J. Life Earth Sci., Vol.

2(2) 75-78, 2007 ISSN 1990-4827

© 2007, JLES, RU
PREVALENCE AND ETIOLOGY OF DERMATOMYCOSES IN RAJSHAHI,
BANGLADESH

Farzana Ashrafi Neela

Department of Botany, University of Rajshahi, Rajshahi 6205, Bangladesh

Abstract: Dearmatomycoses are very common infections caused mainly by dermatophytes. A total of 1186 patients ranging from
1-60 years of age were surveyed for dermatomycotic infections in Rajshahi, Bangladesh. Specimens for mycological
investigations were confirmed by microscopic examinations in 817 cases and the causative agents were isolated and cultured in
70 positive cases. The highest prevalence of dermatomycosis was of Tinea corporis (63%) followed by T. pedies (15%), T.
capitis (12%) and T. unguium (8%). Trichophyton and Microsporum were the major etiological agents followed by
Epidermophyton. This study also showed that there is a great variation in the severity of different types of dermatomycoses at
different months of the year.
Key words: Dermatophytes, dermatomycoses, Tinea
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Introduction puberty (Elewski 1996). It is caused by a variety of

zoophilic, anthropophilic and geophilic dermatophytes
The dermatophytes are fungi which cause diseases of
of the genera Microsporum, Epidermophyton and
the skin of human, animals or both. They parasitize
Trichophyton ((Weitzman and Summerbell 1995).
keratinized tissues, including nails, hair and stratum
corneum of the skin, and cause dermatomycoses The prevalence of dermatomycoses or tinea infections
(Weitzman and Summerbell 1995). The clinical types of have been studied in different parts of the world
dermatomycoses are called tineas by the members of (Devliotou et al. 2000; Metin et al. 2001; Akpolat et al.
medical profession. Traditionally, tinea infections have 2005). The relative occurrence of the etiologic agents of
been named by anatomic location of the body, such as T. these infections varies from country to country and from
capitis for ringworm of the scalp, T. corporis for one climatic region to another (De Vrocy 1985; Ayadi
ringworm of the body, and T. pedis for ringworm of the et al. 1993; Korstanje et al. 1995). In tropical countries,
foot. The dermatophytic groups are typically a warm and humid climate, crowded living and poor
Hyphomycetes with perfect stage in the Gymnoascaceae. sanitary conditions all promote the spread of these
These fungi have frequently been treated as special infections (Abdel et al. 1995). Only a few research
group the ‘Dermatophytes’ or Ringworm fungi or tinea. studies are available on dermatomycoses in Bangladesh
Dermatophytes are cosmopolitan, and occur widely in (Neela and Alam 2000). The present study is aimed at
soil and other keratin containing substrate such as bird’s detecting the prevalence of dermatomycoses infection
nest and thus, the soil serves as a source of infection of and etiological agent in Rajshahi, Bangladesh.
tinea (Ainsworth 1971; Beneke and Rogers 1980). Materials and methods
Untold numbers of people world-wide suffer from these Sample selection: A total of 1186 patients having age
infections with high humid environment. Sex, race and range of 1-60 years suspected to have dermatomycotic
occupation have little recognized differential influence infections were randomly selected from outdoor patients of
upon the frequency of these infections. Children are the Skin and Venereal Disease Section of the Rajshahi
mostly affected by dermatomycoses before and during Medical College Hospital (RMCH), Bangladesh, from July
Neela 76

