Epidemiological and Molecular Characterization of Trichophyton Species Associated with Dermatophytoses in Northeast Nigeria

Epidemiological and Molecular Characterization of Trichophyton Species Associated with Dermatophytoses in Northeast Nigeria | 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 Epidemiological and Molecular Characterization of Trichophyton Species Associated with Dermatophytoses in Northeast Nigeria Auwal Magaji, Ibrahim Musa Moi, Muhammad Abdullahi, Bashir Abubakar Muhammad, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8985440/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Dermatophytoses are superficial fungal infections affecting skin, hair, and nails. Trichophyton species are the primary causative agents of these infections. Despite their burden, diagnosis in many settings remains limited to conventional methods, often leading to misidentification and inadequate treatment. This study investigated the prevalence, molecular characteristics, and risk factors associated with Trichophyton-related dermatophytosis among patients in the selected health facility in northeast Nigeria. Methods A cross-sectional study involving 385 patients with clinical signs of dermatophytoses was conducted at the Infectious Disease Hospital, Bayara. Samples were analyzed using conventional microscopy and culture. Molecular identification was performed via PCR amplification of the 18S rRNA gene using ITS primers. Epidemiological data were collected using structured questionnaires and analyzed statistically using SPSS version 23. Results The overall prevalence of Trichophyton-related infections was 24.94%, with T. rubrum (21.82%) more common than T. soudanense (3.12%). Molecular analysis confirmed two strains of T. rubrum and one strain of T. soudanense . Significant risk factors included regular contact with animals, low socioeconomic status, irregular bathing, communal living, and outdoor labor. Logistic regression identified these as strong predictors of infection (p < 0.05). Conclusion The study underscored the public health importance of Trichophyton infections in northeast Nigeria, with T. rubrum being the predominant species. Molecular techniques improved species identification accuracy. Effective control measures should focus on hygiene education, environmental sanitation, and targeted public health interventions in high-risk populations. Clinical trial number: Not applicable. Dermatophytosis Trichophyton Conventional Prevalence Epidemiology Molecular Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 INTRODUCTION Fungal infections of the skin, hair, and nails are known as superficial mycoses. They are among the most common dermatological problems worldwide particularly in tropical and subtropical regions where warmth and humidity promote fungal proliferation [ 1 , 2 ]. Of the fungi implicated in these infections, dermatophytes especially members of the genus Trichophyton are the most frequently encountered pathogens in both humans and animals [ 3 ]. Trichophyton species are keratinophilic fungi that digest keratin and colonize the outer layers of the skin, nails, and hair causing dermatophytoses such as tinea capitis, tinea corporis, tinea pedis, tinea unguium, and tinea cruris [ 4 , 5 ]. Dermatophytes are traditionally classified into three genera Trichophyton , Microsporum and Epidermophyton based on their microscopic morphology and host specificity. Of these, Trichophyton is the most diverse and clinically important, comprising numerous pathogenic species such as T. rubrum , T. mentagrophytes , T. tonsurans , T. schoenleinii and T. verrucosum [ 1 , 3 ]. These species are further categorized ecologically into anthropophilic (human-associated), zoophilic (animal-associated) and geophilic (soil-associated) groups, each differing in pathogenicity and host interaction [ 5 ]. Transmission occurs through direct contact with infected individuals or animals, or indirectly via contaminated fomites or the environment [ 4 , 6 ]. Trichophyton species are responsible for various clinical conditions depending on the site of infection. For instance, T. rubrum commonly causes tinea corporis and tinea pedis, while T. tonsurans is a leading cause of tinea capitis in children [ 7 ]. The infections often manifest as circular, scaly and itchy lesions with characteristic borders. Inflammatory reactions tend to be more severe with zoophilic and geophilic species, while anthropophilic species tend to cause more chronic and less inflammatory conditions [ 6 , 8 ]. Globally, dermatophytoses affect an estimated 20–25% of the population, with infections caused by Trichophyton species accounting for the majority [ 2 , 9 ]. The prevalence in children, especially tinea capitis, ranges between 21% and 87% in developing countries, with peak occurrence in those under 12 years [ 10 , 11 ]. In Nigeria, prevalence estimates vary significantly by region, ranging from 3.4% to 55.1%, and are influenced by factors such as age, sex, hygiene practices, and socioeconomic conditions [ 10 ]. Several studies across Nigeria have demonstrated regional variations in the prevalence of Trichophyton species causing tinea capitis. For example T. schoenleinii was predominant in Borno State, T. rubrum in Kano, T. mentagrophytes in southwestern states and T. tonsurans in Anambra State [ 12 , 13 ]. These findings underscored the need for continuous mycological surveillance and localized management strategies. The identification of Trichophyton species traditionally relies on direct microscopy and culture, which provide preliminary morphological characterization. However, these methods are limited by their time requirements, subjectivity and difficulty distinguishing between closely related species [ 14 ]. In recent years, molecular techniques such as polymerase chain reaction (PCR) and sequencing of the internal transcribed spacer (ITS) region of ribosomal DNA have emerged as powerful tools for the precise identification and phylogenetic classification of dermatophytes [ 15 ]. Molecular characterization has not only increased diagnostic accuracy but also uncovered cryptic species within the T. mentagrophytes complex, including the recently identified T. indotineae , known for its aggressive clinical course and resistance to terbinafine [ 6 ]. Despite the clinical burden of Trichophyton -related infections, many patients in endemic regions continue to receive empirical treatment without laboratory confirmation. This not only promotes resistance but also delays appropriate therapy. Poor awareness, limited access to diagnostic laboratories and cultural practices further contribute to the underreporting and persistence of infections. In addition, environmental and behavioral risk factors such as close contact with animals, communal living, inadequate personal hygiene, and shared grooming tools (eg clippers, combs, towels etc) are key contributors to the transmission of Trichophyton species [ 10 , 16 ]. Given the medical and public health significance of Trichophyton species in superficial fungal infections, the current study was designed to investigate the prevalence of dermatophytoses caused by Trichophyton spp. among patients presenting with skin and scalp infections at the selected health facility in northeast Nigeria. The study further aimed to identify associated risk factors and utilize both conventional and molecular techniques to accurately characterize the isolates. By integrating epidemiological data with molecular identification, this study could provide valuable insights into the distribution, diversity and control of Trichophyton species in endemic settings. MATERIALS AND METHODS Study Area This study was conducted at the Infectious Disease Hospital (IDH) Bayara one of the referral centers in northeastern Nigeria (Fig. 1 ) for infectious diseases especially those affecting skin. It is located in Birshi, Bauchi Local Government Area (LGA), Bauchi State, Nigeria. It was established on March 11, 1982, and licensed under the Federal Ministry of Health with facility code 05/02/1/2/1/0002. Bauchi LGA covers approximately 3,219 km 2 with estimated population of 881,600, with 51.1% males and 48.9% females. It is located on the coordinates: 10.2820° N latitude and 9.8120° E longitude (Fig. 1 ) [ 17 ]. Study Design and Population The study was cross-sectional, and involved collecting data from patients at IDH Bayara at a single point in time. The study population comprised patients of all genders and ages with clinical signs and symptoms of superficial mycoses. Patients unwilling to participate in the study and those without clinical symptoms of superficial mycoses were excluded. Sample Size Determination The sample size was calculated using Cochran's formula. Prevalence of 50% as reported by Idris et al . [ 18 ], and precision of 5% were taken at 95% confidence level. $$n=\frac{(z/2)²pq}{{d}^{2}}$$ Where: P = previous prevalence (50%) q = 1-p d = precision (5%) 9Z/2) = 1.96 for 95% confidence level n = sample size Therefore, $$n=\frac{{\left(1.96\right)}^{2}\text{X}0.5\left(1-0.5\right)}{{0.05}^{2}}$$ Therefore, 385 patients with clinical presentations of the infections were enrolled in the study. Ethical Considerations Ethical approval was obtained from the Research and Ethics Committees of the Infectious Disease Hospital Bayara in a letter dated 4th May, 2024 with reference number IDH/2024/5V1. Duel signed informed consent was obtained from adult patients and from the guardians of children below seven years prior to the sample collection. Assent was obtained from children aged seven years and above. Confidentiality of patients’ information was maintained, and all procedures