RING WORM: COMPLETE DISCUSSION AND RECOMMENDATIONS


Ringworm is a common dermatophyte infection that constitutes an important public heath problem among children worldwide, including Nigeria (Ive, 1966; Egere and Gugmani 1980; Ajao and Akintude 1985; Ogbonna  et al., 1986). The disease remains endemic in Nigeria, largely because of lack of information on its prevalence and the absence of control measures. The present study revealed that 21.1% of primary school children in Southern Ebonyi of Ebonyi State, Nigeria were infected by species of superficial dermatophytes. This finding agree with other reports in Nigeria. However, much
attention has not been given to ringworm infections of the dermatophytes isolated, M.andoninii with a prevalence of 20.3% is an anthropophilic species. It occurs manly in prepubatal children. T. sondanense  which was recovered from the schools children (20.3%) is an endothrix species and behaved to be endemic in Central and West Africa (Ogbonna  et al.1985). M.canis  with a prevalence of 11.9% in the present study must have originated from the bodies of infected animals. This fungus is believed to be zoophilic and plausibly originated from cats, dogs, cow and other animals since people in the area share their residential houses with domestic animals. Both T. mentagraphytes  and T.schoenleini  are also antropophilic species and the former is the most prevalent and it is of great public heath importance. One of the greatest problems hindering the prevention and eradication of ringworm infection is the presence of healthy asymptomatic dermatophyte carriers. Majority of the pupils examined here in showed physical symptoms of infection. This observation is in line with the reports of Ive (1966) who found that asymptomatic carriers of dermatophytes may be equal to symptomatic sufferers. This should keep both parents and teachers at alert so that a adequate preventive measures would be taken to reduce the rate at which infection spreads in the schools amongst pupils. The prevalence and distribution of ringworm infection observed herein (21.1%) is relatively high compared with either the report of Ajao  et al (1985) amongst children in Ile- Ife, Nigeria (14.02% or those of Omar (2000) in Alexandria (7.4%) as well as fatini and          Ai-samarai (2000) in Iraq children (2.7%). The difference may be due to variation in environmental and climatic conditions of the areas studied. Gender- related studies on the prevalence of ringworm in Nigeria has been fragmentary (Ogbonna  et al., 1985). Here, more females than males were infected though this was statistically significant similar to the reports of Omar (2000) in Alexandria. This finding suggests that the infection is related to personal hygiene and its prevalence can be reduced by adequate health education and good personal hygiene practices. Higher prevalence of infection was found amongst children under the age of 10 years than older ones, suggesting that ringworm is mainly prepubatal disease. Other researchers, Figueroa (1999) in South Western Ethiopian, Venugopal and venugopal (1993) in Saudi Arabia,Adder –Hafez (1997) in johag goveruorate as well as Emar (200) in Alexandrial have subscribe to this age differential. This can be explained by poorer hygiene at this age as well as the absence of saturated fatty acids that provide a natural protective mechanism (Fisher and Cook, 1998).
            Poor infrastructures (houses and classroom) are contributing factors to the high prevalence of dermatophytes amongst school children in Southern Ebonyi. In the four rural schools sampled, they lack good accommodation for studying. They sat on the uncommented floors where side walls are made of palm leaves. Children contact the infection from the soil (Ogbonna  et al,  1985). Mercantini  et al, (1980) recorded high frequency of karetionphilic fungi from floors in Roman primary schools. The playing habits of these children bring them in constant contact with the soil. The habit of accompanying their parents to the farm also brings these children in close contact with the soil. Most pupil examined seldom had regular bath and the fungal. Spore once deposited on the skin from the soil have ample chance of germinating and colorizing the skin. Children were being seen playing with animals such as cow, goat, sheep, cats and local dogs which are known sources of infection (Faith  et al., 2000, Ogbonna  et al., 1986).
            Therefore, the Nigeria environment vis-à-vis personal uncleaness are contributing factors to the high frequency and severity of ringworm infection in Ebonyi State. This calls for good learning environment and intensive health education of the school children on personal cleaness. In nature, man and animals could act as important reservoirs of skin disease. The importance of human and animal presence in the environment in the sense of direct interaction between human and animal ‘pressure’ and the presence and the distribution of these fungi.

RECOMMENDATIONS
Based on the findings of this study, the following recommendations were made.
  1. Government should establish primary health care centres in the rural area in Ohaozara L.G.A so that infected pupils can be cured.
  2.  There should be constant examination of the pupils for early dictation of ringworm infection and subsequent treatment.
  3. The parents in the study area should be enlightened on proper control measures against ringworm infection in the study area.
  4. The species of highest infection rate (T.mentagaphyte) should be adequately tackled to minimize its widespread.      
REFERENCES
Abdel -Rahma. F. (1989)  The  Biology of  Ringworm .  British Medical Journal  2, 867.
 
Adamson, H.G.  (2001)  Observation on parasites  of ringworm. British  Journal Dermatologist . 8:201-211.
   
Addel- Hafez, K. (1997). Clinical and mycological study of Tinea capitis in sohag governorate. Journal pan – arableague dermatologists, 8: 95- 101.

Ajao, A. O, Akintinde, C. (1985) Shidies on the prevalence of tinea capitis infections in Ile – Ife, Nigeria mycopathologia, 89 (1) 43 – 48.


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