PREVALENCE IDENTIFICATION AND ANTIFUNGAL SUSCEPTIBILITY OF DERMATOPHYTES CAUSING TINEA CAPITIS IN A LOCALITY IN NORTH CENTRAL NIGERIA

Background: 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. This study determined the prevalence, identified dermatophytes of tinea capitis in Okelele community in North Central Nigeria and evaluated the susceptibility of isolates to selected antifungal drugs. Materials and Methods: Three hundred and one pupils from seven primary schools in the locality who gave assent and those with parental consent were recruited into the study. Scalp scrapings and hairs were collected from participants and subjected to microscopy and culture. Isolates identified by colonial morphology and micromorphology were subjected to disk diffusion antifungal susceptibility testing. Results: Two hundred and twenty-eight of the participants had mycologically proven tinea capitis giving a prevalence of 75.7%. The dermatophytes identified were T. rubrum (68.0%), M. ferrugineum (22.0%), T. mentagrophytes (8.0%) and T. verrucosum (2.0%). Resistance observed with these isolates was as low as 21.2% to as high as 100% while sensitivity ranged from 78.8% to 100%. Only large family size significantly influenced the occurrence of tinea capitis among the risk factors. Conclusion: The prevalence of tinea capitis from this study is high. T. rubrum being anthropophilic and the predominant dermatophyte identified corroborates large family size as an important risk factor. Antifungal resistance as a cause of therapeutic failure was demonstrated by some isolates in this study

Prevalence, identification and antifungal susceptibility of dermatophytes causing Tinea capitis in a Locality of North Central Nigeria

Background: 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. This study determined the prevalence, identified dermatophytes of Tinea capitis in Okelele community in North Central Nigeria; and evaluated the susceptibility of isolates to selected antifungal drugs.Materials and Methods: Three hundred and one pupils from seven primary schools in the locality who gave assent and those with parental consent were recruited into the study. Scalp scrapings and hairs were collected from participants and subjected to microscopy and culture. Isolates identified by colonial morphology and micromorphology were subjected to disk diffusion antifungal susceptibility testing.Results: Two hundred and twenty-eight of the participants had mycologically proven Tinea capitis giving a prevalence of 75.7%. The dermatophytes identified were T. rubrum (68.0%), M. ferrugineum (22.0%), T. mentagrophytes (8.0%) and T. verrucosum (2.0%). Resistance observed with these isolates was as low as 21.2% to as high as 100% while sensitivity ranged from 78.8% to 100%. Only large family size significantly influenced the occurrence of T. capitis among the risk factors.Conclusion: Prevalence of Tinea capitis from this study is high. T. rubrum being anthropophilic and the predominant dermatophyte identified corroborates large family size as an important risk factor. Antifungal resistance as a cause of therapeutic failure was demonstrated by some isolates in this study. &nbsp

Prior subclinical histoplasmosis revealed in Nigeria using histoplasmin skin testing

Disseminated histoplasmosis is an AIDS-defining illness. Histoplasmosis is commonly misdiagnosed as tuberculosis. Nigeria has the second highest number of people living with HIV/AIDS in Africa. The present study was carried out to investigate the prevalence of skin sensitivity amongst Nigerians to histoplasmin.A cross-sectional study was conducted in six centres across five geopolitical zones of Nigeria.We recruited both healthy non-HIV and HIV-positive adults with CD4 count ≥ 350 cells/mm3 regardless of their ART status from March to May 2017. Skin tests were performed intradermally; induration ≥5 mm were considered to be histoplasmin positive.750 participants were recruited from Lagos (n = 52), Yola (n = 156), Ilorin (n = 125), Calabar (n = 120), Ibadan (n = 202) and Benin (n = 95). 467 (62.3%) were HIV negative, 247 (32.9%) were HIV positive and 36 (4.8%) did not know their HIV status. A total of 32/735 (4.4%) participants had a positive skin test. Study centre (p<0.001), education (p = 0.002) and age (p = 0.005) appeared to be significantly associated with positive skin reactivity at the 0.5% significance level, while sex (p = 0.031) and occupation (p = 0.031) would have been significant at the 5% significance level. Males had a higher rate of reactivity than females (p = 0.031, 7% vs 3%). The highest positive rates were recorded from Benin City (13/86 (15%)) and Calabar (7/120 (6%)) and no positives were recorded in Lagos (p<0.001). HIV status was not statistically significant (p = 0.70).Histoplasmosis diagnostics should be included in the Nigerian HIV guidelines. Epidemiological vigilance of progressive disseminated histoplasmosis should be considered by local health authorities