were conducted in accordance with Helsinki’s (2013) Declaration. Sample Collection Skin scrapings, hair, or lesion samples were collected from 385 patients exhibiting signs and symptoms of dermatophytoses. Before the sample collection, the affected site of the patient’s body was cleaned using a sterile cotton swab soaked in 70% ethanol. The samples were placed in sterile disposable dishes and transported to the Microbiology Laboratory, Sa'adu Zungur University Gadau, for further analysis. Meanwhile, 385 structured questionnaires were administered to the patients at the time of sample collection to obtain sociodemographic and risk factor data from the patients Isolation of Fungal Pathogens Fungal pathogens were isolated using Sabouraud Dextrose Agar (SDA), prepared by dissolving 39 g of SDA in 1000 mL of distilled water, followed by sterilization at 121°C for 15 minutes. After cooling, the medium was inoculated with patients’ samples and incubated at 35°C for up to 7 days [ 19 ]. Identification of Fungal Pathogens Prior to the isolation, direct microscopic examination was conducted. The samples were treated with 10% Potassium Hydroxide (KOH) to dissolve keratin, and observed for the fungal spores, under 10X and 40X objectives. Upon isolation, the colonies were assessed for color, texture, and topography [ 19 , 20 ]. Molecular Identification The isolates were maintained on Sabouraud dextrose agar and kept at 4°C. The isolates were cultured in Sabouraud dextrose broth, and incubated for 14 days at 28°C. Small portion of the isolate’s mycelia was reaped and centrifuged at 1600×g for ten minutes, and then washed with ice-cold phosphate buffered saline and then stored at − 70°C. The genomic DNA from the isolates was isolated as stated by Rezaie et al ., [ 21 ]. About three hundred milligram (300mg) of the mycelia was grounded to powder with liquid nitrogen. 500µL of extraction buffer (50mM Tris-HCl pH 8.0), 50mM EDTA, 25µL of 20% SDS, and 10µL of proteinase-K, were added and gently mixed. This was followed by incubation at 65°C for 60min and centrifugation at 3000×g for 15min. 25µL of Rnase was added to the supernatant and incubated at 37°C for 30 in. This was then mixed with 500µL of phenol:chloroform:isoamyl alcohol (25:24:1) and centrifuged at 10000×g for 10min. The supernatant were collected and transferred to a new steriled eppendorff tube. This was then mixed with 500µL of chloroform:isoamyl alcohol (24:1) and centrifuged at 10000×g for 10min. The supernatant were collected and transferred to another eppendorff tubes. The DNA was precipitated by the addition of 500µL of isopropanol and 30µL of 3M Sodium acetate. This was then followed by centrifugation at 15000×g for 30min. The supernatants were then discarded. The DNA pellet was rinsed with 200µl of 70% cold ethanol and centrifuged at 10000×g for 10min. The pellet was then air dried and stored at -20°C [ 21 ]. ITS1 (5’-TCC GTA GGT GAA CCT GC-3’) and the ITS4 (5’-TCC TCC GCT TAT TGA TAT G-3’) were used as forward and reverse primers respectively [ 22 , 23 ]. A 25µL PCR reaction mixture was prepared comprising of 2.5µL of 10× reaction buffer, 0.5µL of 10mM dNTPs, 1.5µL of 25mM MgCl 2 , 0.5µL of 0.2mM of each of the ITS1 and ITS4 primers, 0.5µL of Taq DNA polymerase (Promega Coporation, USA), 0.5µL of genomic DNA and 18.5µL of distilled water. The PCR reactions were carried out on a thermal cycler (MJ Research Inc. USA), with the following conditions: 1 cycle in an initial step for 5min at 94°C, then 30 cycles consisting of denaturation at 94°C for 30s, then annealing for 40s at 55°C, and then extension at 72°C for 40s. This was followed by a final extension at 72°C for 10min. 5µl of PCR product was loaded on 1% agarose in 1X Tris–Acetic Acid– EDTA buffer and stained with 0.5mg/ml ethidium bromide for 40min at 80V, and visualized with UV trans-illuminator (Alpha Innotech, USA). This was then compared with a standard DNA size marker (100bp DNA ladder), and photographed in UV light [ 22 , 23 ]. The PCR products were sent for sequencing. The sequence result was processed by using the web-based blasting program- basic local alignment search tool (BLAST), at the NCBI website, and the data were compared with the NCBI/Genebank database. The phylogenic tree was constructed using MEGA 11. Data Analysis In presenting the results of this research, a multifaceted approach was employed, integrating tables and charts to effectively communicate key findings visually. The interpretation of these results was underpinned by robust statistical analyses, leveraging a diverse set of tools including Chi-square test where applicable. All of these were computed using SPSS version 23. RESULTS Phenotypically, the current study reported two species of trychophyton to be associated with dermatophytoses among patients from northeastern states of Nigeria, at the infectious disease hospital Bayara. However, the molecular identification confirmed two Trichophyton species (two different strains of Trichophyton rubrum and one strain of Trichophyton soudanense ) based on 18S rRNA homology. The 18S rRNA gene sequences of the pathogens were compared using BLAST with reference sequences from the NCBI database. Phylogenetic trees for the isolates were constructed using MEGA 11 (Figs. 3 and 4 ). The study also revealed that, the overall prevalence of Trichophyton species among patients with dermatophytoses in northeastern Nigeria was 24.94%. The specie-based prevalence indicated high prevalence of Tricophyton rubrum (21.82%) than Trichophyton soudanense (3.12%) (Fig. 2 ). Further, the study indicated that, out of the study participants, the overall prevalence of Trichophyton-related dermatophytosis was higher among males (15.32%) compared to females (9.61%), though the association was not statistically significant (χ² = 1.65, p = 0.20). On the age basis, the study pointed that, age group was significantly associated with high prevalence of the infection ( p = 0.002). The highest prevalence was recorded in participants aged 65 years and above (9.61%), while 10–19 year age group accounted for the lowest prevalence of the infections (0.52%). In terms of residence, a significant association was observed ( p = 0.000). Individuals living in rural areas had the highest prevalence (16.62%) compared to those in urban (5.19%) and semi-urban (3.12%) settings. The participants, who currently had skin, nail or scalp infections were more likely to have higher prevalence of the infection (18.18%) than those who had not (6.75%) ( p = 0.045). There was a strong association between regular contact with animals and high prevalence of the infection, where a prevalence of 20.78% among those with animal contact compared to 4.16% among those without ( p = 0.000). Socioeconomic status significantly influenced infection prevalence ( p = 0.000). Those with low income had the highest prevalence (14.03%) followed by middle income class (7.27%) while those from high income class had lowest prevalence (3.64%). Bathing habits were also significant ( p = 0.000), with infection more common among those who did not bathe regularly (15.58%) compared to those who did (9.35%). Sharing of personal grooming tools showed no significant association ( p = 0.071), though higher prevalence was observed among those who shared tools (15.32%) versus those who did not (9.61%). Interestingly, individuals living in communal settings had a higher prevalence (15.84%) than those who did not (9.09%) ( p = 0.000), and those involved in farming or outdoor labor had a higher infection rate (15.58%) than those who were not (9.35%) ( p = 0.009) (Table 1 ). Table 1 Prevalence of Trichophyton -related Dermatophytosis in the Study Area Variables Prevalence (%) X 2 p-value Gender Males 15.32 1.65 0.20 Females 9.61 Age 0-9years 2.86 19.49 0.002* 10-19years 0.52 20-24years 4.16 25-64years 7.79 65years and above 9.61 Residence Urban 5.19 18.337 0.000* Semi Urban 3.12 Rural 16.62 Do you currently have a skin, nail, or scalp infection? Yes 18.18 4.032 0.045* No 6.75 Do you have regular contact with animals? Yes 20.78 132.818 0.000* No 4.16 Socioeconomic status Low income 14.03 92.776 0.000* Middle income 7.27 High income 3.64 How often do you bathe? Regularly 9.35 66.444 0.000* Not regularly 15.58 Do you share personal grooming tools (clippers, combs, towels)? Yes 15.32 3.264 0.071 No 9.61 Do you live in a communal setting (e.g., boarding school, barracks)? Yes 15.84 28.717 0.000* No 9.09 Are you involved in farming or outdoor labor? Yes 15.58 6.744 0.009* No 9.35 “*” = Significant at p < 0.05, “ X 2 ” = Chi-square Logistic regression analysis revealed several significant predictors of Trichophyton-related dermatophytosis. Regular contact with animals significantly increased the odds of infection ( p = 0.000, OR = 0.045, 95% CI: 0.024–0.083). Also, participants from low-income households were significantly more likely to be infected ( p = 0.000, OR = 0.092, 95% CI: 0.048–0.175). Similarly, irregular bathing was associated with significantly higher odds of infection ( p = 0.000, OR = 0.138, 95% CI: 0.083–0.229). Living in communal settings significantly increased the odds of infection ( p = 0.000, OR = 0.240, 95% CI: 0.139–0.414), as the involvement in farming or outdoor labor was a significant predisposing factor ( p = 0.010, OR = 0.523, 95% CI: 0.319–0.857). Also, presence of current skin, nail or scalp infection was significantly associated ( p = 0.046, OR = 0.596, 95% CI: 0.358–0.991). Other variables like gender, age, and sharing grooming tools were not statistically significant predictors of the infection among the patients (Table 2 ). Table 2 Bivariate Logistics Regression Analyses for the Risk Factors