural than urban communities. The clinical patterns were gray patch and black dot type of non-inflammatory tinea capitis; kerion, tinea corporis with trunk and limb distributions, and pityriasis versicolor with face, trunk and limb distributions. Gray patch was the most frequent pattern of SFI seen in rural and urban communities. Black dot type was more frequent in rural than urban communities. SFIs were frequent among children aged 5 to 8 years in rural and 9 to 12 years in urban communities. SFIs were commoner in males (p<0.001) in rural community whereas female dominance was observed in the urban community. SFIs were more in children from low social class and those with poor hygiene. Trichophyton species were the most common isolates in rural and urban communities. In conclusion, SFIs were less prevalent in rural than urban communities. Demographic factors such as age and sex were associated with the presence of SFIs in both rural and urban communities. Personal hygiene of the children was significantly related to the presence of SFI. Health education of mothers and their children on SFIs and good personal hygiene will reduce the incidence of SFIs

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