Evaluation of knowledge and awareness of invasive fungal infections amongst resident doctors in Nigeria

Introduction: it has been estimated that about 11.8% of the Nigerians suffer serious fungal infections annually. A high index of suspicion with early diagnosis and institution of appropriate therapy significantly impacts on the morbidity and mortality of invasive fungal infections (IFIs).Methods: we conducted a cross-sectional multicentre survey across 7 tertiary hospitals in 5 geopolitical zones of Nigeria between June 2013 and March 2015. Knowledge, awareness and practice of Nigerian resident doctors about the diagnosis and management of invasive fungal infections were evaluated using a semi-structured, self-administered questionnaire. Assessment was categorized as poor, fair and good.Results: 834(79.7%) of the 1046 participants had some knowledge of IFIs, 338(32.3%) from undergraduate medical training and 191(18.3%) during post-graduate (specialty) residency training. Number of years spent in clinical practice was positively related to knowledge of management of IFIs, which was statistically significant (p &lt; 0.001). Only 2 (0.002%) out of the 1046 respondents had a good level of awareness of IFIs. Only 4(0.4%) of respondents had seen &gt; 10 cases of IFIs; while 10(1%) had seen between 5-10 cases, 180(17.2%) less than 5 cases and the rest had never seen or managed any cases of IFIs. There were statistically significant differences in knowledge about IFIs among the various cadres of doctors (p &lt; 0.001) as level of knowledge increased with rank/seniority.Conclusion: knowledge gaps exist that could militate against optimal management of IFIs in Nigeria. Targeted continuing medical education (CME) programmes and a revision of the postgraduate medical education curriculum is recommended.</p

Evaluation of knowledge and awareness of invasive fungal infections amongst resident doctors in Nigeria

Introduction:&nbsp;it has been estimated that about 11.8% of the Nigerians suffer serious fungal infections annually. A high index of suspicion with early diagnosis and institution of appropriate therapy significantly impacts on the morbidity and mortality of invasive fungal infections (IFIs). Methods:&nbsp;we conducted a cross-sectional multicentre survey across 7 tertiary hospitals in 5 geopolitical zones of Nigeria between June 2013 and March 2015. Knowledge, awareness and practice of Nigerian resident doctors about the diagnosis and management of invasive fungal infections were evaluated using a semi-structured, self-administered questionnaire. Assessment was categorized as poor, fair and good. Results:&nbsp;834(79.7%) of the 1046 participants had some knowledge of IFIs, 338(32.3%) from undergraduate medical training and 191(18.3%) during post-graduate (specialty) residency training. Number of years spent in clinical practice was positively related to knowledge of management of IFIs, which was statistically significant (p &lt; 0.001). Only 2 (0.002%) out of the 1046 respondents had a good level of awareness of IFIs. Only 4(0.4%) of respondents had seen &gt; 10 cases of IFIs; while 10(1%) had seen between 5-10 cases, 180(17.2%) less than 5 cases and the rest had never seen or managed any cases of IFIs. There were statistically significant differences in knowledge about IFIs among the various cadres of doctors (p &lt; 0.001) as level of knowledge increased with rank/seniority. Conclusion:&nbsp;knowledge gaps exist that could militate against optimal management of IFIs in Nigeria. Targeted continuing medical education (CME) programmes and a revision of the postgraduate medical education curriculum is recommended

Distribution of reported cases of histoplasmosis in Nigeria in relation to vegetation (A) and soil types (B).

<p>Distribution of reported cases of histoplasmosis in Nigeria in relation to vegetation (A) and soil types (B).</p

Final logistic regression model.

<p>Final logistic regression model.</p

Participants sociodemographic, clinical features and associated factors in relation to histoplasmin reactivity.

<p>Participants sociodemographic, clinical features and associated factors in relation to histoplasmin reactivity.</p