Associated with Trichophuyon -related Dermatophytoses Variables + - Tot P OR Confidence Interval Gender Males 59 159 218 0.200 0.734 0.457 - 1.179 Females 37 130 167 1 Age 0-9years 11 37 48 0.186 0.514 0.226 - 1.167 10-19years 2 28 30 6.509 0.842 - 50.323 20-24years 16 51 67 1.092 0.556 - 2.143 25-64years 30 65 95 0.742 0.419 - 1.314 65years and above 37 108 145 1 Residence Urban 20 53 73 0.000* 1.187 0.659 - 2.135 Semi Urban 12 162 174 3.996 2.047 - 7.801 Rural 64 74 138 1 Do you currently have a skin, nail, or scalp infection? Yes 70 178 248 0.046* 0.596 0.358 - 0.991 No 26 111 137 1 Do you have regular contact with animals? Yes 80 56 136 0.000* 0.045 0.024 - 0.083 No 16 233 249 1 Socioeconomic status Low income 54 72 126 0.000* 0.092 0.048 - 0.175 Middle income 28 17 45 0.044 0.020 - 0.099 High income 14 200 214 1 How often do you bathe? Regularly 36 233 269 0.000* 0.138 0.083 - 0.229 Not regularly 60 56 116 1 Do you share personal grooming tools (clippers, combs, towels)? Yes 59 150 209 0.072 1.544 0.962 - 2.479 No 37 139 176 1 Do you live in a communal setting (e.g., boarding school, barracks)? Yes 35 36 71 0.000* 0.240 0.139 - 0.414 No 61 132 193 1 Are you involved in farming or outdoor labor? Yes 36 69 105 0.010* 0.523 0.319 - 0.857 No 60 220 280 1 “*” = Significant at p < 0.05, “OR” = odds ratio DISCUSSION The findings of this study highlighted Trichophyton soudanense and Trichophyton rubrum as significant contributors to the overall burden of dermatophytoses in the study population. These results aligned with previous research conducted in Nigeria and globally, which have identified these fungal species as common causative agents of dermatophytoses. The predominance of Trichophyton rubrum in this study corresponded with findings from Kano State, as reported by Adeleke et al . [ 24 ]. The consistent occurrence of T. rubrum across different regions suggests its adaptability and widespread distribution in Nigeria. However, the study contrasted the findings of Nweze, [ 25 ] who documented T schoenleinii as the primary causative agent of dermatophytosis in Borno State. These regional differences may be influenced by environmental factors, population demographics, and healthcare practices that affect fungal pathogen transmission dynamics. In contrast to this study, T mentagrophytes was reported as the predominant species in southwestern Nigeria by Ayanlowo et al . [ 26 ]. In this study, T. rubrum was a significant contributor not T mentagrophytes . This discrepancy could be due to environmental differences such as climate, humidity and socio-economic conditions that favor the growth and spread of some fungal species over others. Furthermore, T tonsurans was identified as the most common etiological agent in Anambra State [ 27 ]. The findings of this study also suggest that the infection is more prevalent among males, although the association is not statistically significant. However, age, residence, regular contact with animals, socioeconomic status, bathing habits, and living in communal settings are significant predictors of the infection. The study revealed that age is significantly associated with the prevalence of Trichophyton-related dermatophytosis, with the highest prevalence observed in participants aged 65 years and above. This finding contrasted the previous studies that have reported a high burden of the infections among children than older adults [ 10 , 11 ]. The increased susceptibility among older adults as reported in this study may be attributed to declining immune function, poor hygiene practices and increased exposure to risk factors. The study also highlighted the importance of residence in determining the prevalence of Trichophyton-related dermatophytosis. Individuals living in rural areas had higher prevalence of the infection compared to those in urban and semi-urban settings. This finding is consistent with previous studies that have reported a higher incidence of fungal infections in rural areas, likely due to close proximity to livestock, contaminated soil and limited access to healthcare services [ 28 , 29 , 30 ]. The study also identified several significant risk factors associated with Trichophyton-related dermatophytosis, including regular contact with animals, low socioeconomic status, irregular bathing habits, living in communal settings, and involvement in farming or outdoor labor. These findings are consistent with previous studies that have reported the importance of environmental and behavioral factors in the transmission of the infections [ 4 , 6 , 16 , 30 ]. CONCLUSION This study revealed a high burden of Trichophyton -related dermatophytosis in borthestern Nigeria with T. rubrum emerging as the dominant species confirmed through molecular characterization. The findings highlighted critical sociodemographic and behavioral risk factors particularly among individuals with regular animal contact, low socioeconomic status, poor hygiene and communal living conditions. These factors significantly influence infection prevalence and should be prioritized in public health strategies. The integration of molecular techniques enhanced the accuracy of fungal identification and demonstrated the limitations of conventional methods alone. This emphasized the need for improved diagnostic capacity in endemic areas. To curb the spread of dermatophytoses, there is a pressing need for community-based health education, better hygiene practices, and improved access to dermatological care. Further research is warranted to monitor antifungal resistance patterns and develop effective prevention and treatment protocols. Abbreviations 18S rRNA: 18S Ribosomal Ribonucleic Acid BLAST: Basic Local Alignment Search Tool DNA: Deoxyribonucleic Acid dNTPs: Deoxynucleoside Triphosphates EDTA: Ethylenediaminetetraacetic Acid IDH: Infectious Disease Hospital ITS: Internal Transcribed Spacer KOH: Potassium Hydroxide LGA: Local Government Area MEGA: Molecular Evolutionary Genetics Analysis NCBI: National Center for Biotechnology Information OR: Odds Ratio PCR: Polymerase Chain Reaction SDA: Sabouraud Dextrose Agar SDS: Sodium Dodecyl Sulfate SPSS: Statistical Package for the Social Sciences UV: Ultraviolet Declarations Ethical Approval and Consent to Participate Prior to the commencement of the data collection, the study received approval from the Ethical Research and Review Committee of the Infectious Disease Hospital Bayara, Bauchi State Nigeria, in a letter dated 4 th May, 2024 with reference number IDH/2024/5V1. Duly signed informed consent was obtained from adult patients and from the guardians of children below seven years prior to the sample collection. Assent was obtained from children aged seven years and above. Confidentiality of patients’ information was maintained, and all procedures were conducted in accordance with Helsinki’s (2013) Declaration. Consent for Publication: Not applicable Availability of Data and Materials All data for this research are contained in the manuscript. Additional information and materials can be obtained from NCBI website, and the corresponding author on a serious request. Competing Interests The authors declare that, there is no competing interest Funding No funding was obtained from any institution. The study was funded by the authors throughout. Author Contributions AM designed the work, collected samples and did laboratory analysis, IMM prepared the manuscript, BAM and HAG performed data analysis, while MA proofread the entire work. 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Mycological profile of tinea capitis in schoolchildren in rural southern Ethiopia. Med Mycol. 2017;55(3):262–8. Magaji A, Yakubu A, Mahmud Z, Aminu S, Salihu MR, Sambo H. The Role of Socioeconomic and Environmental Determinants in the Prevalence and Distribution of Superficial Mycoses in Bauchi State Nigeria. Dujopas. 2025;11(2b):352–63. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted 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. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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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-8985440","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":608622304,"identity":"31feb178-c075-4f12-897f-f9d79ddf8038","order_by":0,"name":"Auwal Magaji","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABBElEQVRIie2PsWrDMBCGHQpds2pKXsEmIFow8oN0kRC4i/0ENVSmkG7NmpcoBAKaJQTxEupVIUtCH6DJEjyVno2hULDdMYM+uJ8b7uPnPM/huFYOTWoBEcKMcjWo0F8lrhXxX6XBNNmrjJdJcGIJIYvc5OcqK8n7q4GWLHzoUpBNZohJzpdKvyC02XO5ZaBs4lR0OTZdgXLDPaUF8m/3HCtQRsJ0KlObrismn/kUWir6/cFxeexXfJtKaDHEV3qO9FwRbAdagu3X5Y7Jggag3OdvnGILLbTnl0kRc3uWT9HEFp+76kIiXD4eD6cs7H6/hQmk2qVOOnBeE3lj0S4Oh8Ph+MMPw7Rxds/jXa0AAAAASUVORK5CYII=","orcid":"","institution":"Federal University of Health Sciences, Azare, Bauchi State, Nigeria.","correspondingAuthor":true,"prefix":"","firstName":"Auwal","middleName":"","lastName":"Magaji","suffix":""},{"id":608622305,"identity":"7f5775c9-30cb-4ab2-988a-5b94b7424fb9","order_by":1,"name":"Ibrahim Musa Moi","email":"","orcid":"","institution":"Sa'adu Zungur University","correspondingAuthor":false,"prefix":"","firstName":"Ibrahim","middleName":"Musa","lastName":"Moi","suffix":""},{"id":608622306,"identity":"55bdf2bd-57a2-40df-9d38-1ec7aba0e6b5","order_by":2,"name":"Muhammad Abdullahi","email":"","orcid":"","institution":"National Open University of Nigeria","correspondingAuthor":false,"prefix":"","firstName":"Muhammad","middleName":"","lastName":"Abdullahi","suffix":""},{"id":608622307,"identity":"c103dc75-62f1-4171-ab3c-bdcba0b8d8ec","order_by":3,"name":"Bashir Abubakar Muhammad","email":"","orcid":"","institution":"Sa'adu Zungur