Tinea capitis outbreak among paediatric refugee population, an evolving healthcare challenge

Abstract

Outbreaks of tinea capitis (TC) represent a major medical and economic burden. Population migrations have become a phenomenon of increasing relevance for medical conditions management. Given the recent massive arrival of immigrants, we sought to determine epidemiologic trends for TC among paediatric populations at the Tel Aviv Medical Center. We conducted a retrospective study of all TC cases diagnosed between 2010 and 2014 in a paediatric dermatology unit of a tertiary medical centre, serving as a referral centre for the paediatric refugee population from the great Tel Aviv area. Epidemiologic, clinical and treatment data including effectiveness and safety were reviewed. In all, 145 children met the inclusion criteria. Trend analyses showed increases in TC rates over the study period. Incidence rates were higher in boys than in girls. Children of African origin had the highest TC incidence rates as compared with other ethnic groups. Trichophyton violaceum and Microsporum audouinii were the predominant causative organisms. Treatment with griseofulvin was satisfactory in all cases. There was a significant increase in TC incidence rates in the Tel Aviv area over the study period. TV and MA were the predominant organisms. These trends may be a result of poor living conditions and crowded school premises.

Emergence of African species of dermatophytes in tinea capitis: A 17‐year experience in a Montreal pediatric hospital

“…In recent decades, an increase in TC due to African species of dermatophytes has been reported from cosmopolitan centers in Europe and the Middle East (Table ) . In the Montreal area over the past 17 years, although the overall number of TC cases did not change significantly (mean 344 per year), there was a sixfold increase in African species of dermatophyte infections in children mainly due to anthropophilic M. audouinii and T. soudanense (from 6/82 [7%] in 2000 to 37/95 [39%] in 2016).…”

Griseofulvin vs terbinafine for paediatric tinea capitis: When and for how long

“…During the past decades, Microsporum canis has been reported to be the predominant organism causing TC in Israel . The recent TC outbreak in the Tel Aviv area among children of refugees from Eastern Africa had led to the emergence of novel TC‐associated predominant pathogens, including prevalence Trichophyton violaceum, Trichophyton soudanense and Microsporum audouinii …”

“…We previously reported a TC outbreak in the Tel Aviv area among children of refugees who have fled from combat zones in Eastern Africa. This resulted in a shift of the causative pathogen of TC in Israel from Microsporum canis that was more common prior to this outbreak to Trichophyton violaceum and Microsporum audouinii …”

Atopic dermatitis complicated by severe impetigo in a Syrian refugee infant

“…A retrospective review of paediatric refugees from East Africa at a tertiary care centre in Tel Aviv revealed high rates of tinea capitis over the 4-year study period 26. The authors noted differences in the causative organisms compared with Israeli-born children and postulated that the outbreaks were related to poor living conditions and crowded residences.…”