Epidemiology of tinea capitis among school-children in Dschang, Western Cameroon

Epidemiology of tinea capitis among school-children in Dschang, Western Cameroon | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Epidemiology of tinea capitis among school-children in Dschang, Western Cameroon Dongmo Armel Joseph Agokeng, Solange Dabou, Jihane Kabtani, Kemnang Brice Donald Agokeng, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4000893/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 12 Jun, 2024 Read the published version in Mycopathologia → Version 1 posted 5 You are reading this latest preprint version Abstract Data on the epidemiology of tinea capitis (TC), an infection of the scalp by dermatophytes, are scarce in Cameroon. This study aimed to determine the prevalence of TC among school-children in the Dschang Subdivision, Western Cameroon. A cross-sectional study was carried out in June 2021 in Dschang including pupils aged 5 to 13. First, a standardized questionnaire was administered to participant for the collection of sociodemographic data. Then, samples were collected and cultured onto Sabouraud-Chloramphenicol-Gentamicin Agar. The etiological agents were identified based on their morphological features and with MALDI-TOF mass spectrometry. A total of 1070 children were clinically examined and 108 (10.1%) children presented with TC lesions. The mean age of the 1070 participants was 8.3 ± 2.6 years (ranges: 5-13 years); 772 (72.2%) were males. The use of borehole water (OR=0.01, 95%CI[0.001-0.03]), spring water (OR=0.2, 95%CI[0.08-0.50]), rainwater (OR=0.004, 95%CI[0.001-0.016]), and hairdressing salons visits (OR=0.413, 95%CI[ 0.196-0.872]) were associated with a decreased TC risk in the multivariate logistic regression analysis. In contrast, sharing bed with siblings (OR=4.48, 95%CI[2.095-9.60]) was associated with an increased TC risk in children. Among the 32 dermatophytes isolated in culture, Microsporum audouinii was the most frequent (43.8%), followed by Trichophyton rubrum (25.0%) and T. soudanense (25.0%). Microsporum canis and T. violaceum were both rarely isolated. Further studies are warranted to assess the association of TC with domestic water usage that has been highlighted in this study. Epidemiology Dermatophytes Dermatophytoses Tinea capitis School children Microsporum audouinii Trichophyton rubrum Trichophyton soudanense Figures Figure 1 Figure 2 Introduction Dermatophytosis are fungal superficial infection of keratinized tissues, such as the skin, hair and nails. They affect more than 20–25% of the world’s population [1] . An increase in the incidence of dermatophytosis has been noted worldwide, especially in developing countries [2,3] . They are caused by the infection of the skin, nails, or hair by zoophilic, telluric or anthropophilic dermatophytes . According to Emmons, and despite recent significant taxonomic changes, approximately 30 dermatophyte species have been classified into three genera: Trichophyton , Microsporum , and Epidermophyton [4] . Dermatophytosis are a public health problem worldwide and cause considerable morbidity. Tinea capitis (TC) is mostly a disease of childhood (3-15 years), particularly frequent in children of African and Caribbean origin [5,6] . Depending on the clinical appearance of the lesions, four TC types are differentiated: 1) microsporic TC, characterised by the presence of few large alopecia patches and the ectothrix invasion of the hair shaft (arthroconidia growth on the exterior of the hair shaft); 2) trichophytic TC, characterised by the presence of numerous small alopecia patches and the endothrix invasion of the hair shaft(arthroconidia growth only within the hair shaft); 3) kerion characterised by the presence of an inflammatory pustular folliculitis involving circumscribed scalp areas, and 4) favus characterised by scarring leading to irreversible alopecia [7] . The Trichophyton or Microsporum species involved in TC vary according to geographic areas [8] . Their frequency also varies from one country to another, with a continual epidemiological evolution [9] . In Cameroon, TC prevalence among schoolchildren has been assessed in the Meiganga district (Adamaoua) [10,11] . However data on epidemiology of TC are lacking over a large part of the national territory. To address this knowledge gap, the present study assessed the prevalence of TC among school-children in the Dschang subdivision, Western Cameroon. Patients and Methods Study Site A cross-sectional study was carried out during June 2021 in Dschang (Latitude: 5°26′38″ North, Longitude: 10°03′11″ East), headquarter of the Menoua subdivision, 48 km from Bafoussam; chief town of the West Region of Cameroon (Fig. 1) . The climate throughout the territory of the Menoua subdivision, characterized by an average altitude of 1400 m, is a mountainous equatorial monsoon climate, with a rainy season from mid-March to mid-November, and a dry season from mid-November to mid-March. However, climate variation have been noted, with a decrease in annual rainfall from 1872.3 mm in 1997 to 1654 mm in 2005. The warmest month is March, with an average temperature of 21.2 °C, while the coolest month is July or August, with temperatures ranging from 18.9 to 19.5 °C. The annual thermal amplitude is low, around 3 °C. The sunshine is 1864 hours per year. The duration of sunshine varies from 8.5 hours per day during the dry season to 2.2 hours per day in rainy season. The relative humidity is constantly high with an annual average of 83%. The water vapor pressure remains constant throughout the year, between 16.5 (in January) and 19.8 mb (in April). The localities in the subdivision are at heterogeneous altitudes. The population of Dschang is estimated at 180,000 inhabitants and their main activity is subsistence farming. There are approximately 141 primary schools and the number of children in this community is unknown (https://www.commune-dschang.org/presentation-de-la-commune, accessed on November 2023) Population and sample collection The study was carried out in 10 primary schools in the Dschang subdivision. The list of these schools was received from the basic education inspector of the subdivision. It comprises the public schools of Plateau, Valley, Group II Dschang, Foto II A, Nzong, Balefang, Foto-Tsinkop, Nzentso, Lipo and Likong. Pupils, aged 5 to 13 years, were selected in each primary school using a block randomization design adjusted on the number of pupils in each classroom. First, parents or guardians provided written informed oral consent on behalf of the participating children. Sociodemographic information was collected using a standardized questionnaire. Missing school children during the study period as well as those who were either on antifungal treatment or who took antifungals less than 14 days before the date of collection were not included in the study. After clinical examination, the skin areas showing clinical signs compatible with dermatophytosis were sampled by rubbing with a sterile gauze. The samples were sent to the Parasitology and Mycology laboratory at the University Hospital of Marseille, France, for analysis. Laboratory procedures Each specimen was inoculated on Sabouraud dextrose agar plates supplemented with chloramphenicol and cycloheximide ( Thermo Scientific ™, Germany) and then incubated at 27 o C up to four weeks. Identification of dermatophyte species was based on macro-morphological examination of colonies, further Matrix Assisted Laser Desorption Ionization - Time of Flight/ Mass Spectrometry (MALDI-TOF-MS), and rDNA internal transcribed spacer (ITS) sequence analysis as previously described [12,13] . Statistical analysis The data were analysed using SAS 9.2 for Windows (SAS Institute Inc., Cary, NC, USA). Continuous variables were expressed as the mean and standard deviation (SD), while categorical variables were expressed as percentages and 95% confidence intervals (CI). Continuous variables were compared using ANOVA. Categorical variables were compared using the Chi square or the Fisher's exact tests as required. All statistical tests were two-sided with a p <0.05 significance level. Univariate and multivariate unconditional logistic regression analyses were performed to estimate odds ratios (ORs) with 95%CI. All covariates with a P <0.20 significance level in the univariate analysis were included in the multivariate logistic regression model. A stepwise selection was performed to retain the most parsimonious model including the covariates that displayed an independent statistically significant ( P <0.05) effect on tinea capitis risk. Ethical issues The study protocol was reviewed and approved by the Faculty of Medicine’s Institutional Review Board at the University of Douala, Cameroun (N o 3146 CIE-Udo/06/2022/T). The study protocol was also approved by the Local Education Authorities at each study site. Parent or guardian provided written informed consent on behalf of the participating children. Results Characteristics of the study population A total of 1070 children were included and clinically examined in this study. The mean age of the participants was 8.3 ± 2.6 years (range: 5-13 years). There were 772 (72.15%) males; and 923 (86.3%) lived in urban areas. Overall, biological samples were collected from 108 (10.1%) of these children who presented with lesions compatible with TC (Fig 2). TC prevalence As detailed in Table 1, 108 children presented with clinical TC, thereby yielding an overall clinical dermatophytosis prevalence of 10.1% among the entire study population. TC prevalence was homogeneously distributed 10.1% and 10.2 % ( P = 0.961) in urban and rural areas, respectively. Table I shows that the prevalence of TC among siblings ( P <10 -4 ), the use of a public hairdresser ( P <10 -4 ), and the use of spring ( P = 0.035) and borehole water ( P = 0.022) were significantly more frequent in urban than in rural areas. In contrast, the presence of domestic animals was significantly higher in rural areas than in urban areas, including cats ( P = 0.001), dogs ( P = 0.048), and chickens ( P <10 -4 ). Table 1. Univariate analysis of the sociodemographic characteristics of the study population in either urban or rural areas in Dschang, Cameroon. Variables Total Population N=1070 (%) Rural area N=147 (%) Urban area N=923 (%) P value Sex Female 298 (27.8) 41 (27.9) 257 (27.8) - Male 917 (85.7) 117 (79.6) 800 (86.7) 0.023 Habits spring water 1030 (96.3) 146 (99.3) 884 (95.8) 0.035 Rainwater 70 (6.5) 4 (0.4) 66 (6.2) 0.044 Borehole water 917 (85.7) 117 (79.6) 800 (86.7) 0.023 Public hairdresser attendance 948 (88.6) 113 (76.9) 835 (90.5) <10 -4 Trimmer use 1011 (94.5) 139 (94.5) 872 (94.5) 1.0 Use common comb 974 (91.4) 129 (87.8) 845 (92.05) 0.084 Presence of domestic animals Cat 307 (28.7) 59 (40.1) 248 (26.9) 0.001 Dog 199 (18.6) 36 (24.5) 163 (17.7) 0.048 Chicken 405 (37.9) 108 (73.5) 297 (32.2) <10 -4 Presence of ringworm in siblings 481 (45.1) 45 (30.6) 436 (47.4) 10 -4 Common room 913 (85.3) 133 (90.5) 780 (84.5) 0.057 common bed 873 (81.6) 122 (82.1) 751 (81.4) 0.636 Use trash can for garbage 1008 (94.2) 107 (72.8) 901 (97.6) <10 -4 Use field for garbage 70 (6.5) 40 (27.2) 30 (3.3) <10 -4 Games next to the trash can 310 (28.1) 40 (27.2) 270 (29.3) 0.612 Tinea capitis 108 (10.1) 15 (10.2) 93 (10.1) 0.962 The factors associated with TC in the univariate analysis are detailed in Table 2 . There was no statistically significant association between TC and sex ( P = 0.375), the area of residence ( P = 0.962), as well as the presence of domestic animals notably cats ( P = 0.824), dogs ( P = 0.184), or pigs ( P =1.000). The same tendency was observed with the presence of TC in the siblings ( P = 0.197) and sharing the same room with ( P = 0.164). In contrast, TC was statistically significantly more frequent in children sharing bed, while it was statistically significantly more frequent in children sharing combs or attending public hairdressing salons. Table 2. Univariate analysis of tinea capitis risk factors among school children in Dschang, Cameroon. Factors Total Population N=1070 (%) Tinea capitis N=108 (%) No tinea capitis N=962 (%) P . value Sex Female 298 (27.9) 34 (31.5) 264 (27.4) 0.375 Male 772 (72.2) 74 (68.5) 698 (72.6) Area Rural 147 (13.7) 15 (13.9) 137 (13.7) 0.962 Urban 923 (86.) 