University","correspondingAuthor":false,"prefix":"","firstName":"Bashir","middleName":"Abubakar","lastName":"Muhammad","suffix":""},{"id":608622309,"identity":"5e532a56-3bc5-4b24-b014-d3fe54b2563c","order_by":4,"name":"Haladu Ali Gagman","email":"","orcid":"","institution":"Sa'adu Zungur University","correspondingAuthor":false,"prefix":"","firstName":"Haladu","middleName":"Ali","lastName":"Gagman","suffix":""}],"badges":[],"createdAt":"2026-02-27 08:38:28","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8985440/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8985440/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":105563001,"identity":"85471ed4-d725-409d-ae7b-2ef83e3f9a62","added_by":"auto","created_at":"2026-03-27 12:45:36","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":129480,"visible":true,"origin":"","legend":"\u003cp\u003eMap of Nigeria Showing the Study Area\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8985440/v1/cbf2ebb5254532908bcaa302.jpg"},{"id":105057805,"identity":"a1ef16a8-f553-49e7-9076-11ba2b7eadea","added_by":"auto","created_at":"2026-03-20 12:06:57","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":24351,"visible":true,"origin":"","legend":"\u003cp\u003eAgarose gel electrophoresis of amplified 18S rRNA gene using ITS primer.. Lane: M-represents marker, lanes 1-2 represent isolates of T rubrum and 3 represents T soudanense isolate\u003c/p\u003e","description":"","filename":"2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8985440/v1/1462e2c1a3fc9e93d1fc7926.jpg"},{"id":105057807,"identity":"79017f05-114c-4d74-b80d-83d62fe6e694","added_by":"auto","created_at":"2026-03-20 12:06:57","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":164936,"visible":true,"origin":"","legend":"\u003cp\u003eA phylogenetic tree showing the relationship between the 18S rRNA gene sequences of the Isolated T rubrum and that of other T runrum species from NCBI. The T runrum strains isolated were designated as MM* and MM** strains. The maximum likely hood was i inferred using the Neighbor-joining method. The horizontal bar indicates 0.05\u003c/p\u003e","description":"","filename":"3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8985440/v1/e50c02bea19f0e1c0fc62f22.jpg"},{"id":105057809,"identity":"0517268a-95f4-4a60-ac99-afaf6d6bf2aa","added_by":"auto","created_at":"2026-03-20 12:06:57","extension":"jpg","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":75309,"visible":true,"origin":"","legend":"\u003cp\u003eA phylogenetic tree showing the relationship between the 18S rRNA gene sequences of the Isolated T soudanense and that of other T soudanense species from NCBI. The T soudanense strain isolated was designated as MM* strain. The maximum likely hood was i nferred using the Neighbor-joining method. The horizontal bar indicates 0.05\u003c/p\u003e","description":"","filename":"4.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8985440/v1/c8dadea759c277dc1ae7e17b.jpg"},{"id":105057806,"identity":"b210b0a8-524f-42d1-8e6f-313fef35bc2c","added_by":"auto","created_at":"2026-03-20 12:06:57","extension":"jpg","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":52576,"visible":true,"origin":"","legend":"\u003cp\u003eFigure 2: Specie-based prevalence of the Pathogens\u003c/p\u003e","description":"","filename":"5.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8985440/v1/fe134a59710a87ca8f7e1f2d.jpg"},{"id":106040354,"identity":"42125734-c3d5-4c59-bf24-7b5db0cd4f15","added_by":"auto","created_at":"2026-04-02 17:25:09","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1374807,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8985440/v1/136cbaa7-5d3f-4edc-905a-8613a36047d3.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eEpidemiological and Molecular Characterization of Trichophyton Species Associated with Dermatophytoses in Northeast Nigeria\u003c/p\u003e","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eFungal infections of the skin, hair, and nails are known as superficial mycoses. They are among the most common dermatological problems worldwide particularly in tropical and subtropical regions where warmth and humidity promote fungal proliferation [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Of the fungi implicated in these infections, dermatophytes especially members of the genus \u003cem\u003eTrichophyton\u003c/em\u003e are the most frequently encountered pathogens in both humans and animals [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. \u003cem\u003eTrichophyton\u003c/em\u003e species are keratinophilic fungi that digest keratin and colonize the outer layers of the skin, nails, and hair causing dermatophytoses such as tinea capitis, tinea corporis, tinea pedis, tinea unguium, and tinea cruris [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eDermatophytes are traditionally classified into three genera \u003cem\u003eTrichophyton\u003c/em\u003e, \u003cem\u003eMicrosporum\u003c/em\u003e and \u003cem\u003eEpidermophyton\u003c/em\u003e based on their microscopic morphology and host specificity. Of these, \u003cem\u003eTrichophyton\u003c/em\u003e is the most diverse and clinically important, comprising numerous pathogenic species such as \u003cem\u003eT. rubrum\u003c/em\u003e, \u003cem\u003eT. mentagrophytes\u003c/em\u003e, \u003cem\u003eT. tonsurans\u003c/em\u003e, \u003cem\u003eT. schoenleinii\u003c/em\u003e and \u003cem\u003eT. verrucosum\u003c/em\u003e [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. These species are further categorized ecologically into anthropophilic (human-associated), zoophilic (animal-associated) and geophilic (soil-associated) groups, each differing in pathogenicity and host interaction [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eTransmission occurs through direct contact with infected individuals or animals, or indirectly via contaminated fomites or the environment [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e \u003cem\u003eTrichophyton\u003c/em\u003e species are responsible for various clinical conditions depending on the site of infection. For instance, \u003cem\u003eT. rubrum\u003c/em\u003e commonly causes tinea corporis and tinea pedis, while \u003cem\u003eT. tonsurans\u003c/em\u003e is a leading cause of tinea capitis in children [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. The infections often manifest as circular, scaly and itchy lesions with characteristic borders. Inflammatory reactions tend to be more severe with zoophilic and geophilic species, while anthropophilic species tend to cause more chronic and less inflammatory conditions [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eGlobally, dermatophytoses affect an estimated 20\u0026ndash;25% of the population, with infections caused by \u003cem\u003eTrichophyton\u003c/em\u003e species accounting for the majority [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. The prevalence in children, especially tinea capitis, ranges between 21% and 87% in developing countries, with peak occurrence in those under 12 years [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. In Nigeria, prevalence estimates vary significantly by region, ranging from 3.4% to 55.1%, and are influenced by factors such as age, sex, hygiene practices, and socioeconomic conditions [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eSeveral studies across Nigeria have demonstrated regional variations in the prevalence of \u003cem\u003eTrichophyton\u003c/em\u003e species causing tinea capitis. For example \u003cem\u003eT. schoenleinii\u003c/em\u003e was predominant in Borno State, \u003cem\u003eT. rubrum\u003c/em\u003e in Kano, \u003cem\u003eT. mentagrophytes\u003c/em\u003e in southwestern states and \u003cem\u003eT. tonsurans\u003c/em\u003e in Anambra State [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. These findings underscored the need for continuous mycological surveillance and localized management strategies.\u003c/p\u003e \u003cp\u003eThe identification of \u003cem\u003eTrichophyton\u003c/em\u003e species traditionally relies on direct microscopy and culture, which provide preliminary morphological characterization. However, these methods are limited by their time requirements, subjectivity and difficulty distinguishing between closely related species [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. In recent years, molecular techniques such as polymerase chain reaction (PCR) and sequencing of the internal transcribed spacer (ITS) region of ribosomal DNA have emerged as powerful tools for the precise identification and phylogenetic classification of dermatophytes [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Molecular characterization has not only increased diagnostic accuracy but also uncovered cryptic species within the \u003cem\u003eT. mentagrophytes\u003c/em\u003e complex, including the recently identified \u003cem\u003eT. indotineae\u003c/em\u003e, known for its aggressive clinical course and resistance to terbinafine [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eDespite the clinical burden of \u003cem\u003eTrichophyton\u003c/em\u003e-related infections, many patients in endemic regions continue to receive empirical treatment without laboratory confirmation. This not only promotes resistance but also delays appropriate therapy. Poor awareness, limited access to diagnostic laboratories and cultural practices further contribute to the underreporting and persistence of infections. In addition, environmental and behavioral risk factors such as close contact with animals, communal living, inadequate personal hygiene, and shared grooming tools (eg clippers, combs, towels etc) are key contributors to the transmission of \u003cem\u003eTrichophyton\u003c/em\u003e species [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eGiven the medical and public health significance of \u003cem\u003eTrichophyton\u003c/em\u003e species in superficial fungal infections, the current study was designed to investigate the prevalence of dermatophytoses caused by \u003cem\u003eTrichophyton\u003c/em\u003e spp. among patients presenting with skin and scalp infections at the selected health facility in northeast Nigeria. The study further aimed to identify associated risk factors and utilize both conventional and molecular techniques to accurately characterize the isolates. By integrating epidemiological data with molecular identification, this study could provide valuable insights into the distribution, diversity and control of \u003cem\u003eTrichophyton\u003c/em\u003e species in endemic settings.