Prevalence Of Dermatophytes And Non-dermatophyte Fungal Infection Among Patients Visiting Dermatology Clinic At Tikur Anbessa Hospital Addis Ababa Ethiopia
Back ground: Dermatomycosis is a common fungal infection that constitutes public healthrnproblem among humans and animals worldwide, including Ethiopia. Though it is a trivialrndisease, its psychological effect and morbidity in terms of loss of time and treatment cost isrnconsiderable.rnObjective: To describe the most dominant clinical manifestation, the dominant fungi implicatedrnas a cause of dermatomycosis and determine the prevalence of dermatophytes, non-rndermatophyte fungi and yeasts collected from clinical samples suspected of dermatomycosis.rnMaterial and methods: a cross sectional descriptive study design from January to May, 2014rnwas conducted at Tikur Anbessa Hospital. Scrapings from skin nail and scalp of 305 studyrnparticipants was collected by employing standard routine microbiological techniques. A portionrnof each sample was placed on a slide and a drop of an aqueous solution of 10% (w/v) potassiumrnhydroxide, was added. After 5 minutes, the wet mount was examined under low (X10) and highrn(X40) power magnification for the presence of fungal elements. The remaining portion of eachrnclinical sample was cultured irrespective of the negative or positive direct microscopicrnexamination results. Each sample was streaked on two plates of Sabouraud’s dextrose agar (SDA)rnwith chloramphenicol and SDA, with chloramphenicol and cychloheximide which were preparedrnaccording to the manufacture’s instruction. All inoculated plates were then incubated at invertedrnposition for 4-6 weeks at 25-300C aerobically. Incubated plates were examined twice a week forrnany fungal growth. Colonies suspected of dermatophytes were sub-cultured into potato dextrosernagar for the production of spores. Mold isolates were identified by examining macroscopic andrnmicroscopic characteristics of their colony. Microscopic identification of mold isolates wasrnperformed by placing pieces cultures from SDA and/or PDA to clean microscopic slide andrnstaining with lactophenol cotton blue. After placing a cover slip, each preparation was observedrnmicroscopically. Yeast identification, C. albicans was differentiated from other yeasts by germrntube production. Data was analyzed using SPSS version 20 software.rnResult: A total of 305, study participants were enrolled in the present study of which 97 (31.8%)rnwere males and 208 (68.2%) females. The ages of study subjects ranged from 1 to 80 year with arnmean age of 26 years. Out of the 305 study subjects, fungal species were detected (directrnmicroscopy) in 166 (54.4%) of clinical samples while 242(79.3%) clinical samples were culturernpositive. Sixteen clinical samples that were culture negative were positive by direct microscopy.rnThe three predominant clinical manifestation were tinea ungium accounting 156(51.1%) ofrnclinical manifestations of which 119 (76.3%) were in females and 37(23.7%) in males. This wasrnfollowed by tinea capitis accounting 61 (20%) of which 37 (60.7%) in females and 24 (39.3%) inrnmales followed tinea corporis accounting 33(10.8%) of which 26 (78.8%) in females and 7rn(21.2 %) in males. Fungal species belong to dermatophyte; non-dermatophyte molds and yeastsrnwere isolated and identified from 242 patients. Dermatophytes were isolated in 129 (53.3%) ofrnculture positives followed by non-dermatophyte molds 60 (24.8%) and this was followed byrnyeast that accounted 53 (21.9%). Fungal groups that were predominant in clinical sites inrndescending order were dermatophyte, followed by non dermatophyte molds and the least werernyeasts. Among dermatophytes T. violaceum and T.mentagrophyte were the dominant ones.rnConclusion: The prevalence of fungi that cause different manifestation of dermatomycosis wasrnhigh, which was 79.3%. Though dermatophytes were the predominat group the isolation rate ofrnnon-dermatophyte fungi and yeasts was also considerable indicating that the spectrums of fungirncausing dermatomycosis are diverse