93 (86.1) 830 (86.3) Domestic water usages borehole water 917 (85.7) 32 (29.6) 885 (92.0) <10 -4 spring water 1030 (96.3) 88 (81.5) 942 (97.1) <10 -4 Rainwater 70 (6.5) 22 (20.4) 48 (4.1) <10 -4 Hairdressing habits hairdressing salons attendance 948 (88.6) 88 (81.5) 860 (89.4) 0.014 Trimmer use 1011 (94.5) 106 (98.2) 905 (94.07) 0.079 Use common comb 974 (91.5) 86 (81.1) 888 (92.6) <10 -4 Presence of domestic animals Presence of cat 307 (28.7) 30 (27.8) 277 (28.8) 0.825 Presence of dog 199 (18.6) 15 (13.9) 184 (19.1) 0.185 Presence of hen 405 (37.8) 41 (37.1) 364 (37.9) 1.000 Presence of pig 66 (6.2) 6 (5.6) 60 (6.2) 1.000 Familial factors Ringworm in siblings 481 (45.08) 55 (50.9) 426 (44.4) 0.198 sharing room 913 (85.3) 97 (89.8) 816 (84.8) 0.164 sharing bed 873 (81.6) 96 (88.9) 777 (80.8) 0.039 sharing clothes 168 (15.7) 17 (15.7) 151 (15.7) 0.990 Using trash bins for garbage 1008 (94.2) 91 (84.3) 917 (95.3) <10 -4 Using fields for garbage 70 (6.5) 7 (6.5) 63 (6.5) 0.979 Playing next to the trash bin 310 (28.1) 31 (28.7) 279 (29) 0.948 Factors such as the use of borehole water, spring water, rainwater and hairdressing salons visits were associated with a decreased TC risk. In contrast, sharing the same bed was associated with a 4.5 times increased TC risk in children (Table 3) . Among the 32 cultured dermatophytes in this study, M. audouinii was the most frequently (43.75%) isolated species, followed by T. rubrum (25%), and T. soudanense (25%). M. canis and T. violaceum (3.1% each) were rarely isolated. Table 3: Univariate and multivariate unconditional logistic regression analyses of the tinea capitis risk factors identified in this population. Factors Univariate analysis Multivariate analysis OR 95%IC P . value OR 95%IC P . value Borehole Water 0.04 [0.02-0.06] <10 -4 0.01 [0.001-0.03] <10 -4 Rainwater 4.87 [2.80-8.45] <10 -4 0.2 [0.08-0.50] 0.0005 spring water 0.09 [0.05-0.18] <10 -4 0.004 [0.001-0.016] <10 -4 hairdressing salons visits 0.52 [0.30-0.88] 0.014 0.41 [0.196-0.872] 0.020 common bed 1.90 [1.02-3.54] 0.039 4.48 [2.095-9.60] 0.0001 Trimmer use 0.3 [0.07-1.24] 0.079 - - - Use common comb 0.34 [0.20-0.60] <10 -4 - - - Presence of cat 0.95 [0.61-1.48] 0.825 - - - Presence of dog 0.69 [0.39-1.20] 0.185 - - - Presence of hen 1.00 [0.67-1.51] 1.000 - - - Presence of pig 0.88 [0.37-2.09] 1.000 - - - Presence of ringworm in siblings 1.3 [0.87-1.93] 0.198 - - - Common room 1.58 [0.82-3.01] 0.164 - - - common clothing 1.00 [0.58-1.73] 0.990 - - - Use trash can for garbage 0.26 [0.14-0.48] <10 -4 - - - Use field for garbage 0.99 [0.44-2.21] 0.979 - - - Games next to the trash can 0.98 [0.63-1.53] 0.948 - - - Discussion This study main finding was the estimation of a 10.1% prevalence of TC among schoolchildren in the Dschang area in Cameroon. This estimation derives from a representative sample of relatively large size. It is similar to the 8.1% prevalence observed by Kechia et al. in Meiganga (Cameroon) [11] . It is also similar to that found by Sy et al. in Mauritania, who reported a 10.5 prevalence among school-age children [14] . A higher prevalence in school-aged children was reported in Ethiopia (32.3%) by Hibstu and Kebede [15] , and in Benin (25.2%) by Koudoukpo et al [16] . In Dschang, TC prevalence was homogeneous in the children of both urban and rural areas. This contrasts with Sy et al. [14] , who found a 9.5% prevalence in urban areas vs 12.2% in rural areas in Mauritania. This difference may be explained by our comparatively relatively small geographical study area. In line with Hibstu and Kebede in Southern Ethiopia [15] , more than 94% of TC cases in Dschang occurred in children aged between 5 and 10 years. This finding is usually explained by the relatively poor hygiene at this age as well as the absence of saturated fatty acids in children skin that provide a natural protective mechanism against dermatophytoses [15] . Notably, the prevalence of TC in our study population was relatively homogeneous in boys and girls ( P =0.375). We have no explanation for this result that sharply contrasts with those of the majority of the previous studies conducted in African school children, including those of Nzenze-Afene et al [17] , Kechia et al [11] , and Coulibaly et al. [ 18 ], who consistently found that TC was more frequent in boys than in girls , in Gabon, Cameroon, and Mali, respectively. The presence of TC in siblings, sharing bedroom, and bed, increased the risk of TC in the univariate analysis. Sharing bed was the most statistically significant of these redundant variables, which remained in the multivariate analysis. A similar observations has been reported in Ethiopia [15] . This increased TC risk might be due to the promiscuity between family members as well as the sharing of several fomites including combs and towels. To the best of our knowledge, the influence of water on TC risk had never been investigated. We found that the use of rainwater was associated with a 4.9 times increased risk of TC. We have no clear explanation for this epidemiological association, which warrants to be confirmed in further independent epidemiological studies. One limitation of our study findings was a relatively high false-negative dermatophyte culture rate with a small number of positive dermatophytes cultures. In contrast to Kechia et al . [11] , who found a higher prevalence (56.8%) of T. soudanense in Cameroon's Adamaoua, in our study we found a higher prevalence (43.35%) of M. audouinii . This may be justified by the fact that M. audouinii is one of the most common dermatophyte species in Central Africa [19] . Moreover, both Sidat et al. [20] and Carod et al. [21] found M. audouinii to be the most prevalent species involved TC among school-age children in Mozambique and Madagascar, respectively. Conclusion The prevalence of TC in Dschang was relatively similar with those previously reported in Cameroon and neighbouring African countries. We identified sharing bed among siblings as an independent TC risk factors in school-aged children. Further epidemiological studies are warranted to confirm the relatively strong statistical association of TC with the use of domestic water that we highlighted in this study. Health policies promoting the diagnosis and treatment of TC in school children should play a key role in the prevention and the control of this communicable disease. Declarations Funding This study was supported by the Fondation Méditerranée Infection. Competing Interests The authors have no relevant financial or non-financial interests to disclose. Ethics approval This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Faculty of Medicine’s Institutional Review Board at the University of Douala, Cameroun (No3146 CIE-Udo/06/2022/T). The study protocol was also approved by the Local Education Authorities at each study site. Consent to participate Freely-given, informed consent to participate was obtained from the parent or legal guardian of the participating children. Written informed consent was obtained from the parent or legal guardian. Data availability Raw data are available at DOI: 10.13140/RG.2.2.18342.70722 References Havlickova B, Czaika VA, Friedrich M. Epidemiological trends in skin mycoses worldwide. Mycoses. 2008;51:2–15. Ameen M. Epidemiology of superficial fungal infections. Clin Dermatol. 2010;28:197–201. Moriarty B, Hay R, Morris-Jones R. The diagnosis and management of tinea. 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Epidemiology of Tinea Capitis and Associated Factors among School Age Children in Hawassa Zuria District, Southern Ethiopia, 2016. J Bacteriol Parasitol 2017, 8:2 Koudoukpo C, Dégboé B, Aïkou N, Akpadjan F, Agbéssi N, Atadokpèdé F, et al. Profil Mycologique des Teignes du Cuir Chevelu en Milieu Scolaire à Parakou (Benin) en 2018. 2019;20. Nzenze-Afene S, Kendjo E, Bouyou-Akotet M, Mabika Manfoumbi M, Kombila M. Les teignes du cuir chevelu en milieu scolaire à Libreville, Gabon. J Mycol Médicale. 2009;19:155–60. Coulibaly O, Kone AK, Niaré-Doumbo S, Goïta S, Gaudart J, Djimdé AA, Piarroux R, Doumbo OK, Thera MA, Ranque S. Dermatophytosis among schoolchildren in three eco-climatic zones of Mali. PLoS Negl Trop Dis. 2016;10(4):e0004675. Coulibaly O, L’Ollivier C, Piarroux R, Ranque S. Epidemiology of human dermatophytoses in Africa. Med Mycol. 2018;56:145–61. Sidat MM, Correia D, Buene TP. Tinea capitis among rural school children of the district of Magude, in Maputo province, Mozambique. Mycoses. 2006;49(6):480-3 Carod J-F, Ratsitorahina M, Raherimandimby H, Vitrat VH, Andrianaja VR, Contet-Audonneau N. Outbreak of Tinea capitis and corporis in a primary school in Antananarivo, Madagascar. J Infect Dev Ctries. 