\u003c/p\u003e"},{"header":"MATERIALS AND METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Area\u003c/h2\u003e \u003cp\u003eThis study was conducted at the Infectious Disease Hospital (IDH) Bayara one of the referral centers in northeastern Nigeria (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e) for infectious diseases especially those affecting skin. It is located in Birshi, Bauchi Local Government Area (LGA), Bauchi State, Nigeria. It was established on March 11, 1982, and licensed under the Federal Ministry of Health with facility code 05/02/1/2/1/0002. Bauchi LGA covers approximately 3,219 km\u003csup\u003e2\u003c/sup\u003e with estimated population of 881,600, with 51.1% males and 48.9% females. It is located on the coordinates: 10.2820\u0026deg; N latitude and 9.8120\u0026deg; E longitude (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e) [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eStudy Design and Population\u003c/h3\u003e\n\u003cp\u003eThe study was cross-sectional, and involved collecting data from patients at IDH Bayara at a single point in time.\u003c/p\u003e \u003cp\u003eThe study population comprised patients of all genders and ages with clinical signs and symptoms of superficial mycoses. Patients unwilling to participate in the study and those without clinical symptoms of superficial mycoses were excluded.\u003c/p\u003e\n\u003ch3\u003eSample Size Determination\u003c/h3\u003e\n\u003cp\u003eThe sample size was calculated using Cochran's formula. Prevalence of 50% as reported by Idris \u003cem\u003eet al\u003c/em\u003e. [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e], and precision of 5% were taken at 95% confidence level.\u003cdiv id=\"Equa\" class=\"Equation\"\u003e\u003cdiv format=\"TEX\" class=\"mathdisplay\" id=\"FileID_Equa\" name=\"EquationSource\"\u003e\n$$n=\\frac{(z/2)\u0026sup2;pq}{{d}^{2}}$$\u003c/div\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eWhere:\u003c/p\u003e \u003cp\u003eP\u0026thinsp;=\u0026thinsp;previous prevalence (50%)\u003c/p\u003e \u003cp\u003eq\u0026thinsp;=\u0026thinsp;1-p\u003c/p\u003e \u003cp\u003ed\u0026thinsp;=\u0026thinsp;precision (5%)\u003c/p\u003e \u003cp\u003e9Z/2)\u0026thinsp;=\u0026thinsp;1.96 for 95% confidence level\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;sample size\u003c/p\u003e \u003cp\u003eTherefore,\u003cdiv id=\"Equb\" class=\"Equation\"\u003e\u003cdiv format=\"TEX\" class=\"mathdisplay\" id=\"FileID_Equb\" name=\"EquationSource\"\u003e\n$$n=\\frac{{\\left(1.96\\right)}^{2}\\text{X}0.5\\left(1-0.5\\right)}{{0.05}^{2}}$$\u003c/div\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eTherefore, 385 patients with clinical presentations of the infections were enrolled in the study.\u003c/p\u003e\n\u003ch3\u003eEthical Considerations\u003c/h3\u003e\n\u003cp\u003e \u003cstrong\u003eEthical approval\u003c/strong\u003e \u003cp\u003ewas obtained from the Research and Ethics Committees of the Infectious Disease Hospital Bayara in a letter dated 4th May, 2024 with reference number IDH/2024/5V1. Duel signed informed consent was obtained from adult patients and from the guardians of children below seven years prior to the sample collection. Assent was obtained from children aged seven years and above. Confidentiality of patients\u0026rsquo; information was maintained, and all procedures were conducted in accordance with Helsinki\u0026rsquo;s (2013) Declaration.\u003c/p\u003e \u003c/p\u003e\n\u003ch3\u003eSample Collection\u003c/h3\u003e\n\u003cp\u003eSkin scrapings, hair, or lesion samples were collected from 385 patients exhibiting signs and symptoms of dermatophytoses. Before the sample collection, the affected site of the patient\u0026rsquo;s body was cleaned using a sterile cotton swab soaked in 70% ethanol. The samples were placed in sterile disposable dishes and transported to the Microbiology Laboratory, Sa'adu Zungur University Gadau, for further analysis. Meanwhile, 385 structured questionnaires were administered to the patients at the time of sample collection to obtain sociodemographic and risk factor data from the patients\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eIsolation of Fungal Pathogens\u003c/h2\u003e \u003cp\u003eFungal pathogens were isolated using Sabouraud Dextrose Agar (SDA), prepared by dissolving 39 g of SDA in 1000 mL of distilled water, followed by sterilization at 121\u0026deg;C for 15 minutes. After cooling, the medium was inoculated with patients\u0026rsquo; samples and incubated at 35\u0026deg;C for up to 7 days [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eIdentification of Fungal Pathogens\u003c/h3\u003e\n\u003cp\u003ePrior to the isolation, direct microscopic examination was conducted. The samples were treated with 10% Potassium Hydroxide (KOH) to dissolve keratin, and observed for the fungal spores, under 10X and 40X objectives. Upon isolation, the colonies were assessed for color, texture, and topography [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e].\u003c/p\u003e\n\u003ch3\u003eMolecular Identification\u003c/h3\u003e\n\u003cp\u003eThe isolates were maintained on Sabouraud dextrose agar and kept at 4\u0026deg;C. The isolates were cultured in Sabouraud dextrose broth, and incubated for 14 days at 28\u0026deg;C. Small portion of the isolate\u0026rsquo;s mycelia was reaped and centrifuged at 1600\u0026times;g for ten minutes, and then washed with ice-cold phosphate buffered saline and then stored at \u0026minus;\u0026thinsp;70\u0026deg;C.\u003c/p\u003e \u003cp\u003eThe genomic DNA from the isolates was isolated as stated by Rezaie \u003cem\u003eet al\u003c/em\u003e., [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. About three hundred milligram (300mg) of the mycelia was grounded to powder with liquid nitrogen. 500\u0026micro;L of extraction buffer (50mM Tris-HCl pH 8.0), 50mM EDTA, 25\u0026micro;L of 20% SDS, and 10\u0026micro;L of proteinase-K, were added and gently mixed. This was followed by incubation at 65\u0026deg;C for 60min and centrifugation at 3000\u0026times;g for 15min. 25\u0026micro;L of Rnase was added to the supernatant and incubated at 37\u0026deg;C for 30 in. This was then mixed with 500\u0026micro;L of phenol:chloroform:isoamyl alcohol (25:24:1) and centrifuged at 10000\u0026times;g for 10min. The supernatant were collected and transferred to a new steriled eppendorff tube. This was then mixed with 500\u0026micro;L of chloroform:isoamyl alcohol (24:1) and centrifuged at 10000\u0026times;g for 10min. The supernatant were collected and transferred to another eppendorff tubes. The DNA was precipitated by the addition of 500\u0026micro;L of isopropanol and 30\u0026micro;L of 3M Sodium acetate. This was then followed by centrifugation at 15000\u0026times;g for 30min. The supernatants were then discarded. The DNA pellet was rinsed with 200\u0026micro;l of 70% cold ethanol and centrifuged at 10000\u0026times;g for 10min. The pellet was then air dried and stored at -20\u0026deg;C [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eITS1 (5\u0026rsquo;-TCC GTA GGT GAA CCT GC-3\u0026rsquo;) and the ITS4 (5\u0026rsquo;-TCC TCC GCT TAT TGA TAT G-3\u0026rsquo;) were used as forward and reverse primers respectively [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. A 25\u0026micro;L PCR reaction mixture was prepared comprising of 2.5\u0026micro;L of 10\u0026times; reaction buffer, 0.5\u0026micro;L of 10mM dNTPs, 1.5\u0026micro;L of 25mM MgCl\u003csub\u003e2\u003c/sub\u003e, 0.5\u0026micro;L of 0.2mM of each of the ITS1 and ITS4 primers, 0.5\u0026micro;L of Taq DNA polymerase (Promega Coporation, USA), 0.5\u0026micro;L of genomic DNA and 18.5\u0026micro;L of distilled water. The PCR reactions were carried out on a thermal cycler (MJ Research Inc. USA), with the following conditions: 1 cycle in an initial step for 5min at 94\u0026deg;C, then 30 cycles consisting of denaturation at 94\u0026deg;C for 30s, then annealing for 40s at 55\u0026deg;C, and then extension at 72\u0026deg;C for 40s. This was followed by a final extension at 72\u0026deg;C for 10min. 5\u0026micro;l of PCR product was loaded on 1% agarose in 1X Tris\u0026ndash;Acetic Acid\u0026ndash; EDTA buffer and stained with 0.5mg/ml ethidium bromide for 40min at 80V, and visualized with UV trans-illuminator (Alpha Innotech, USA). This was then compared with a standard DNA size marker (100bp DNA ladder), and photographed in UV light [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. The PCR products were sent for sequencing. The sequence result was processed by using the web-based blasting program- basic local alignment search tool (BLAST), at the NCBI website, and the data were compared with the NCBI/Genebank database. The phylogenic tree was constructed using MEGA 11.