Tinea capitis in south-east London-a new pattern of infection with public health implications

Abstract

Recent observations on tinea capitis cases in London suggest that there has been a change in the pattern of infection with a recent and significant rise in the incidence of infections due to anthropophilic fungi. The purpose of this study was to investigate the prevalence and identity of tinea capitis in schools in south-east London and factors which might affect the spread of infection. This was achieved by carrying out a survey of all children, with parental consent for scalp examination, in 14 nursery, infant or junior schools in Lambeth. In addition, the accuracy of clinical diagnosis was compared with mycological findings. There were 1057 children from 4 to 14 years of age in the study. The infection rate in different schools ranged from 0 to 12% with a mean of 2.5%. A further 4.9% of children were scalp carriers of dermatophytes (range in classes 0-47%). A striking feature was that all infections were caused by anthropophilic fungi, mainly Trichophyton tonsurans or Microsporum rivalieri, and there was a correlation between the presence of two or more carriers within a class and the infection in the other children. There was a poor correlation between ability of trained observers to predict infection on clinical grounds and mycological results. This investigation shows variable but significant levels of scalp ringworm in schools and that the dominant organisms are anthropophilic. It provides support for the observation that there has been a shift in the pattern of tinea capitis in London and, possibly, other U.K. centres, with a trend towards more infections transmissible among children, with T, tonsurans being the commonest organism. The implications for control, which involve screening in schools, where appropriate, and guidance to general practitioners on treatment, are discussed.

Superficial mycoses in the Nis region, Southeast-Serbia

“…However in the United Kingdom [7] the most prevalent species is T. tonsurans, while in France [2] those are T. soudanense and M. audouinii. Nevertheless in these European countries it was found that the zoophilic species such as M. canis, T. mentagrophytes and T. verrucosum are the most frequentely isolated dermathophytes from the material of patientes who live in rural areas [1][2][3][4][7][8][9][10]. Epidermophyton flocossum, was detected in a significant percentage as the cause of superficial mycosis in Finland and Germany [8,9].…”

“…By evaluating numerous studies of a large group of authors, it is discovered that the most comon cause of superficial mycosis in European countries are the species T. rubrum, M. canis, T. mentagrophytes var granulosum and T. verrucosum [7][8][9][10]. Species M. audouinii, T. soudanense and T. violaceum, causes of so-called immigrational mycosis, can rarely be detected in this area of our continent, considering the fact that endemic zones for these species are in Africa and some regions of Asia [1].…”

“…This species is a frequent pathogen in Germany, Finland and Russia urban regions [1][2][3][4][7][8][9]. However in the United Kingdom [7] the most prevalent species is T. tonsurans, while in France [2] those are T. soudanense and M. audouinii. Nevertheless in these European countries it was found that the zoophilic species such as M. canis, T. mentagrophytes and T. verrucosum are the most frequentely isolated dermathophytes from the material of patientes who live in rural areas [1][2][3][4][7][8][9][10].…”

“…It is supposed that there will be an incident increase of mycoses caused by this species, due to a greater migration of people and development of tourism. T. rubrum is proven to be the most common cause of dermatomycosis in developing countries in Europe [1,[7][8][9][10]. This species is a frequent pathogen in Germany, Finland and Russia urban regions [1][2][3][4][7][8][9].…”

Tinea capitis

“…Die Prävalenz für die USA wird mit 3-8% der Gesamtbevölkerung angegeben [53]. Daten aus dieser Region sowie Großbritannien belegen eine Zunahme der Erkrankungsfälle, insbesondere in Hinblick auf eine durch Trichophyton tonsurans bedingte Kopfpilzerkrankung [27,36].…”