2011; 13;5(10):732-6 Cite Share Download PDF Status: Published Journal Publication published 12 Jun, 2024 Read the published version in Mycopathologia → Version 1 posted Reviewers agreed at journal 13 Mar, 2024 Reviewers invited by journal 11 Mar, 2024 Editor invited by journal 07 Mar, 2024 Editor assigned by journal 29 Feb, 2024 First submitted to journal 28 Feb, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4000893","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":278500828,"identity":"9db4d279-ed49-4249-86b3-5d854f635e02","order_by":0,"name":"Dongmo Armel Joseph Agokeng","email":"","orcid":"","institution":"IHU Méditerranée Infection: IHU Mediterranee Infection","correspondingAuthor":false,"prefix":"","firstName":"Dongmo","middleName":"Armel Joseph","lastName":"Agokeng","suffix":""},{"id":278500829,"identity":"ab368828-3249-4101-8ed0-112f507996bc","order_by":1,"name":"Solange Dabou","email":"","orcid":"","institution":"University of Dschang Faculty of Sciences: Universite de Dschang Faculte des Sciences","correspondingAuthor":false,"prefix":"","firstName":"Solange","middleName":"","lastName":"Dabou","suffix":""},{"id":278500830,"identity":"0015fe46-5dfa-4784-aaf9-d1b059a57283","order_by":2,"name":"Jihane Kabtani","email":"","orcid":"","institution":"IHU Méditerranée Infection: IHU Mediterranee Infection","correspondingAuthor":false,"prefix":"","firstName":"Jihane","middleName":"","lastName":"Kabtani","suffix":""},{"id":278500831,"identity":"c29a5c3c-242e-4eae-9770-ff899caafde9","order_by":3,"name":"Kemnang Brice Donald Agokeng","email":"","orcid":"","institution":"University of Dschang Faculty of Sciences: Universite de Dschang Faculte des Sciences","correspondingAuthor":false,"prefix":"","firstName":"Kemnang","middleName":"Brice 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Ranque","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABD0lEQVRIie3RMWrDMBSA4QcFdZHJqmCwrqAgcAild3EoxItNOgZaqCCgsVldcoreQEWgLj6AIZ4ayF4onoKp3CRtFjlrB/1g8QZ/+BkB+Hz/MCoArg7TmySfso3siOwTOQkzJ0Lu3ocvUvEj4W6CfsksXQdSTcVFQpdme/9YR0CycUfS1VqgjwrY3PkvEqW8MDsOtIw3gdznRa2ueQZsIlzG4DjESE8FxR1RuajmTZjBnjk3M4MmxK1+EsNV85DbxWiVIEtYD8EoDKROgJTxza1UCbtEmJmNefCsR5Jk8aQo1ei1VpYwN6FLvdviRtOBJeRr0dJoIyxZ9Cx2uIXT2UV+vt4Dzl8+Iz6fz+f76xv7e1iL8z1PxgAAAABJRU5ErkJggg==","orcid":"https://orcid.org/0000-0003-3293-5276","institution":"Aix Marseille University","correspondingAuthor":true,"prefix":"","firstName":"Stephane","middleName":"","lastName":"Ranque","suffix":""}],"badges":[],"createdAt":"2024-02-29 19:04:15","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4000893/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4000893/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1007/s11046-024-00857-y","type":"published","date":"2024-06-12T14:53:20+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":52623736,"identity":"11791494-841d-4f0c-965c-d94417eab674","added_by":"auto","created_at":"2024-03-13 17:21:15","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":1088536,"visible":true,"origin":"","legend":"\u003cp\u003eGeographic location of Dschang in Western Cameroon\u003cstrong\u003e \u003c/strong\u003e(\u003ca href=\"https://mairies-du-cameroun.org/en/collectivites-territoriales/carte-communale/ouest/dschang\"\u003ehttps://mairies-du-cameroun.org/en/collectivites-territoriales/carte-communale/ouest/dschang\u003c/a\u003e, accessed on January 2024)\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-4000893/v1/2a6d6de3b6eb9b56fb050d4f.png"},{"id":52623734,"identity":"949e438e-4022-4200-bfb7-db04a9036e71","added_by":"auto","created_at":"2024-03-13 17:21:14","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":994322,"visible":true,"origin":"","legend":"\u003cp\u003eTinea capitis clinical presentations: the trichophytic form, characterised by the presence of numerous small alopecia patches (A), and the microsporic form, characterised by the presence of few large alopecia patches (B).\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-4000893/v1/913a52e9d283dad35c8435c2.png"},{"id":58822327,"identity":"69091fd9-2f46-450d-bbfb-5fe074efc5b9","added_by":"auto","created_at":"2024-06-21 16:41:11","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2779146,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4000893/v1/c8ee7019-dd99-43d1-9c7a-7f1a0b53a976.pdf"}],"financialInterests":"","formattedTitle":"Epidemiology of tinea capitis among school-children in Dschang, Western Cameroon","fulltext":[{"header":"Introduction","content":"\u003cp\u003eDermatophytosis are fungal superficial infection of\u0026nbsp;keratinized tissues, such as the skin, hair and nails. They affect more than 20\u0026ndash;25% of the world\u0026rsquo;s population\u0026nbsp;\u003cstrong\u003e[1]\u003c/strong\u003e\u003cstrong\u003e.\u003c/strong\u003e An increase in the incidence of dermatophytosis has been noted worldwide, especially in developing countries\u0026nbsp;\u003cstrong\u003e[2,3]\u003c/strong\u003e. They are caused by the infection of the skin, nails, or hair by zoophilic, telluric or anthropophilic dermatophytes\u003cstrong\u003e.\u0026nbsp;\u003c/strong\u003eAccording to Emmons, and despite recent significant taxonomic changes, approximately 30 dermatophyte species have been classified into three genera: \u003cem\u003eTrichophyton\u003c/em\u003e, \u003cem\u003eMicrosporum\u003c/em\u003e, and \u003cem\u003eEpidermophyton\u003c/em\u003e \u003cstrong\u003e[4]\u003c/strong\u003e\u003cstrong\u003e.\u0026nbsp;\u003c/strong\u003eDermatophytosis are a public health problem worldwide and cause considerable morbidity. Tinea capitis (TC) is mostly a disease of childhood (3-15 years), particularly frequent in children of African and Caribbean origin\u0026nbsp;\u003cstrong\u003e[5,6]\u003c/strong\u003e\u003cstrong\u003e.\u0026nbsp;\u003c/strong\u003eDepending on the clinical appearance of the lesions, four TC types are differentiated: 1) microsporic TC, characterised by the presence of few large alopecia patches and the ectothrix invasion of the hair shaft (arthroconidia growth on the exterior of the hair shaft); 2) trichophytic TC, characterised by the presence of numerous small alopecia patches and the endothrix invasion of the hair shaft(arthroconidia growth only within the hair shaft); 3) kerion characterised by the presence of an inflammatory pustular folliculitis involving circumscribed scalp areas, and 4) favus characterised by scarring leading to irreversible alopecia\u0026nbsp;\u003cstrong\u003e[7]\u003c/strong\u003e. The \u003cem\u003eTrichophyton\u003c/em\u003e or \u003cem\u003eMicrosporum\u003c/em\u003e species involved in TC vary according to geographic areas\u0026nbsp;\u003cstrong\u003e[8]\u003c/strong\u003e. Their frequency also varies from one country to another, with a continual epidemiological evolution\u0026nbsp;\u003cstrong\u003e[9]\u003c/strong\u003e. In Cameroon,\u0026nbsp;TC prevalence among schoolchildren has been assessed in the Meiganga district (Adamaoua)\u0026nbsp;\u003cstrong\u003e[10,11]\u003c/strong\u003e. However data on epidemiology of TC are lacking over a large part of the national territory. To address this knowledge gap, the present study assessed the prevalence of TC among school-children in the Dschang subdivision, Western Cameroon.\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e"},{"header":"Patients and Methods","content":"\u003cp\u003e\u003cstrong\u003eStudy Site\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA cross-sectional study was carried out during June 2021 in Dschang (Latitude: 5\u0026deg;26\u0026prime;38\u0026Prime; North, Longitude: 10\u0026deg;03\u0026prime;11\u0026Prime; East), headquarter of the Menoua subdivision, 48 km from Bafoussam; chief town of the West Region of Cameroon \u003cstrong\u003e(Fig. 1)\u003c/strong\u003e. The climate throughout the territory of the Menoua subdivision, characterized by an average altitude of 1400 m, is a mountainous equatorial monsoon climate, with a rainy season from mid-March to mid-November, and a dry season from mid-November to mid-March. However, climate variation have been noted, with a decrease in annual rainfall from 1872.3 mm in 1997 to 1654 mm in 2005. The warmest month is March, with an average temperature of 21.2 \u0026deg;C, while the coolest month is July or August, with temperatures ranging from 18.9 to 19.5 \u0026deg;C. The annual thermal amplitude is low, around 3 \u0026deg;C. The sunshine is 1864 hours per year. The duration of sunshine varies from 8.5 hours per day during the dry season to 2.2 hours per day in rainy season. The relative humidity is constantly high with an annual average of 83%. The water vapor pressure remains constant throughout the year, between 16.5 (in January) and 19.8 mb (in April). The localities in the subdivision are at heterogeneous altitudes. The population of Dschang is estimated at 180,000 inhabitants and their main activity is subsistence farming. There are approximately 141 primary schools and the number of children in this community is unknown (https://www.commune-dschang.org/presentation-de-la-commune, accessed on November 2023)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePopulation and sample collection\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was carried out in 10 primary schools in the Dschang subdivision. The list of these schools was received from the basic education inspector of the subdivision. It comprises the public schools of Plateau, Valley, Group II Dschang, Foto II A, Nzong, Balefang, Foto-Tsinkop, Nzentso, Lipo and Likong.\u0026nbsp;Pupils, aged 5 to 13 years, were selected in each primary school using a block randomization design adjusted on the number of pupils in each classroom.\u0026nbsp;First, parents or guardians provided written informed oral consent on behalf of the participating children. Sociodemographic information was collected using a standardized questionnaire. Missing school children during the study period as well as those who were either on antifungal treatment or who took antifungals less than 14 days before the date of collection were not included in the study. After clinical examination, the skin areas showing clinical signs compatible with dermatophytosis were sampled\u0026nbsp;by\u0026nbsp;rubbing with a sterile gauze. The samples were sent to the Parasitology and Mycology laboratory at the University Hospital of Marseille, France, for analysis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLaboratory procedures\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEach specimen was inoculated on Sabouraud dextrose agar plates supplemented with\u0026nbsp;chloramphenicol and cycloheximide (\u003cem\u003eThermo Scientific\u003c/em\u003e\u0026trade;, Germany) and then incubated at 27 \u003csup\u003eo\u003c/sup\u003eC up to four weeks. Identification of dermatophyte species was based on macro-morphological examination of colonies, further Matrix Assisted Laser Desorption Ionization - Time of Flight/ Mass Spectrometry (MALDI-TOF-MS), and rDNA internal transcribed spacer (ITS) sequence analysis as previously described \u003cstrong\u003e[12,13]\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data were analysed using SAS 9.2 for Windows (SAS Institute Inc., Cary, NC, USA). Continuous variables were expressed as the mean and standard deviation (SD), while categorical variables were expressed as percentages and 95% confidence intervals (CI). Continuous variables were compared using ANOVA. Categorical variables were compared using the Chi square or the Fisher\u0026apos;s exact tests as required. All statistical tests were two-sided with a \u003cem\u003ep\u003c/em\u003e\u0026lt;0.05 significance level. Univariate and multivariate unconditional logistic regression analyses were performed to estimate odds ratios (ORs) with 95%CI. All covariates with a \u003cem\u003eP\u003c/em\u003e \u0026lt;0.20 significance level in the univariate analysis were included in the multivariate logistic regression model. A stepwise selection was performed to retain the most parsimonious model including the covariates that displayed an independent statistically significant (\u003cem\u003eP\u003c/em\u003e\u0026lt;0.05) effect on tinea capitis risk. \u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical issues\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study protocol was reviewed and approved by the Faculty of Medicine\u0026rsquo;s Institutional Review Board at the University of Douala, Cameroun (N\u003csup\u003eo\u003c/sup\u003e3146 CIE-Udo/06/2022/T). The study protocol was also approved by the Local Education Authorities at each study site. Parent or guardian provided written informed consent on behalf of the participating children.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eCharacteristics of the study population\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA total of 1070 children were included and clinically examined in this study. The mean age of the participants was 8.3 \u0026plusmn; 2.6 years (range: 5-13 years). There were 772 (72.15%) males; and 923 (86.3%) lived in urban areas. Overall, biological samples were collected from 108 (10.1%) of these children who presented with lesions compatible with TC (Fig 2).