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eData Analysis\u003c/h2\u003e \u003cp\u003eIn presenting the results of this research, a multifaceted approach was employed, integrating tables and charts to effectively communicate key findings visually. The interpretation of these results was underpinned by robust statistical analyses, leveraging a diverse set of tools including Chi-square test where applicable. All of these were computed using SPSS version 23.\u003c/p\u003e \u003c/div\u003e"},{"header":"RESULTS","content":"\u003cp\u003ePhenotypically, the current study reported two species of \u003cem\u003etrychophyton\u003c/em\u003e to be associated with dermatophytoses among patients from northeastern states of Nigeria, at the infectious disease hospital Bayara. However, the molecular identification confirmed two \u003cem\u003eTrichophyton\u003c/em\u003e species (two different strains of \u003cem\u003eTrichophyton rubrum\u003c/em\u003e and one strain of \u003cem\u003eTrichophyton soudanense\u003c/em\u003e) based on 18S rRNA homology. The 18S rRNA gene sequences of the pathogens were compared using BLAST with reference sequences from the NCBI database. Phylogenetic trees for the isolates were constructed using MEGA 11 (Figs.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e3\u003c/span\u003e and \u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe study also revealed that, the overall prevalence of \u003cem\u003eTrichophyton\u003c/em\u003e species among patients with dermatophytoses in northeastern Nigeria was 24.94%. The specie-based prevalence indicated high prevalence of \u003cem\u003eTricophyton rubrum\u003c/em\u003e (21.82%) than Trichophyton \u003cem\u003esoudanense\u003c/em\u003e (3.12%) (Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eFurther, the study indicated that, out of the study participants, the overall prevalence of Trichophyton-related dermatophytosis was higher among males (15.32%) compared to females (9.61%), though the association was not statistically significant (χ\u0026sup2; = 1.65, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.20).\u003c/p\u003e \u003cp\u003eOn the age basis, the study pointed that, age group was significantly associated with high prevalence of the infection (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.002). The highest prevalence was recorded in participants aged 65 years and above (9.61%), while 10\u0026ndash;19 year age group accounted for the lowest prevalence of the infections (0.52%).\u003c/p\u003e \u003cp\u003eIn terms of residence, a significant association was observed (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.000). Individuals living in rural areas had the highest prevalence (16.62%) compared to those in urban (5.19%) and semi-urban (3.12%) settings.\u003c/p\u003e \u003cp\u003eThe participants, who currently had skin, nail or scalp infections were more likely to have higher prevalence of the infection (18.18%) than those who had not (6.75%) (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.045).\u003c/p\u003e \u003cp\u003eThere was a strong association between regular contact with animals and high prevalence of the infection, where a prevalence of 20.78% among those with animal contact compared to 4.16% among those without (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.000).\u003c/p\u003e \u003cp\u003eSocioeconomic status significantly influenced infection prevalence (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.000). Those with low income had the highest prevalence (14.03%) followed by middle income class (7.27%) while those from high income class had lowest prevalence (3.64%).\u003c/p\u003e \u003cp\u003eBathing habits were also significant (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.000), with infection more common among those who did not bathe regularly (15.58%) compared to those who did (9.35%).\u003c/p\u003e \u003cp\u003eSharing of personal grooming tools showed no significant association (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.071), though higher prevalence was observed among those who shared tools (15.32%) versus those who did not (9.61%).\u003c/p\u003e \u003cp\u003eInterestingly, individuals living in communal settings had a higher prevalence (15.84%) than those who did not (9.09%) (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.000), and those involved in farming or outdoor labor had a higher infection rate (15.58%) than those who were not (9.35%) (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.009) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePrevalence of \u003cem\u003eTrichophyton\u003c/em\u003e-related Dermatophytosis in the Study Area\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrevalence (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eX\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003ep-value\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e0-9years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.002*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10-19years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e20-24years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e25-64years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e65years and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eResidence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18.337\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSemi Urban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e16.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDo you currently have a skin, nail, or scalp infection?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.032\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.045*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDo you have regular contact with animals?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e20.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e132.818\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSocioeconomic status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLow income\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e92.776\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMiddle income\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh income\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHow often do you bathe?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRegularly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e66.444\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot regularly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDo you share personal grooming tools (clippers, combs, towels)?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.264\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.071\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDo you live in a communal setting (e.g., boarding school, barracks)?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e28.717\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAre you involved in farming or outdoor labor?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6.744\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.009*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003e\u0026ldquo;*\u0026rdquo; = Significant at \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05, \u0026ldquo;\u003cem\u003eX\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u0026rdquo; = Chi-square\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eLogistic regression analysis revealed several significant predictors of Trichophyton-related dermatophytosis. Regular contact with animals significantly increased the odds of infection (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.000, OR\u0026thinsp;=\u0026thinsp;0.045, 95% CI: 0.024\u0026ndash;0.083).\u003c/p\u003e \u003cp\u003eAlso, participants from low-income households were significantly more likely to be infected (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.000, OR\u0026thinsp;=\u0026thinsp;0.092, 95% CI: 0.048\u0026ndash;0.175). Similarly, irregular bathing was associated with significantly higher odds of infection (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.000, OR\u0026thinsp;=\u0026thinsp;0.138, 95% CI: 0.083\u0026ndash;0.229).\u003c/p\u003e \u003cp\u003eLiving in communal settings significantly increased the odds of infection (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.000, OR\u0026thinsp;=\u0026thinsp;0.240, 95% CI: 0.139\u0026ndash;0.414), as the involvement in farming or outdoor labor was a significant predisposing factor (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.010, OR\u0026thinsp;=\u0026thinsp;0.523, 95% CI: 0.319\u0026ndash;0.857). Also, presence of current skin, nail or scalp infection was significantly associated (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.046, OR\u0026thinsp;=\u0026thinsp;0.596, 95% CI: 0.358\u0026ndash;0.991).