Prevalence of Tinea unguium (Onychomycosis) in Toe Nails of boot wearing group in Owerri, Imo State, Nigeria

Abstract

Foot mycoses are a frequent disease that represents a public health problem worldwide. This study among footballers in Owerri, Imo State, Nigeria, with the aim to evaluate the epidemiology of foot mycoses, in order to determine the etiological fungal agents and to identify possible risk factors, as well as investigate the treatment and preventive measures for the susceptible groups.  A total of 50 samples were collected by nail scraping method; Tinea unguium was confirmed in 88.2% of cases using direct microscopy and cultural methods in lactophenol cotton blue and Sabouraud agar media respectively. A prospective study of fifty footballers was undertaken within one year. A complete mycological diagnosis was carried out on all footballers using direct microscopy and cultural methods in lactophenol cotton blue and Sabouraud agar media respectively. Confirmatory test such as germ-tube test was carried out on the yeast Candida albicans isolates for accurate identification.  The results obtained were subjected to statistical analysis using percentage and ANOVA revealed that out of the 50 toe nail samples of footballers examined 28(56.0%) were positive for the infective agent on direct microscopy which served as the screening test. The causative pathogens of Onychomycosis isolated from fungal culture on Sabouraud agar medium, are dermatophytes , and the most frequent pathogen was Trichophyton  rubrum 15(30.0%), yeast isolates were confirmed by germ-tube test, Candida albicans  9(18.0%) . Non-dermatophyte molds were observed in 8(16.0%) cases and Fusarium species was the most frequent genus 14(28.0%) and Aspergillus species 4(8.0%). The main predisposing factors of fungal foot infections were practicing ritual washing (56.6%) and frequentation of communal showers (50.5%). The age group 31- 35 years had the highest prevalence of onychomycosis 12(92.30%) and age group 16-20 years presented the lowest prevalence of onychomycosis 4(28.57%). The confinement of toe nail inside dark, warm and moist environment inside shoes is the major factor that promotes this fungal infection. Therefore proper care of toe nails and boots is necessary to prevent the increasing rate of those infection.

Keywords:  Mycoses, epidemiology, Tinea unguium, Onychomycosis, infections.