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTC prevalence\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAs detailed in\u0026nbsp;Table 1, 108 children presented with clinical TC, thereby yielding an overall clinical dermatophytosis prevalence of 10.1% among the entire study population. TC prevalence was homogeneously distributed 10.1% and 10.2 % (\u003cem\u003eP\u0026nbsp;\u003c/em\u003e= 0.961) in urban and rural areas, respectively. Table I shows that the prevalence of TC among siblings (\u003cem\u003eP\u0026nbsp;\u003c/em\u003e\u0026lt;10\u003csup\u003e-4\u003c/sup\u003e), the use of a public hairdresser (\u003cem\u003eP\u003c/em\u003e \u0026lt;10\u003csup\u003e-4\u003c/sup\u003e), and the use of spring (\u003cem\u003eP\u0026nbsp;\u003c/em\u003e= 0.035) and borehole water (\u003cem\u003eP\u003c/em\u003e = 0.022) were significantly more frequent in urban than in rural areas. In contrast, the presence of domestic animals was significantly higher in rural areas than in urban areas, including cats (\u003cem\u003eP\u003c/em\u003e = 0.001), dogs (\u003cem\u003eP\u003c/em\u003e = 0.048), and chickens (\u003cem\u003eP\u003c/em\u003e \u0026lt;10\u003csup\u003e-4\u003c/sup\u003e).\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1.\u0026nbsp;\u003c/strong\u003eUnivariate analysis of the sociodemographic characteristics of the study population in either urban or rural areas in Dschang, Cameroon.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"673\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.16913946587537%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.364985163204746%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal Population N=1070 (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.243323442136498%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eRural area\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eN=147 (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.094955489614243%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eUrban area\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eN=923 (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.127596439169139%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003cstrong\u003e\u0026nbsp;value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.16913946587537%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.364985163204746%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.243323442136498%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.094955489614243%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.127596439169139%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.16913946587537%\" valign=\"top\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.364985163204746%\" valign=\"top\"\u003e\n \u003cp\u003e298 (27.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.243323442136498%\" valign=\"top\"\u003e\n \u003cp\u003e41 (27.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.094955489614243%\" valign=\"top\"\u003e\n \u003cp\u003e257 (27.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.127596439169139%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.16913946587537%\" valign=\"top\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.364985163204746%\" valign=\"top\"\u003e\n \u003cp\u003e917 (85.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.243323442136498%\" valign=\"top\"\u003e\n \u003cp\u003e117 (79.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.094955489614243%\" valign=\"top\"\u003e\n \u003cp\u003e800 (86.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.127596439169139%\" valign=\"top\"\u003e\n \u003cp\u003e0.023\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.16913946587537%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eHabits\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.364985163204746%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.243323442136498%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.094955489614243%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.127596439169139%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.16913946587537%\" valign=\"top\"\u003e\n \u003cp\u003espring water\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.364985163204746%\" valign=\"top\"\u003e\n \u003cp\u003e1030 (96.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.243323442136498%\" valign=\"top\"\u003e\n \u003cp\u003e146 (99.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.094955489614243%\" valign=\"top\"\u003e\n \u003cp\u003e884 (95.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.127596439169139%\" valign=\"top\"\u003e\n \u003cp\u003e0.035\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.16913946587537%\" valign=\"top\"\u003e\n \u003cp\u003eRainwater\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.364985163204746%\" valign=\"top\"\u003e\n \u003cp\u003e70 (6.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.243323442136498%\" valign=\"top\"\u003e\n \u003cp\u003e4 (0.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.094955489614243%\" valign=\"top\"\u003e\n \u003cp\u003e66 (6.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.127596439169139%\" valign=\"top\"\u003e\n \u003cp\u003e0.044\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.16913946587537%\" valign=\"top\"\u003e\n \u003cp\u003eBorehole water\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.364985163204746%\" valign=\"top\"\u003e\n \u003cp\u003e917 (85.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.243323442136498%\" valign=\"top\"\u003e\n \u003cp\u003e117 (79.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.094955489614243%\" valign=\"top\"\u003e\n \u003cp\u003e800 (86.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.127596439169139%\" valign=\"top\"\u003e\n \u003cp\u003e0.023\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.16913946587537%\" valign=\"top\"\u003e\n \u003cp\u003ePublic hairdresser attendance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.364985163204746%\" valign=\"top\"\u003e\n \u003cp\u003e948 (88.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.243323442136498%\" valign=\"top\"\u003e\n \u003cp\u003e113 (76.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.094955489614243%\" valign=\"top\"\u003e\n \u003cp\u003e835 (90.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.127596439169139%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;10\u003csup\u003e-4\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.16913946587537%\" valign=\"top\"\u003e\n \u003cp\u003eTrimmer use\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.364985163204746%\" valign=\"top\"\u003e\n \u003cp\u003e1011 (94.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.243323442136498%\" valign=\"top\"\u003e\n \u003cp\u003e139 (94.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.094955489614243%\" valign=\"top\"\u003e\n \u003cp\u003e872 (94.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.127596439169139%\" valign=\"top\"\u003e\n \u003cp\u003e1.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.16913946587537%\" valign=\"top\"\u003e\n \u003cp\u003eUse common comb\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.364985163204746%\" valign=\"top\"\u003e\n \u003cp\u003e974 (91.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.243323442136498%\" valign=\"top\"\u003e\n \u003cp\u003e129 (87.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.094955489614243%\" valign=\"top\"\u003e\n \u003cp\u003e845 (92.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.127596439169139%\" valign=\"top\"\u003e\n \u003cp\u003e0.084\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.16913946587537%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePresence of domestic animals\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.364985163204746%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.243323442136498%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.094955489614243%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.127596439169139%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.16913946587537%\" valign=\"top\"\u003e\n \u003cp\u003eCat\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.364985163204746%\" valign=\"top\"\u003e\n \u003cp\u003e307 (28.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.243323442136498%\" valign=\"top\"\u003e\n \u003cp\u003e59 (40.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.094955489614243%\" valign=\"top\"\u003e\n \u003cp\u003e248 (26.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.127596439169139%\" valign=\"top\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.16913946587537%\" valign=\"top\"\u003e\n \u003cp\u003eDog\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.364985163204746%\" valign=\"top\"\u003e\n \u003cp\u003e199 (18.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.243323442136498%\" valign=\"top\"\u003e\n \u003cp\u003e36 (24.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.094955489614243%\" valign=\"top\"\u003e\n \u003cp\u003e163 (17.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.127596439169139%\" valign=\"top\"\u003e\n \u003cp\u003e0.048\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.16913946587537%\" valign=\"top\"\u003e\n \u003cp\u003eChicken\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.364985163204746%\" valign=\"top\"\u003e\n \u003cp\u003e405 (37.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.243323442136498%\" valign=\"top\"\u003e\n \u003cp\u003e108 (73.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.094955489614243%\" valign=\"top\"\u003e\n \u003cp\u003e297 (32.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.127596439169139%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;10\u003csup\u003e-4\u003c/sup\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.16913946587537%\" valign=\"top\"\u003e\n \u003cp\u003ePresence of ringworm in siblings\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.364985163204746%\" valign=\"top\"\u003e\n \u003cp\u003e481 (45.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.243323442136498%\" valign=\"top\"\u003e\n \u003cp\u003e45 (30.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.094955489614243%\" valign=\"top\"\u003e\n \u003cp\u003e436 (47.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.127596439169139%\" valign=\"top\"\u003e\n \u003cp\u003e10\u003csup\u003e-4\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.16913946587537%\" valign=\"top\"\u003e\n \u003cp\u003eCommon room\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.364985163204746%\" valign=\"top\"\u003e\n \u003cp\u003e913 (85.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.243323442136498%\" valign=\"top\"\u003e\n \u003cp\u003e133 (90.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.094955489614243%\" valign=\"top\"\u003e\n \u003cp\u003e780 (84.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.127596439169139%\" valign=\"top\"\u003e\n \u003cp\u003e0.057\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.16913946587537%\" valign=\"top\"\u003e\n \u003cp\u003ecommon bed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.364985163204746%\" valign=\"top\"\u003e\n \u003cp\u003e873 (81.