A study of tinea capitis was carried out during the period January-June 1996 in 7525 primary schoolchildren aged 6-14 years comprising 4050 boys and 3475 girls in the Nablus district in the Palestinian area. Fourteen primary schools located in rural, urban and refugee camp areas were surveyed in this study. Seventy-five (1.0%) mycologically proven cases of tinea capitis were detected. The incidence was higher in schools in rural areas (1.9%) than in refugee camps (1.1%) or urban areas (0.4%). Also, the incidence was higher in young children (1.4%) aged 6-10 years than in older children (0.5%) aged 10-14 years. Boys 52 (1.3%) were more commonly affected than girls 23 (0.7%). Higher disease incidence was found to be correlated with larger family and class sizes. Trichophyton violaceum was the most common aetiological agent (82.7%) followed by Microsporum canis (16%) and Trichophyton schoenleinii (1.3%). The findings are discussed in relation to the children's different socioeconomic and hygienic backgrounds. A mycological investigation carried out on 117 tinea capitis cases at a clinic in the area under study showed similar results to those of the school survey.

Hair and scalp mycobiota of 1389 clinically normal children aged 6-12 years attending 12 schools in the Nablus District, Palestinian Authority, was assessed on three occasions over 8-month period (October 1998-May 1999) using the hair brush technique. One hundred and one fungal species belonging to 33 genera were recovered: 6 dermatophytes, 16 dermatophyte-like keratinophilic fungi, and 79 other keratinophilic fungal species. Species varied considerably in their frequency of occurrence and abundance based on their relative importance values (RIVs). The most frequent and abundant species were: Cladosporium cladosporioides, Cl. herbarum, Penicillium chrysogenum and Aspergillus flavus, Microsporum canis, Aphanoascus fulvescence and Chrysosporum sulfureum were the most frequent and abundant species of all dermatophytes and dermatophyte-like keratinophilic fungi recovered. The most frequent and abundant dermatophytes in different communities were M. canis in rural (RIV 0.87) and urban children (0.45), and Trichophyton violaceum (1.41) in refugee camp children. Chrysosporium species were the most frequent and abundant dermatophyte-like keratinophilic fungus in children from all localities followed by Aphanoascus fulvescence. Comparable results on the frequency and abundance of human hair and scalp mycobiota component fungi were obtained based on age group and sex of children. Higher number of species was recovered in spring months (73 species) than in autumn (57) and winter (44) months. Similar occurrence pattern was also noted for dermatophyte-like keratinophilic species and dermatophytes. Higher percentages of children with moderate (11-50) and heavy (< or = 50) spore loads (7.54 and 0.73, respectively) were found in urban school children community than in rural and refugee camp school children (4.7 and 0.1, respectively). Also significantly higher light (1-10) spore load percentages were found in rural (63.67) and refugee camp (62.9) than in urban children (52.6). Of all localities, school children with light spore load comprised the highest percentage of the children examined (37.4), followed by moderate (6.13), and heavy (0.41) spore load categories. However, children with undetected spore load comprised 36.05% of all children. Spore load distribution did not show clear seasonal variations in the study period. Higher percentages of moderate and heavy spore loads were found in male children (8.72 and 0.69, respectively) than in female children (3.4 and 0.1, respectively). However, higher percentages of undetected (38.3) or light spore loads (58.4) were found in females than in males (34.04 and 56.53, respectively).

A study of tinea capitis was carried out during October 1998, involving 8531 school children aged 6-14 years (4718 males and 3813 females), attending 12 primary schools located in urban, rural, and refugee camp communities in the Nablus district in the Palestinian Authority. A total of approximately 1389 of the school children aged 6-12 years (724 males and 665 females) were also surveyed on three occasions at 2-3 month intervals, over a 9-month period (October 1998-May 1999) using the hair brush technique, for prevalence of asymptomatic tinea capitis carriage. Twenty-three(0.27%) mycologically proven cases of tinea capitis were detected.

The effect of raw city wastewater irrigation on biodiversity and population densities of a cycloheximide-resistant (CH) fungal community was studied in 13 field soils receiving either raw city wastewater or normal irrigation, and in raw city wastewater in the Nablus area, using the hair baiting technique (HBT) and a surface soil dilution plating (SSDP) technique. Three of these fields [one had been receiving raw city wastewater for more than ten years and was designated a heavily polluted field, and the other 2 were cultivated for the first time and were either irrigated with raw city wastewater (newly polluted field) or normal irrigation water (nonpolluted)], were sampled 4-7 times over a 9-month period. The other ten fields, which had been under raw city wastewater irrigation for more than 10 years, were sampled only once. Fifty-seven CH-resistant species belonging to 18 genera were recovered, of which 49 species were recovered from soil habitats and 28 species from raw city wastewater. The HBT had shown to be more efficient in the isolation of pathogenic and potentially pathogenic fungi including dermatophytes. A higher percentage of this group of fungi was recovered from the three main field soils studied using HBT (70% of all isolates), than the SSDP (35.5%); no dermatophytes were recovered by the SSDP method. Two dermatophytes (Microsporum gypseum, and Trichophyton ajelloi), and five more fungi (Arthroderma cuniculi, A. curreyi, Chrysosporium keratinophilum, C. tropicum, C. pannorum), were recovered from these habitats. Wastewater irrigation seemed to have affected the fungal population densities, with the highest population densities being found in the heavily polluted field soil, while lower population densities were found in the nonpolluted field soil. Increases in organic matter were also observed as a result of sewage effluent irrigation. However, basic similarities in the biodiversity of CH-resistant fungal communities existed in nonpolluted and polluted field soils, and raw city wastewater. Comparable numbers of fungal species were recovered from the three main field soils. The species most commonly found in those habitats included: Alternaria alternata, Aspergillus candidus, Geotrichum candidum, and Paecilomyces lilacinus. Field soils receiving either raw city wastewater or normal irrigation water, were found to be rich in pathogenic and potentially pathogenic CH-resistant fungi, including dermatophytes, with raw city wastewater yielding the highest percentage (81%), followed by the newly wastewater irrigated field (77.7%), the nonpolluted field (67%), and the heavily polluted field (63.4%) Hygienic measures should therefore be taken to control the spread of these fungi in the environment of human communities, and to avoid mycotic infections among farmers.