Tinea capitis in schoolchildren in southern Ivory Coast.

OBJECTIVES: Fungal infections of the scalp commonly affect the pediatric population. These infections are caused by dermatophytes that are able to invade the keratinized structures of skin, hair, and nails. This study aimed to analyze the epidemiology of fungal scalp infections in southern Ivory Coast during 2008-2009.

METHODS: From October 2008 to July 2009, 17,745 children ranging in age from 4-16 years, attending urban and rural primary schools in seven towns in Ivory Coast, were examined clinically for tinea capitis. Hair stumps and scales were collected from children who showed symptoms suggestive of scalp ringworm. Samples were exposed to direct microscopic examination using 30% potassium hydroxide solution and cultivation on Sabouraud's dextrose agar with or without actidione.

RESULTS: Of the 17,745 children who were clinically examined, a total of 2645 exhibited symptoms suggestive of scalp ringworm. Positive cultures for fungi were found in 2458, yielding an overall prevalence of tinea capitis of 13.9%. The majority of infections occurred in males (74.0%). The most commonly affected age group involved children ranging from 9-12 years (n = 1335, 54.3%), followed by those in the range of 4-8 years (n = 936, 38.1%). Trichophyton soudanense, Microsporum langeronii, and Trichophyton mentagrophytes were the most prevalent etiologic agents (56.7%, 21.4% and 19.7%, respectively). Other species were occasionally isolated, including Trichophyton violaceum (1.4%) and Trichophyton rubrum (0.8%).

CONCLUSIONS: Epidemiological surveys are an essential tool for developing strategies for infection control.