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.243323442136498%\" valign=\"top\"\u003e\n \u003cp\u003e122 (82.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.094955489614243%\" valign=\"top\"\u003e\n \u003cp\u003e751 (81.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.127596439169139%\" valign=\"top\"\u003e\n \u003cp\u003e0.636\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.16913946587537%\" valign=\"top\"\u003e\n \u003cp\u003eUse trash can for garbage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.364985163204746%\" valign=\"top\"\u003e\n \u003cp\u003e1008 (94.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.243323442136498%\" valign=\"top\"\u003e\n \u003cp\u003e107 (72.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.094955489614243%\" valign=\"top\"\u003e\n \u003cp\u003e901 (97.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.127596439169139%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;10\u003csup\u003e-4\u003c/sup\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.16913946587537%\" valign=\"top\"\u003e\n \u003cp\u003eUse field for garbage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.364985163204746%\" valign=\"top\"\u003e\n \u003cp\u003e70 (6.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.243323442136498%\" valign=\"top\"\u003e\n \u003cp\u003e40 (27.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.094955489614243%\" valign=\"top\"\u003e\n \u003cp\u003e30 (3.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.127596439169139%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;10\u003csup\u003e-4\u003c/sup\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.16913946587537%\" valign=\"top\"\u003e\n \u003cp\u003eGames next to the trash can\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.364985163204746%\" valign=\"top\"\u003e\n \u003cp\u003e310 (28.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.243323442136498%\" valign=\"top\"\u003e\n \u003cp\u003e40 (27.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.094955489614243%\" valign=\"top\"\u003e\n \u003cp\u003e270 (29.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.127596439169139%\" valign=\"top\"\u003e\n \u003cp\u003e0.612\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.16913946587537%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTinea capitis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.364985163204746%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e108 (10.1)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.243323442136498%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e15 (10.2)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.094955489614243%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e93 (10.1)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.127596439169139%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.962\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eThe factors associated with TC in the univariate analysis are detailed in \u003cstrong\u003eTable 2\u003c/strong\u003e. There was no statistically significant association between\u0026nbsp;TC\u0026nbsp;and sex (\u003cem\u003eP\u003c/em\u003e = 0.375), the area of residence (\u003cem\u003eP\u003c/em\u003e = 0.962), as well as the presence of domestic animals notably cats (\u003cem\u003eP\u003c/em\u003e = 0.824), dogs (\u003cem\u003eP\u003c/em\u003e = 0.184), or pigs (\u003cem\u003eP\u003c/em\u003e =1.000). The same tendency was observed with the presence of TC in the siblings (\u003cem\u003eP\u003c/em\u003e = 0.197) and sharing the same room with (\u003cem\u003eP\u0026nbsp;\u003c/em\u003e= 0.164). In contrast,\u0026nbsp;TC\u0026nbsp;was\u0026nbsp;statistically significantly more frequent in children sharing bed, while it was statistically significantly more frequent in children sharing combs or attending public hairdressing salons.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2.\u0026nbsp;\u003c/strong\u003eUnivariate analysis of tinea capitis risk factors among school children in Dschang, Cameroon.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"\" width=\"650\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.866359447004605%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFactors\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.589861751152075%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal Population\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eN=1070 (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.740399385560675%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTinea capitis\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;N=108 (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.204301075268816%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo tinea capitis\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;N=962 (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.599078341013826%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e. value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.866359447004605%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.589861751152075%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.740399385560675%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.204301075268816%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.599078341013826%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.866359447004605%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFemale\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.589861751152075%\" valign=\"top\"\u003e\n \u003cp\u003e298 (27.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.740399385560675%\" valign=\"top\"\u003e\n \u003cp\u003e34 (31.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.204301075268816%\" valign=\"top\"\u003e\n \u003cp\u003e264 (27.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.599078341013826%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e0.375\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.23711340206186%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMale\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.556701030927837%\" valign=\"top\"\u003e\n \u003cp\u003e772 (72.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.962199312714777%\" valign=\"top\"\u003e\n \u003cp\u003e74 (68.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.243986254295532%\" valign=\"top\"\u003e\n \u003cp\u003e698 (72.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.866359447004605%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eArea\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.589861751152075%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.740399385560675%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.204301075268816%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.599078341013826%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.866359447004605%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eRural\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.589861751152075%\" valign=\"top\"\u003e\n \u003cp\u003e147 (13.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.740399385560675%\" valign=\"top\"\u003e\n \u003cp\u003e15 (13.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.204301075268816%\" valign=\"top\"\u003e\n \u003cp\u003e137 (13.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.599078341013826%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e0.962\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.23711340206186%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eUrban\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.556701030927837%\" valign=\"top\"\u003e\n \u003cp\u003e923 (86.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.962199312714777%\" valign=\"top\"\u003e\n \u003cp\u003e93 (86.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.243986254295532%\" valign=\"top\"\u003e\n \u003cp\u003e830 (86.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.866359447004605%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eDomestic water usages\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.589861751152075%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.740399385560675%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.204301075268816%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.599078341013826%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.866359447004605%\" valign=\"top\"\u003e\n \u003cp\u003eborehole water\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.589861751152075%\" valign=\"top\"\u003e\n \u003cp\u003e917 (85.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.740399385560675%\" valign=\"top\"\u003e\n \u003cp\u003e32 (29.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.204301075268816%\" valign=\"top\"\u003e\n \u003cp\u003e885 (92.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.599078341013826%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;10\u003csup\u003e-4\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.866359447004605%\" valign=\"top\"\u003e\n \u003cp\u003espring water\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.589861751152075%\" valign=\"top\"\u003e\n \u003cp\u003e1030 (96.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.740399385560675%\" valign=\"top\"\u003e\n \u003cp\u003e88 (81.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.204301075268816%\" valign=\"top\"\u003e\n \u003cp\u003e942 (97.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.599078341013826%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;10\u003csup\u003e-4\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.866359447004605%\" valign=\"top\"\u003e\n \u003cp\u003eRainwater\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.589861751152075%\" valign=\"top\"\u003e\n \u003cp\u003e70 (6.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.740399385560675%\" valign=\"top\"\u003e\n \u003cp\u003e22 (20.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.204301075268816%\" valign=\"top\"\u003e\n \u003cp\u003e48 (4.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.599078341013826%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;10\u003csup\u003e-4\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.866359447004605%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eHairdressing habits\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.589861751152075%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.740399385560675%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.204301075268816%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.599078341013826%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.866359447004605%\" valign=\"top\"\u003e\n \u003cp\u003ehairdressing salons attendance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.589861751152075%\" valign=\"top\"\u003e\n \u003cp\u003e948 (88.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.740399385560675%\" valign=\"top\"\u003e\n \u003cp\u003e88 (81.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.204301075268816%\" valign=\"top\"\u003e\n \u003cp\u003e860 (89.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.599078341013826%\" valign=\"top\"\u003e\n \u003cp\u003e0.014\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.866359447004605%\" valign=\"top\"\u003e\n \u003cp\u003eTrimmer use\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.589861751152075%\" valign=\"top\"\u003e\n \u003cp\u003e1011 (94.