1996 to June 1997, covering all the seasons of a year. the isolates were Microsporum, Epidermophyton and
Questionnaires and physical observations were used to Trichophyton (Table1). Microsporum was isolated from
obtain information on duration of the lesion, clinical skin and hair, whereas Epidermophyton from nail only and
picture, prior therapy as well as demographic data such as Trichophyton from skin, nail and hair.
age, sex, nationality and family status of the respondents. The effect of seasonal weather conditions on the incidence
The final selected culture positive for this study consisted of dermatophytic infections showed that the incidence
of 817 patients. during each of the months July, August, September and
October was evidently higher than that found during each
Sample collection: Samples were collected from skin, of the months of November, December, January and
hair and nail using a sterile scalpel blade following February. During the months of March, April, May and
cleaning of the affected sites with 70% alcohol. The June the incidence of the infections was somewhat
scrapings were collected on a piece of sterile paper. The intermediate in position (Fig. 2).
samples were divided into two portions: one for
microscopic examination and the other for culture. The Although dermatomycoses/tinea diseases have
collected samples were transported to the laboratory worldwide occurrence, its frequency is variable and
within 2 hours for microscopic and cultural analysis. depends on different climate condition, sex, age,
occupational and economical conditions (Neela and
Sample processing Alam 2000). This disease appears to be prevalent in
Direct microscopic examination: Direct microscopic Rajshahi. Accurate assessment of the prevalence of
examination of scales and broken-off hairs placed on a etiologic agents is therefore useful to cure the disease
microscope slide with one or two drops of 10-20% and to prevent its transmission.
potassium hydroxide (KOH) and a cover slip was Concerning individual types of dermatophytic infection
performed. The sample was warmed for 5 minutes over a the severity was found the highest in the case of T.
flame as described by Behl (1990). Each treated slide was corporis followed by T. pedis (Fig. 1). These data
then carefully examined under low (×10) and high (×40) suggest that the body is always covered with cloths
power objective for the presence of hyphae and/or conidia. which may help keep the body moist and favorable
Fungal culture: Each scraping was cultured into environment for T. corporis infections. In contrast, T.
Sabouraud dextrose agar (Ajello et al. 1996). The plates or capitis is predominant in North America (Weitzman and
slants were incubated at 28°C for up to 4 weeks and Summerbell 1995). Mabata and Nwajagu (2007)
examined at 2 to 3 days intervals for fungal growth. Fungal reported that in Nigeria most common incidence of tinea
isolates were sub-cultured onto plates of Sabouraud's agar. disease is T. capitis and children suffer more than adults
The isolates were examined visually and microscopically (Srejaard 1982). In Bangladesh, the age groups of 16-30
for morphology of the fungi using lactophenol cotton blue years suffer different types of tinea disease (Neela and
by slide culture technique. The dermatophytes were Alam 2000). This may be due to the fact that younger
confirmed by dermatophyte test medium, incubated at people are more physically active and tend to sweat
30°C for 14 days. Genus identification was based on the more. Personal hygiene plays an important role for the
presence or absence of macro- and microconidia, their dissemination of T. corporis. Other tinea diseases are
shape, and their distribution along the hyphae (Beneki and not so prevalent in Rajshahi region.
Rogers 1980).
Table 1. Etiological agents in dermatomycoses
Results and Discussion infections
Of 1186 patients, diagnosis of 817 cases was confirmed by Types of Clinical name of
Etiological agents
specimen the diseases
microscopic examinations, and the causative agents were
Tinea corporis Microsporum
isolated in 70 cases. From the total number of isolates Skin scraping
Tinea pedis Trichophyton
identified, dermatophytes were the most prevalent (Fig. 1). Epidermophyton
The highest prevalent of dermatophytic infection was T. Nail clipping Tinea unguium
Trichophyton
corporis (63%), followed by T. pedies (15%), T. capitis Hair stubs Tinea capitis
Microsporum
(12%) and T. unguium (8%). Three genera identified from Trichophyton
77 Prevalence and etiology of dermatomycoses in Rajshahi

This study also demonstrates that a variety of

dermatophytes can cause dermatomycoses. Of the 70
isolated species Trichophyton is the most prevalent 60
isolate followed by Microsporum. Occurrence of these 50

% o f p a tie n ts
organisms as the major cause of dermatomycoses in 40
Rajshahi has been recorded (Neela and Alam 2000). 30
Oyeka et al. (2003) also reported a similar phenomenon
20
in Nigeria. In our studies Microsporum was isolated
10
from T. corporis and T. capitis. These fungi can be
0
transmitted by infected clothing, towels, bedding and T. corporis T. pedis T. capitis T. unguium
combs. Microsporum is usually acquired from infected Name of diseases
pet animals (Shah et al. 1989) that are the reservoir of
zoophilic dermatophytes. Trichophyton was isolated
from T. pedies, T. unguium and T. capitis. Babel et al. Fig. 1. Prevalence of various types of tinea diseases in
(1989) reported that T. capitis in children was caused by Rajshahi
Trichophyton but in adults this genus was more
frequently seen as an agent of T. corporis (Bronson et al. 100
1983). This genus has been reported to have a large

T o tal N o . o f p atien ts
80
number of pathogenic species. The distribution of this
genus has been shown to be of similar pattern in 60
connection with Microsporum. Epidermophyton was 40
isolated only from T. unguium. It has been reported to 20
have only two known species to date and only a single 0
species is pathogenic that attacks skin and nails and also
ly

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1995). Months
Month
Incidence of dermatomycoses in relation to seasonal
weather conditions was shown in Fig. 2. These data Fig. 2. Incidence of dermatomycotic patients in relation
clearly show that environmental factors play an to different months of the year
important role in increasing and decreasing the
Conclusion
incidence of the disease. During the period between July
and October, the weather remains relatively warm and The present investigation provides data that are valuable
humid which would favour the infection, spread and to the determination of dermatomycoses among the
consequently higher incidence of the disease. During the population in Rajshahi region. The etiological agents of
period of November and February the weather remains these diseases could be specifically diagnosed, which
relatively dry and cold which would decrease the could help the physicians to combat the disease with
incidence of the disease. Gugnani (1982) attributed the specific drugs. It is obvious that this sort of information
public health problem caused by dermatophytes in is essential for the physician of our country to have
Nigeria to the warm humid climate. Oyekaa and Eze correct diagnosis of various types of dermatomycoses
(2006) reported that dermatomycoses are public health that exist here.
problem in many countries with high humid Acknowledgement: The author wishes to express
environment. Bangladesh, especially Rajshahi, is a sincere thanks and gratitude to Professor M. Shah Alam,
warm and humid region; therefore the dermatomycoses Department of Botany, University of Rajshahi,
are prevalent here. Bangladesh, for his guidance and supervising this work.
Neela 78

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