Dermatophytes and other fungi associated with hair-scalp of Primary school children in Visakhapatnam, India: A Case Study And Literature Review
Y Avasn Maruthi, K Aruna Lakshmi, S Ramakrishna Rao, K Hossain, D Apta Chaitanya, K Karuna
children, dermatophytes, fungi, hair- scalp infection, hygiene, primary schools
Y Avasn Maruthi, K Aruna Lakshmi, S Ramakrishna Rao, K Hossain, D Apta Chaitanya, K Karuna. Dermatophytes and other fungi associated with hair-scalp of Primary school children in Visakhapatnam, India: A Case Study And Literature Review. The Internet Journal of Microbiology. 2007 Volume 5 Number 2.
A total of 2804 primary section pupils aged 6-15 years of 12 schools located at different places in Visakhapatnam were physically screened for hair -scalp infection. Three hundred and thirty six (11.98%) of these children were positive for the dermatophytic infection. The majority of the isolated dermatophytes according to percentage of occurrence were
Name of the Laboratory: Air pollution and Environmental Microbiology laboratory, Dept.of Environmental Studies, Institute of Science, GITAM University,Visakhapatnam-530045,A.P,India.
Children playgrounds represent a favorite environment for children's play and are therefore expected to play an important role in epidemiology of human and animal mycoses 4 . In India, only a few research studies are available on prevalence and etiological agents of
Materials and Methods
Visakhapatnam has approximately total number of 113 government schools (primary, upper primary and high schools) in and round it. .Questionnaire was administered along with physical examination of volunteers for scalp, body and nail ringworms. Based on health data, both collected both from city schools and King George Hospital and some schools were selected as study areas, with respect to control (K. D. P. M. High School). The particulars of the study areas are given in Table-1.
Volunteers were randomly selected in visited schools and examined to confirm the causative agents of the infection. This was carried out by the “hair brush diagnosis” of scalp ringworm or microscopic demonstration of fungus 6 . The samples were divided into two portions: one for microscopic examination and one for culture. For Microscopic observation, Potassium hydroxide preparation two to four fragments of scalp and broken hair samples were placed on a glass slide with KOH(30%), gently heated and then evaluated microscopically for the presence fungal elements. Each scraping was cultured into Sabaroud dextrose Chloramphenecol actidione agar 7 . A duplicate inoculation of the specimen was also cultured on sabouraud's dextrose cycloheximide agar. The plates were incubated at 28°C for up to 4 weeks and examined at 2 to 3 day intervals for fungal growth. Fungal isolates were subcultured onto plates of sabouraud's agar, potato glucose agar and corn meal agar. The isolates were examined visually and microscopically for morphology of fungi using lactophenol cotton blue by slide culture technique. Yeasts were identified with the taxonomic criteria outlined by Lodder 8 .
Results and Discussion
According to health Data, it was observed that dermatophytes affected 336 of 11.98% (N=2804) of sample population of children (Table-1) of infected pupil. It was observed that 82 (21.9%) pupil reported with incidence of Dermatophytic infections out of 375 total sampled pupil at Allipuram Model School. The collected health data revealed that the rate of prevalence of dermatophytes and related hair-scalp infection among pupil was low 8(2.28%) at K D P M School, which was chosen as control.
The collected health data elucidates that the occurrence of hair-scalp infection was more in boys (61.60%) on comparison with girls (38.39%) (Table-2). After analyzing the health data of prevalence of hair-scalp infection in pupil with respect to age group, it was conspicuous that the number of pupils of age group 5-8 years was suffering with infection (34.82%) (Table-3). But age group of 12-15 reported with less number of infections both in boys and girls, when compared with other age groups of selected pupil (Table-3).
Many fungi belonging to 11 genera were recovered from hail scalp of 90 of 2804 children. The majority of the isolated dermatophytes according to percentage of occurrence were
Most infected children on physical examination revealed a characteristics pattern of inflammation characterized by a greater degree of redness and scaling at the edge of the lesion or occasionally blister formation as in the case of most dermatophytes identified 9 . Mucosal involvement with an adjacent red, scaly skin rash was seen in
The presence of other non-dermatophytes (particularly
Transmission between hosts usually occurs by direct contact with a symptomatic or asymptomatic host, or direct air borne contact with its hairs or skin scales. Infective spores in hair and dermal scales can remain viable for several months to years in the environment. It is necessary to replace the soil of school playgrounds periodically. Dermatophytic fungal spores are susceptible to common disinfectants such as Benzalkonium Chloride, dilute (1:10) chlorine bleach or strong detergents. The mechanical removal of any material containing keratin, such as shed skin and hairs, facilitates disinfection. Vacuuming is considered to be the best method to make soil free of dermatophytes 11 .
Treatment of Dermatophytosis is often dependant on the clinical setting. For instance uncomplicated single cutaneous lesions can be adequately treated with a topical antifungal agent, however topical treatment of scalp and nail infections is often ineffective and systemic therapy is usually needed to cure these conditions 12 .
In contrast, anthropophilic dermatophytes are readily spread between people. Control of disease in human beings can be prevented by adopting the good sanitation strategies.
Most dermatophytic infections are more common in children than adults. In view of these findings it may be concluded that the unclean soil of Schools may be considered as a health risk to children. The study showed that dermatophytes were the most common cause of all culture positive fungal infections involving the hair-scalp among children. However, there is a need for children who are generally at risk to be aware of the dangers of contracting dermatophytes. The government should create greater awareness of environment and personal hygiene to help to curb the incidence.
Except second author all are grateful to management of GITAM University for providing necessary facilities. The authors are also thankful to Prof.Dr. A.Narayana, Head,dept.of Dermatology, King George Hospital, Visakhapatnam for providing necessary facilities to collect health data with reference to Dermatophysis.
DR (Mrs).Y.AVASN MARUTHI, Associate Professor, W/o V.B.K Srinivas,D.No:4-60-5/3(First floor), LIG-21, Lawsons bay colony,Visakhapatnam-530017-,A.P ,India. e-mail: email@example.com