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.740399385560675%\" valign=\"top\"\u003e\n \u003cp\u003e106 (98.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.204301075268816%\" valign=\"top\"\u003e\n \u003cp\u003e905 (94.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.599078341013826%\" valign=\"top\"\u003e\n \u003cp\u003e0.079\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.866359447004605%\" valign=\"top\"\u003e\n \u003cp\u003eUse common comb\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.589861751152075%\" valign=\"top\"\u003e\n \u003cp\u003e974 (91.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.740399385560675%\" valign=\"top\"\u003e\n \u003cp\u003e86 (81.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.204301075268816%\" valign=\"top\"\u003e\n \u003cp\u003e888 (92.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.599078341013826%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;10\u003csup\u003e-4\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.866359447004605%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePresence of domestic animals\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.589861751152075%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.740399385560675%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.204301075268816%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.599078341013826%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.866359447004605%\" valign=\"top\"\u003e\n \u003cp\u003ePresence of cat\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.589861751152075%\" valign=\"top\"\u003e\n \u003cp\u003e307 (28.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.740399385560675%\" valign=\"top\"\u003e\n \u003cp\u003e30 (27.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.204301075268816%\" valign=\"top\"\u003e\n \u003cp\u003e277 (28.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.599078341013826%\" valign=\"top\"\u003e\n \u003cp\u003e0.825\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.866359447004605%\" valign=\"top\"\u003e\n \u003cp\u003ePresence of dog\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.589861751152075%\" valign=\"top\"\u003e\n \u003cp\u003e199 (18.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.740399385560675%\" valign=\"top\"\u003e\n \u003cp\u003e15 (13.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.204301075268816%\" valign=\"top\"\u003e\n \u003cp\u003e184 (19.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.599078341013826%\" valign=\"top\"\u003e\n \u003cp\u003e0.185\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.866359447004605%\" valign=\"top\"\u003e\n \u003cp\u003ePresence of hen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.589861751152075%\" valign=\"top\"\u003e\n \u003cp\u003e405 (37.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.740399385560675%\" valign=\"top\"\u003e\n \u003cp\u003e41 (37.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.204301075268816%\" valign=\"top\"\u003e\n \u003cp\u003e364 (37.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.599078341013826%\" valign=\"top\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.866359447004605%\" valign=\"top\"\u003e\n \u003cp\u003ePresence of pig\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.589861751152075%\" valign=\"top\"\u003e\n \u003cp\u003e66 (6.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.740399385560675%\" valign=\"top\"\u003e\n \u003cp\u003e6 (5.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.204301075268816%\" valign=\"top\"\u003e\n \u003cp\u003e60 (6.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.599078341013826%\" valign=\"top\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.866359447004605%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFamilial factors\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.589861751152075%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.740399385560675%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.204301075268816%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.599078341013826%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.866359447004605%\" valign=\"top\"\u003e\n \u003cp\u003eRingworm in siblings\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.589861751152075%\" valign=\"top\"\u003e\n \u003cp\u003e481 (45.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.740399385560675%\" valign=\"top\"\u003e\n \u003cp\u003e55 (50.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.204301075268816%\" valign=\"top\"\u003e\n \u003cp\u003e426 (44.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.599078341013826%\" valign=\"top\"\u003e\n \u003cp\u003e0.198\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.866359447004605%\" valign=\"top\"\u003e\n \u003cp\u003esharing room\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.589861751152075%\" valign=\"top\"\u003e\n \u003cp\u003e913 (85.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.740399385560675%\" valign=\"top\"\u003e\n \u003cp\u003e97 (89.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.204301075268816%\" valign=\"top\"\u003e\n \u003cp\u003e816 (84.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.599078341013826%\" valign=\"top\"\u003e\n \u003cp\u003e0.164\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.866359447004605%\" valign=\"top\"\u003e\n \u003cp\u003esharing bed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.589861751152075%\" valign=\"top\"\u003e\n \u003cp\u003e873 (81.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.740399385560675%\" valign=\"top\"\u003e\n \u003cp\u003e96 (88.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.204301075268816%\" valign=\"top\"\u003e\n \u003cp\u003e777 (80.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.599078341013826%\" valign=\"top\"\u003e\n \u003cp\u003e0.039\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.866359447004605%\" valign=\"top\"\u003e\n \u003cp\u003esharing clothes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.589861751152075%\" valign=\"top\"\u003e\n \u003cp\u003e168 (15.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.740399385560675%\" valign=\"top\"\u003e\n \u003cp\u003e17 (15.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.204301075268816%\" valign=\"top\"\u003e\n \u003cp\u003e151 (15.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.599078341013826%\" valign=\"top\"\u003e\n \u003cp\u003e0.990\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.866359447004605%\" valign=\"top\"\u003e\n \u003cp\u003eUsing trash bins for garbage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.589861751152075%\" valign=\"top\"\u003e\n \u003cp\u003e1008 (94.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.740399385560675%\" valign=\"top\"\u003e\n \u003cp\u003e91 (84.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.204301075268816%\" valign=\"top\"\u003e\n \u003cp\u003e917 (95.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.599078341013826%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;10\u003csup\u003e-4\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.866359447004605%\" valign=\"top\"\u003e\n \u003cp\u003eUsing fields for garbage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.589861751152075%\" valign=\"top\"\u003e\n \u003cp\u003e70 (6.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.740399385560675%\" valign=\"top\"\u003e\n \u003cp\u003e7 (6.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.204301075268816%\" valign=\"top\"\u003e\n \u003cp\u003e63 (6.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.599078341013826%\" valign=\"top\"\u003e\n \u003cp\u003e0.979\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.866359447004605%\" valign=\"top\"\u003e\n \u003cp\u003ePlaying next to the trash bin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.589861751152075%\" valign=\"top\"\u003e\n \u003cp\u003e310 (28.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.740399385560675%\" valign=\"top\"\u003e\n \u003cp\u003e31 (28.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.204301075268816%\" valign=\"top\"\u003e\n \u003cp\u003e279 (29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.599078341013826%\" valign=\"top\"\u003e\n \u003cp\u003e0.948\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eFactors such as the use of borehole water, spring water, rainwater and hairdressing salons visits were associated with a decreased TC risk. In contrast, sharing the same bed was associated with a 4.5 times increased TC risk in children \u003cstrong\u003e(Table 3)\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003eAmong the 32 cultured dermatophytes in this study, \u003cem\u003eM. audouinii\u003c/em\u003e was the most frequently (43.75%) isolated species, followed by \u003cem\u003eT. rubrum\u003c/em\u003e (25%), and \u003cem\u003eT. soudanense\u003c/em\u003e (25%). \u003cem\u003eM. canis\u003c/em\u003e and \u003cem\u003eT. violaceum\u003c/em\u003e (3.1% each) were rarely isolated.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3:\u0026nbsp;\u003c/strong\u003eUnivariate and multivariate unconditional logistic regression analyses of the tinea capitis risk factors identified in this population.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.77777777777778%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFactors\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"36.79245283018868%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eUnivariate analysis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"35.42976939203354%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMultivariate analysis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"15.384615384615385%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eOR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.287373004354137%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e95%IC\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.271407837445572%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e. value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.400580551523948%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eOR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.271407837445572%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e95%IC\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.384615384615385%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e. value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.77777777777778%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eBorehole Water\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.20754716981132%\" valign=\"top\"\u003e\n \u003cp\u003e[0.02-0.06]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.473794549266247%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;10\u003csup\u003e-4\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.844863731656185%\" valign=\"top\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.473794549266247%\" valign=\"top\"\u003e\n \u003cp\u003e[0.001-0.03]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;10\u003csup\u003e-4\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.77777777777778%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eRainwater\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e4.