Dermatophyte Infections Among Primary School Children In Kibera, Nairobi, Kenya

Abstract

Study objective was to determine the prevalence and etiology of dermatophyte infections and establish the relationship between type of infection and age and gender of the primary school children in Kibera during the period between September 2006 and January 2007. Study design, was a cross- sectional descriptive study that focused on the prevalence, distribution and species differentiation of the causative agents of dermatophytosis in city council sponsored primary schools in Kibera, Nairobi. The setting. The study was conducted in Kibera, the largest of the informal settlements within the capital city, Nairobi which is home to between 700-1,000,000 inhabitants. Subjects. The study targeted primary school children from the ages of 5 years to 15 years from four government sponsored primary schools namely Olympic, Kibera, Ayany and Mbagathi Way. A sample of 424 pupils was selected from a population of 8904 pupils in the four schools. Materials and Methods. The pupils responded to questions from a structured questionnaire that was prepared to elicit socio economic and demographic data from the participants. Physical examination was carried out on every participant to determine presence of skin infection. Photography was done for those with skin lesions and specimens collected from the infected sites. The specimens were processed in the mycology laboratory to determine the etiological agents of the skin infections. Results. From the participants, 11.2% had ringworm infection with tinea capitis being the commonest type while the grey patch type was the dominant clinical manifestation. The distribution of ringworm among schools was statistically significant with Olympic primary school registering the highest ratio of those infected to those not infected. (P=O.OOI). xu Both male and female pupils within the age bracket of 6-8 years were significantly infectedthan other age categories. Infection rate decreased with increase in age. (p= 0.002) Gender related prevalence was statistically significant with girls registering more infectionsthan boys in their categories. (P=O.033) All the three genera of fungi associated with dermatophytes were isolated with a number of species namely T violecium (35), T mentagrophytes(3), T terestre(3), T schoenleinii(2), and T interdigitale( 1), M canis(2), M. equinum( 1), E. jlocossum(1). T. violecium was the predominant species isolated, at (35)71% followed by T. mentagrophytes and T terrestre at (3)6% each. Conclusion: The study shows a high prevalence of 11.2% dermatophyte infection among the school children in this locality. Contributing factors to the high frequency and chronic occurrences of ring worm in this area include poor living environment, children interaction patterns and poor health seeking behaviour. There is need for health education to create awareness among the communities in urban informal settlements to seek treatment and improve on hygiene to reduce the prevalence of these infections.