\u003c/p\u003e \u003cp\u003eOther variables like gender, age, and sharing grooming tools were not statistically significant predictors of the infection among the patients (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBivariate Logistics Regression Analyses for the Risk Factors Associated with \u003cem\u003eTrichophuyon\u003c/em\u003e-related Dermatophytoses\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026minus;\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e+\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTot\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eOR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003eConfidence Interval\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e159\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e218\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.734\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c7\"\u003e \u003cp\u003e0.457 -\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e1.179\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e130\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e167\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e0-9years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.186\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.514\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c7\"\u003e \u003cp\u003e0.226 -\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e1.167\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10-19years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6.509\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c7\"\u003e \u003cp\u003e0.842 -\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e50.323\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e20-24years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.092\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c7\"\u003e \u003cp\u003e0.556 -\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e2.143\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e25-64years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.742\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c7\"\u003e \u003cp\u003e0.419 -\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e1.314\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e65years and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e108\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e145\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eResidence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.000*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.187\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c7\"\u003e \u003cp\u003e0.659 -\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e2.135\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSemi Urban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e162\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e174\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.996\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c7\"\u003e \u003cp\u003e2.047 -\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e7.801\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e138\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDo you currently have a skin, nail, or scalp infection?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e178\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e248\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.046*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.596\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c7\"\u003e \u003cp\u003e0.358 -\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.991\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e111\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e137\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDo you have regular contact with animals?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e136\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.000*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.045\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c7\"\u003e \u003cp\u003e0.024 -\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.083\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e233\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e249\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSocioeconomic status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLow income\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e126\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.000*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.092\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c7\"\u003e \u003cp\u003e0.048 -\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.175\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMiddle income\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.044\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c7\"\u003e \u003cp\u003e0.020 -\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.099\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh income\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e214\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHow often do you bathe?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRegularly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e233\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e269\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.000*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.138\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c7\"\u003e \u003cp\u003e0.083 -\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.229\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot regularly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e116\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDo you share personal grooming tools (clippers, combs, towels)?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e150\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e209\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.072\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.544\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c7\"\u003e \u003cp\u003e0.962 -\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e2.479\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e139\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e176\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDo you live in a communal setting (e.g., boarding school, barracks)?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.000*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.240\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c7\"\u003e \u003cp\u003e0.139 -\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.414\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e132\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e193\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAre you involved in farming or outdoor labor?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e105\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.010*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.523\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c7\"\u003e \u003cp\u003e0.319 -\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.857\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e220\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e280\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"8\"\u003e\u0026ldquo;*\u0026rdquo; = Significant at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05, \u0026ldquo;OR\u0026rdquo; = odds ratio\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThe findings of this study highlighted \u003cem\u003eTrichophyton soudanense\u003c/em\u003e and \u003cem\u003eTrichophyton rubrum\u003c/em\u003e as significant contributors to the overall burden of dermatophytoses in the study population. These results aligned with previous research conducted in Nigeria and globally, which have identified these fungal species as common causative agents of dermatophytoses. The predominance of \u003cem\u003eTrichophyton rubrum\u003c/em\u003e in this study corresponded with findings from Kano State, as reported by Adeleke \u003cem\u003eet al\u003c/em\u003e. [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. The consistent occurrence of \u003cem\u003eT. rubrum\u003c/em\u003e across different regions suggests its adaptability and widespread distribution in Nigeria.\u003c/p\u003e \u003cp\u003eHowever, the study contrasted the findings of Nweze, [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e] who documented \u003cem\u003eT schoenleinii\u003c/em\u003e as the primary causative agent of dermatophytosis in Borno State. These regional differences may be influenced by environmental factors, population demographics, and healthcare practices that affect fungal pathogen transmission dynamics.\u003c/p\u003e \u003cp\u003eIn contrast to this study, \u003cem\u003eT mentagrophytes\u003c/em\u003e was reported as the predominant species in southwestern Nigeria by Ayanlowo \u003cem\u003eet al\u003c/em\u003e. [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. In this study, \u003cem\u003eT. rubrum\u003c/em\u003e was a significant contributor not \u003cem\u003eT mentagrophytes\u003c/em\u003e. This discrepancy could be due to environmental differences such as climate, humidity and socio-economic conditions that favor the growth and spread of some fungal species over others. Furthermore, \u003cem\u003eT tonsurans\u003c/em\u003e was identified as the most common etiological agent in Anambra State [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe findings of this study also suggest that the infection is more prevalent among males, although the association is not statistically significant. However, age, residence, regular contact with animals, socioeconomic status, bathing habits, and living in communal settings are significant predictors of the infection.\u003c/p\u003e \u003cp\u003eThe study revealed that age is significantly associated with the prevalence of Trichophyton-related dermatophytosis, with the highest prevalence observed in participants aged 65 years and above. This finding contrasted the previous studies that have reported a high burden of the infections among children than older adults [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. The increased susceptibility among older adults as reported in this study may be attributed to declining immune function, poor hygiene practices and increased exposure to risk factors.