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.20754716981132%\" valign=\"top\"\u003e\n \u003cp\u003e[2.80-8.45]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.473794549266247%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;10\u003csup\u003e-4\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.844863731656185%\" valign=\"top\"\u003e\n \u003cp\u003e0.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.473794549266247%\" valign=\"top\"\u003e\n \u003cp\u003e[0.08-0.50]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e0.0005\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.77777777777778%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003espring water\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.20754716981132%\" valign=\"top\"\u003e\n \u003cp\u003e[0.05-0.18]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.473794549266247%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;10\u003csup\u003e-4\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.844863731656185%\" valign=\"top\"\u003e\n \u003cp\u003e0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.473794549266247%\" valign=\"top\"\u003e\n \u003cp\u003e[0.001-0.016]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;10\u003csup\u003e-4\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.77777777777778%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ehairdressing salons visits\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e0.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.20754716981132%\" valign=\"top\"\u003e\n \u003cp\u003e[0.30-0.88]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.473794549266247%\" valign=\"top\"\u003e\n \u003cp\u003e0.014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.844863731656185%\" valign=\"top\"\u003e\n \u003cp\u003e0.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.473794549266247%\" valign=\"top\"\u003e\n \u003cp\u003e[0.196-0.872]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e0.020\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.77777777777778%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ecommon bed\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e1.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.20754716981132%\" valign=\"top\"\u003e\n \u003cp\u003e[1.02-3.54]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.473794549266247%\" valign=\"top\"\u003e\n \u003cp\u003e0.039\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.844863731656185%\" valign=\"top\"\u003e\n \u003cp\u003e4.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.473794549266247%\" valign=\"top\"\u003e\n \u003cp\u003e[2.095-9.60]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e0.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.77777777777778%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTrimmer use\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.20754716981132%\" valign=\"top\"\u003e\n \u003cp\u003e[0.07-1.24]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.473794549266247%\" valign=\"top\"\u003e\n \u003cp\u003e0.079\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.844863731656185%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.473794549266247%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.77777777777778%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eUse common comb\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e0.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.20754716981132%\" valign=\"top\"\u003e\n \u003cp\u003e[0.20-0.60]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.473794549266247%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;10\u003csup\u003e-4\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.844863731656185%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.473794549266247%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.77777777777778%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePresence of cat\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e0.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.20754716981132%\" valign=\"top\"\u003e\n \u003cp\u003e[0.61-1.48]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.473794549266247%\" valign=\"top\"\u003e\n \u003cp\u003e0.825\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.844863731656185%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.473794549266247%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.77777777777778%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePresence of dog\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e0.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.20754716981132%\" valign=\"top\"\u003e\n \u003cp\u003e[0.39-1.20]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.473794549266247%\" valign=\"top\"\u003e\n \u003cp\u003e0.185\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.844863731656185%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.473794549266247%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.77777777777778%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePresence of hen\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.20754716981132%\" valign=\"top\"\u003e\n \u003cp\u003e[0.67-1.51]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.473794549266247%\" valign=\"top\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.844863731656185%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.473794549266247%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.77777777777778%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePresence of pig\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e0.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.20754716981132%\" valign=\"top\"\u003e\n \u003cp\u003e[0.37-2.09]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.473794549266247%\" valign=\"top\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.844863731656185%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.473794549266247%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.77777777777778%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePresence of ringworm in siblings\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e1.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.20754716981132%\" valign=\"top\"\u003e\n \u003cp\u003e[0.87-1.93]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.473794549266247%\" valign=\"top\"\u003e\n \u003cp\u003e0.198\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.844863731656185%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.473794549266247%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.77777777777778%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCommon room\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e1.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.20754716981132%\" valign=\"top\"\u003e\n \u003cp\u003e[0.82-3.01]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.473794549266247%\" valign=\"top\"\u003e\n \u003cp\u003e0.164\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.844863731656185%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.473794549266247%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.77777777777778%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ecommon clothing\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.20754716981132%\" valign=\"top\"\u003e\n \u003cp\u003e[0.58-1.73]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.473794549266247%\" valign=\"top\"\u003e\n \u003cp\u003e0.990\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.844863731656185%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.473794549266247%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.77777777777778%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eUse trash can for garbage\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e0.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.20754716981132%\" valign=\"top\"\u003e\n \u003cp\u003e[0.14-0.48]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.473794549266247%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;10\u003csup\u003e-4\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.844863731656185%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.473794549266247%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.77777777777778%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eUse field for garbage\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e0.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.20754716981132%\" valign=\"top\"\u003e\n \u003cp\u003e[0.44-2.21]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.473794549266247%\" valign=\"top\"\u003e\n \u003cp\u003e0.979\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.844863731656185%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.473794549266247%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.77777777777778%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eGames next to the trash can\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e0.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.20754716981132%\" valign=\"top\"\u003e\n \u003cp\u003e[0.63-1.53]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.473794549266247%\" valign=\"top\"\u003e\n \u003cp\u003e0.948\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.844863731656185%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.473794549266247%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study main finding was the estimation of a\u0026nbsp;10.1%\u0026nbsp;prevalence of TC among schoolchildren in the Dschang area in Cameroon. This estimation derives from a representative sample of relatively large size.\u0026nbsp;It is similar to the 8.1% prevalence observed by Kechia\u0026nbsp;\u003cem\u003eet al.\u003c/em\u003e in Meiganga (Cameroon)\u003cstrong\u003e[11]\u003c/strong\u003e. It is also\u0026nbsp;similar\u0026nbsp;to that found by\u0026nbsp;Sy\u0026nbsp;\u003cem\u003eet al.\u003c/em\u003e in Mauritania, who reported a 10.5 prevalence among school-age children\u0026nbsp;\u003cstrong\u003e[14]\u003c/strong\u003e.\u0026nbsp;A higher prevalence in school-aged children was reported in Ethiopia (32.3%) by Hibstu and Kebede\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e[15]\u003c/strong\u003e\u003cstrong\u003e,\u0026nbsp;\u003c/strong\u003eand in Benin (25.2%) by Koudoukpo \u003cem\u003eet al\u003c/em\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e[16]\u003c/strong\u003e.\u0026nbsp;In Dschang, TC prevalence was homogeneous in the children of both urban and rural areas. This contrasts with Sy \u003cem\u003eet al.\u003c/em\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e[14]\u003c/strong\u003e, who found a 9.5% prevalence in urban areas vs 12.2% in rural areas in Mauritania.\u0026nbsp;This difference may be explained by our comparatively relatively small geographical study area.