Onychomycosis in primary school children: association with socioeconomic conditions

Abstract

Onychomycosis in childhood is reported to be unusual. The aim of this study was to determine the prevalence of onychomycosis in primary school children and to make comparison between different socioeconomic status in the rural and urban areas of the city. Hand and foot nails of 23235 children aged 7-14 were examined. Onychomycosis was suspected and nail scrapings for mycological examination were taken in 116 of them. Hyphae or spores were seen in 41 (0.18%) by direct microscopic examination, and mycological cultures were positive in 24 (0.1%) of them. Toenails were affected in all of the fungal culture positive cases. Trichosporon spp, Trichophyton rubrum, Candida albicans and Candida glabrata grew in 11, 6, 5 and 2 of the cultures respectively. Onychomycosis prevalence was significantly higher in the children living in the rural areas (p = 0.016) [Odds ratio = 3.43 (%95 CI 1.11<OR<11.84)], and onychomycosis was more frequent in boys than girls (p = 0.001) [(Odds ratio = 5.85 (1.66<OR<24.61)].

Onychomycosis in Children: An Experience of 59 Cases

“…The prevalence was higher in patients living in urban areas than in rural areas, which was not consistent with the report of Gunduz et al9 that the prevalence was higher in schoolchildren aged between 7 and 14 in rural areas. It might be because rural areas were administratively reorganized into cities, and most people in rural area tended to think nothing of onychomycosis.…”

“…In a study by Gupta et al4, the concurrent rate reached 47.0%. It is known that onychomycosis is more likely to occur in patients with Down syndrome or with human immunodeficiency virus (HIV) infection4-6,9,13-15. In this study, however, there was no patient with Down syndrome or HIV infection.…”

“…The reported prevalence of onychomycosis ranges from 0.2% to 2.6% among children approximately 1/30th that of adults4,9. The low prevalence of pediatric onychomycosis is probably due to faster nail growth, smaller surface area available for exposure to onychomycotic pathogens, lack of cumulative trauma, and reduced environmental exposure to public places such such as locker rooms and public showers that harbor high densities of infective hyphae and spores4-7,13-15.…”

Childhood Fungal Infections

“…Onikomikoz Çocuklarda onikomikoz nadirdir; %0,2-2,6 oranında bildirilmiştir. Bunun yanında distrofik tırnaklar söz konusu olduğunda, bunların içinde onikomikoz sıklığı %23-30 arasında bildirilmiştir 34 . Dünyada artan sıklıkta çocukta onikomikoz bildirilmektedir 35,36 .…”

“…Düşük sosyoekonomik şartlarda, kötü hijyenik koşullarda yaşayan köy çocuklarında onikomikoza daha sık rastlanmış. Hepsinin lastik ayakkabı giydiği gözlenmiştir 34 . Manisa bölgesindeki ilkokul çağı çocuklar araştırılda, 785 kişinin 2sinde onikomikoz tespit edilmiştir 31 .…”