\u003c/p\u003e \u003cp\u003eThe study also highlighted the importance of residence in determining the prevalence of Trichophyton-related dermatophytosis. Individuals living in rural areas had higher prevalence of the infection compared to those in urban and semi-urban settings. This finding is consistent with previous studies that have reported a higher incidence of fungal infections in rural areas, likely due to close proximity to livestock, contaminated soil and limited access to healthcare services [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe study also identified several significant risk factors associated with Trichophyton-related dermatophytosis, including regular contact with animals, low socioeconomic status, irregular bathing habits, living in communal settings, and involvement in farming or outdoor labor. These findings are consistent with previous studies that have reported the importance of environmental and behavioral factors in the transmission of the infections [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e].\u003c/p\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eThis study revealed a high burden of \u003cem\u003eTrichophyton\u003c/em\u003e-related dermatophytosis in borthestern Nigeria with \u003cem\u003eT. rubrum\u003c/em\u003e emerging as the dominant species confirmed through molecular characterization. The findings highlighted critical sociodemographic and behavioral risk factors particularly among individuals with regular animal contact, low socioeconomic status, poor hygiene and communal living conditions. These factors significantly influence infection prevalence and should be prioritized in public health strategies.\u003c/p\u003e \u003cp\u003eThe integration of molecular techniques enhanced the accuracy of fungal identification and demonstrated the limitations of conventional methods alone. This emphasized the need for improved diagnostic capacity in endemic areas. To curb the spread of dermatophytoses, there is a pressing need for community-based health education, better hygiene practices, and improved access to dermatological care. Further research is warranted to monitor antifungal resistance patterns and develop effective prevention and treatment protocols.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003col\u003e\n \u003cli\u003e18S rRNA: 18S Ribosomal Ribonucleic Acid\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eBLAST: Basic Local Alignment Search Tool\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eDNA: Deoxyribonucleic Acid\u0026nbsp;\u003c/li\u003e\n \u003cli\u003edNTPs: Deoxynucleoside Triphosphates\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eEDTA: Ethylenediaminetetraacetic Acid\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eIDH: Infectious Disease Hospital\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eITS: Internal Transcribed Spacer\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eKOH: Potassium Hydroxide\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eLGA: Local Government Area\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eMEGA: Molecular Evolutionary Genetics Analysis\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eNCBI: National Center for Biotechnology Information\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eOR: Odds Ratio\u0026nbsp;\u003c/li\u003e\n \u003cli\u003ePCR: Polymerase Chain Reaction\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eSDA: Sabouraud Dextrose Agar\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eSDS: Sodium Dodecyl Sulfate\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eSPSS: Statistical Package for the Social Sciences\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eUV: Ultraviolet\u0026nbsp;\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical Approval and Consent to Participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePrior to the commencement of the data collection, the study received approval from the Ethical\u003cbr\u003eResearch and Review Committee of the Infectious Disease Hospital Bayara, Bauchi State Nigeria, in a letter dated 4\u003csup\u003eth\u003c/sup\u003e May, 2024 with reference number IDH/2024/5V1. Duly signed informed consent was obtained from adult patients and from the guardians of children below seven years prior to the sample collection. Assent was obtained from children aged seven years and above. Confidentiality of patients\u0026rsquo; information was maintained, and all procedures were conducted in accordance with Helsinki\u0026rsquo;s (2013) Declaration.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for Publication:\u0026nbsp;\u003c/strong\u003eNot applicable\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of Data and Materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data for this research are contained in the manuscript. Additional information and materials can be obtained from NCBI website, and the corresponding author on a serious request.\u003c/p\u003e\n\u003ch4\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/h4\u003e\n\u003cp\u003eThe authors declare that, there is no competing interest\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding was obtained from any institution. The study was funded by the authors throughout.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAM designed the work, collected samples and did laboratory analysis, IMM prepared the manuscript, BAM and HAG performed data analysis, while MA proofread the entire work.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe sincerely thank the entire staff of the Infectious Disease Hospital Bayara especially those in the Department of Microbiology for providing necessary supports during this study.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eHusain AE, Abdel Fattah NS, Afify AA, Mostafa NS. Epidemiology and risk factors of superficial fungal infections in Toukh Primary Health Care Centre. 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BMC Res Notes. 2015;8:274.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eP\u0026eacute;rez-Tanoira R, Mar\u0026iacute;n I, Berbegal L. Mycological profile of tinea capitis in schoolchildren in rural southern Ethiopia. Med Mycol. 2017;55(3):262\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMagaji A, Yakubu A, Mahmud Z, Aminu S, Salihu MR, Sambo H. The Role of Socioeconomic and Environmental Determinants in the Prevalence and Distribution of Superficial Mycoses in Bauchi State Nigeria. Dujopas. 2025;11(2b):352\u0026ndash;63.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Dermatophytosis, Trichophyton, Conventional, Prevalence, Epidemiology Molecular","lastPublishedDoi":"10.21203/rs.3.rs-8985440/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8985440/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDermatophytoses are superficial fungal infections affecting skin, hair, and nails. \u003cem\u003eTrichophyton\u003c/em\u003e species are the primary causative agents of these infections. Despite their burden, diagnosis in many settings remains limited to conventional methods, often leading to misidentification and inadequate treatment. This study investigated the prevalence, molecular characteristics, and risk factors associated with Trichophyton-related dermatophytosis among patients in the selected health facility in northeast Nigeria.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA cross-sectional study involving 385 patients with clinical signs of dermatophytoses was conducted at the Infectious Disease Hospital, Bayara. Samples were analyzed using conventional microscopy and culture. Molecular identification was performed via PCR amplification of the 18S rRNA gene using ITS primers. Epidemiological data were collected using structured questionnaires and analyzed statistically using SPSS version 23.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe overall prevalence of Trichophyton-related infections was 24.94%, with \u003cem\u003eT. rubrum\u003c/em\u003e (21.82%) more common than \u003cem\u003eT. soudanense\u003c/em\u003e (3.12%). Molecular analysis confirmed two strains of \u003cem\u003eT. rubrum\u003c/em\u003e and one strain of \u003cem\u003eT. soudanense\u003c/em\u003e. Significant risk factors included regular contact with animals, low socioeconomic status, irregular bathing, communal living, and outdoor labor. Logistic regression identified these as strong predictors of infection (p \u0026lt; 0.05).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study underscored the public health importance of \u003cem\u003eTrichophyton\u003c/em\u003e infections in northeast Nigeria, with \u003cem\u003eT. rubrum\u003c/em\u003e being the predominant species. Molecular techniques improved species identification accuracy. Effective control measures should focus on hygiene education, environmental sanitation, and targeted public health interventions in high-risk populations.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number:\u003c/strong\u003e Not applicable.\u003c/p\u003e","manuscriptTitle":"Epidemiological and Molecular Characterization of Trichophyton Species Associated with Dermatophytoses in Northeast Nigeria","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-20 12:06:48","doi":"10.21203/rs.3.rs-8985440/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"3cc57962-0c8a-4a87-93ed-ae4f1243b48d","owner":[],"postedDate":"March 20th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-04-02T17:24:34+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-20 12:06:48","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8985440","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8985440","identity":"rs-8985440","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}