\u003c/p\u003e\n\u003cp\u003eIn line with Hibstu and Kebede in Southern Ethiopia\u0026nbsp;\u003cstrong\u003e[15]\u003c/strong\u003e, more than 94% of TC cases in Dschang occurred in children aged between 5 and 10 years. This finding is usually explained by the relatively poor hygiene at this age as well as the absence of saturated fatty acids in children skin that provide a natural protective mechanism against dermatophytoses\u0026nbsp;\u003cstrong\u003e[15]\u003c/strong\u003e. Notably, the prevalence of TC in our study population was relatively homogeneous in boys and girls (\u003cem\u003eP\u003c/em\u003e =0.375). We have no explanation for this result that sharply contrasts with those of the majority of the previous studies conducted in African school children, including those of Nzenze-Afene \u003cem\u003eet al\u003c/em\u003e \u003cstrong\u003e[17]\u003c/strong\u003e, Kechia \u003cem\u003eet al\u003c/em\u003e \u003cstrong\u003e[11]\u003c/strong\u003e, and Coulibaly\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cem\u003eet al.\u0026nbsp;\u003c/em\u003e[\u003cstrong\u003e18\u003c/strong\u003e], who consistently found that TC was more frequent in boys than in girls\u003cstrong\u003e,\u003c/strong\u003e in Gabon, Cameroon, and Mali,\u0026nbsp;respectively.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe presence of TC in siblings, sharing bedroom, and bed, increased the risk of TC in the univariate analysis. Sharing bed was the most statistically significant of these redundant variables, which remained in the multivariate analysis. A similar observations has been reported in Ethiopia \u003cstrong\u003e[15]\u003c/strong\u003e. This increased TC risk might be due to the promiscuity between family members as well as the sharing of several fomites including combs and towels. To the best of our knowledge, the influence of water on TC risk had never been investigated. We found that the use of rainwater was associated with a 4.9 times increased risk of TC. We have no clear explanation for this epidemiological association, which warrants to be confirmed in further independent epidemiological studies.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOne limitation of our study findings was a relatively high false-negative dermatophyte culture rate with a small number of positive dermatophytes cultures. In contrast to Kechia \u003cem\u003eet al\u003c/em\u003e.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e[11]\u003c/strong\u003e\u003cstrong\u003e,\u003c/strong\u003e who found a higher prevalence (56.8%) of \u003cem\u003eT. soudanense\u003c/em\u003e in Cameroon\u0026apos;s Adamaoua, in our study we found a higher prevalence (43.35%) of \u003cem\u003eM. audouinii\u003c/em\u003e. This may be justified by the fact that \u003cem\u003eM. audouinii\u003c/em\u003e is one of the most common dermatophyte species in Central Africa\u0026nbsp;\u003cstrong\u003e[19]\u003c/strong\u003e. Moreover, both Sidat \u003cem\u003eet al.\u003c/em\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e[20]\u003c/strong\u003e and Carod \u003cem\u003eet al.\u003c/em\u003e \u003cstrong\u003e[21]\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003efound \u003cem\u003eM. audouinii\u003c/em\u003e to be the most prevalent species involved TC among school-age children in Mozambique and Madagascar, respectively.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe prevalence of TC in Dschang was relatively similar with those previously reported in Cameroon and neighbouring African countries. We identified sharing bed among siblings as an independent TC risk factors in school-aged children. Further epidemiological studies are warranted to confirm the relatively strong statistical association of TC with the use of domestic water that we highlighted in this study. Health policies promoting the diagnosis and treatment of TC in school children should play a key role in the prevention and the control of this communicable disease.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was supported by the Fondation M\u0026eacute;diterran\u0026eacute;e Infection.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no relevant financial or non-financial interests to disclose.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the\u0026nbsp;Faculty of Medicine\u0026rsquo;s Institutional Review Board at the University of Douala, Cameroun (No3146 CIE-Udo/06/2022/T). The study protocol was also approved by the Local Education Authorities at each study site.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFreely-given, informed consent to participate was obtained from the parent or legal guardian of the participating children. Written informed consent was obtained from the parent or legal guardian.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eRaw data are available at DOI: 10.13140/RG.2.2.18342.70722\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eHavlickova B, Czaika VA, Friedrich M. Epidemiological trends in skin mycoses worldwide. Mycoses. 2008;51:2\u0026ndash;15. \u003c/li\u003e\n\u003cli\u003eAmeen M. Epidemiology of superficial fungal infections. Clin Dermatol. 2010;28:197\u0026ndash;201. \u003c/li\u003e\n\u003cli\u003eMoriarty B, Hay R, Morris-Jones R. 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Mycopathologia. 2017;182:87\u0026ndash;93. \u003c/li\u003e\n\u003cli\u003eElmaataoui A, Zeroual Z, Lyagoubi M, Aoufi S. Profil \u0026eacute;tiologique des teignes du cuir chevelu \u0026agrave; l\u0026rsquo;h\u0026ocirc;pital Ibn Sina de Rabat (Maroc). J Mycol M\u0026eacute;dicale. 2012;22:261\u0026ndash;4. \u003c/li\u003e\n\u003cli\u003eKoueke.P, EBENYE C. Les teignes du cuir chevelu \u0026agrave; Yaound\u0026eacute;. Med.Afr.Noire. 1981; 28(2): 115-121.\u003c/li\u003e\n\u003cli\u003eKechia FA, Kouoto EA, Nkoa T, Nweze EI, Fokoua DCM, Fosso S, et al. Epidemiology of tinea capitis among school-age children in Meiganga, Cameroon. J Mycol M\u0026eacute;dicale. 2014;24:129\u0026ndash;34. \u003c/li\u003e\n\u003cli\u003eL\u0026rsquo;Ollivier C, Cassagne C, Normand A-C, Bouchara J-P, Contet-Audonneau N, Hendrickx M, et al. A MALDI-TOF MS procedure for clinical dermatophyte species identification in the routine laboratory. Med Mycol. 2013;51:713\u0026ndash;20. \u003c/li\u003e\n\u003cli\u003eKabtani J, Diongue K, Dione J-N, Delmas A, L\u0026rsquo;Ollivier C, Amoureux M-C, et al. Real-Time PCR Assay for the Detection of Dermatophytes: Comparison between an In-House Method and a Commercial Kit for the Diagnosis of Dermatophytoses in Patients from Dakar, Senegal. J Fungi. 2021;7:949. \u003c/li\u003e\n\u003cli\u003eSy O, Diongue K, Ba O, Ahmed CB, Elbechir MA, Abdallahi MSM, et al. Tinea capitis in school children from Mauritania: A comparative study between urban and rural areas. J Med Mycol. 2021;31:101048. \u003c/li\u003e\n\u003cli\u003eHibstu DT, Kebede DL. Epidemiology of Tinea Capitis and Associated Factors among School Age Children in Hawassa Zuria District, Southern Ethiopia, 2016. J Bacteriol Parasitol 2017, 8:2\u003c/li\u003e\n\u003cli\u003eKoudoukpo C, D\u0026eacute;gbo\u0026eacute; B, A\u0026iuml;kou N, Akpadjan F, Agb\u0026eacute;ssi N, Atadokp\u0026egrave;d\u0026eacute; F, et al. 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Mycoses. 2006;49(6):480-3\u003c/li\u003e\n\u003cli\u003eCarod J-F, Ratsitorahina M, Raherimandimby H, Vitrat VH, Andrianaja VR, Contet-Audonneau N. Outbreak of Tinea capitis and corporis in a primary school in Antananarivo, Madagascar. J Infect Dev Ctries. 2011; 13;5(10):732-6\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":true,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"mycopathologia","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"myco","sideBox":"Learn more about [Mycopathologia](https://www.springer.com/journal/11046)","snPcode":"11046","submissionUrl":"https://submission.nature.com/new-submission/11046/3","title":"Mycopathologia","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"Epidemiology, Dermatophytes, Dermatophytoses, Tinea capitis, School children, Microsporum audouinii, Trichophyton rubrum, Trichophyton soudanense","lastPublishedDoi":"10.21203/rs.3.rs-4000893/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4000893/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eData on the epidemiology of tinea capitis (TC), an infection of the scalp by dermatophytes, are scarce in Cameroon. This study aimed to determine the prevalence of TC among school-children in the Dschang Subdivision, Western Cameroon. A cross-sectional study was carried out in June 2021 in Dschang including pupils aged 5 to 13. First, a standardized questionnaire was administered to participant for the collection of sociodemographic data. Then, samples were collected and cultured onto Sabouraud-Chloramphenicol-Gentamicin Agar. The etiological agents were identified based on their morphological features and with MALDI-TOF mass spectrometry. A total of 1070 children were clinically examined and 108 (10.1%) children presented with TC lesions. The mean age of the 1070 participants was 8.3 ± 2.6 years (ranges: 5-13 years); 772 (72.2%) were males. The use of borehole water (OR=0.01, 95%CI[0.001-0.03]), spring water (OR=0.2, 95%CI[0.08-0.50]), rainwater (OR=0.004, 95%CI[0.001-0.016]), and hairdressing salons visits (OR=0.413, 95%CI[ 0.196-0.872]) were associated with a decreased TC risk in the multivariate logistic regression analysis. In contrast, sharing bed with siblings (OR=4.48, 95%CI[2.095-9.60]) was associated with an increased TC risk in children. Among the 32 dermatophytes isolated in culture, \u003cem\u003eMicrosporum audouinii\u003c/em\u003e was the most frequent (43.8%), followed by \u003cem\u003eTrichophyton rubrum\u003c/em\u003e (25.0%) and \u003cem\u003eT. soudanense\u003c/em\u003e(25.0%). \u003cem\u003eMicrosporum\u003c/em\u003e \u003cem\u003ecanis\u003c/em\u003e and \u003cem\u003eT. violaceum\u003c/em\u003e were both rarely isolated. Further studies are warranted to assess the association of TC with domestic water usage that has been highlighted in this study.\u003c/p\u003e","manuscriptTitle":"Epidemiology of tinea capitis among school-children in Dschang, Western Cameroon","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-03-13 17:21:08","doi":"10.21203/rs.3.rs-4000893/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"","date":"2024-03-13T10:31:16+00:00","index":0,"fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-03-12T00:39:57+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"Mycopathologia","date":"2024-03-07T22:34:32+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-02-29T06:49:12+00:00","index":"","fulltext":""},{"type":"submitted","content":"Mycopathologia","date":"2024-02-28T11:06:28+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"mycopathologia","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"myco","sideBox":"Learn more about [Mycopathologia](https://www.springer.com/journal/11046)","snPcode":"11046","submissionUrl":"https://submission.nature.com/new-submission/11046/3","title":"Mycopathologia","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"a493d70c-1c73-46cc-8492-8e2fa05de056","owner":[],"postedDate":"March 13th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2024-06-21T14:53:20+00:00","versionOfRecord":{"articleIdentity":"rs-4000893","link":"https://doi.org/10.1007/s11046-024-00857-y","journal":{"identity":"mycopathologia","isVorOnly":false,"title":"Mycopathologia"},"publishedOn":"2024-06-12 14:53:20","publishedOnDateReadable":"June 12th, 2024"},"versionCreatedAt":"2024-03-13 17:21:08","video":"","vorDoi":"10.1007/s11046-024-00857-y","vorDoiUrl":"https://doi.org/10.1007/s11046-024-00857-y","workflowStages":[]},"version":"v1","identity":"rs-4000893","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4000893","identity":"rs-4000893","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}