RESUMO
In the context of increasing incidence of fungal infections worldwide, the availability of antifungal drugs was studied in Senegal, a country with limited resources where diagnosis of invasive fungal infections is not often established by lack of specialists and/or diagnostic tools. After a background on the country's situation with regard to fungal infections and the drug distribution network in Senegal, a compilation of the various available antifungals was presented before concluding with recommendations to prepare for a situation that could allow to treat appropriately invasive mycoses.
Assuntos
Antifúngicos , Micoses , Antifúngicos/uso terapêutico , Humanos , Micoses/tratamento farmacológico , Micoses/epidemiologia , Senegal/epidemiologiaRESUMO
To determine fungal species distribution of interdigital intertrigo among seafarers in Dakar, Senegal, a cross-sectional study was carried out from May to August 2017 among seafarers clinically diagnosed with interdigital intertrigo. A questionnaire was filled to each patient before sampling the affected folds and transporting to Aristide Le Dantec University Hospital where mycological analyses were realized. Species identification by MALDI-TOF MS was performed in Marseille, France. In total, 169 men (21-66 years) were included. Few of them (3%) had a high level of education and the duration of the mycosis exceed 10 years for 88% of patients. Direct microscopic examination (ME) was positive in 34.3%. Among samples with positive ME, 58.6% had positive culture. An overall incidence of 30.2% was found. Patients with confirmed cases aged between 28 and 66 years. Among them, those between 36-50 years were predominant (52.9%). Those with a high level of education were less representative (2%). For 52.1% of patients, the duration of the mycosis was superior to 10 years. Furthermore, 57% of cases were significantly associated with other types of tinea pedis and/or onychomycosis (P=0.03). Culture was positive in 23.7% isolating 43 strains successfully identified at the species level by MALDI-TOF MS for 31 isolates: 20 Candida and 11 dermatophytes. The rest was identified only at the genus level belonged to Fusarium. In definitive, MALDI-TOF MS could be a useful tool for routine and fast identification of dermatophytes, yeasts and NDFF in clinical mycology laboratories.
Assuntos
Dermatoses do Pé/microbiologia , Intertrigo/microbiologia , Militares , Técnicas de Tipagem Micológica/métodos , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz , Adulto , Idoso , Candida/isolamento & purificação , Estudos Transversais , Dermatoses do Pé/epidemiologia , Humanos , Intertrigo/epidemiologia , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Militares/estatística & dados numéricos , Onicomicose/epidemiologia , Onicomicose/microbiologia , Senegal/epidemiologia , Tinha dos Pés/epidemiologia , Tinha dos Pés/microbiologia , Viagem , Trichophyton/classificação , Trichophyton/isolamento & purificação , Adulto JovemRESUMO
INTRODUCTION: Candida infections are most frequently encountered on the skin and nails. Their proportions vary according to geoclimatic and sociocultural conditions. The objective of this study was to determine the prevalence of skin and/or nail candidiasis diagnosed in the parasitology and mycology laboratory of Le Dantec University Hospital in Dakar, Senegal. MATERIALS AND METHODS: This study included 994 patients with suspected skin and/or nail mycosis tested at the parasitology and mycology laboratory during the 8-year study period of 2008-2015. Each patient had both a direct examination and a mycological culture. RESULTS: The patients' median age was 34 with an interquartile range of 25 years. Of these 994 patients, 613 had confirmed skins and/or nail fungal infections. In descending order, the fungi isolated and identified from these mycoses were Candida (n= 387, 63.1%), dermatophytes (28.4%), and mold (8.5%). Thus Candida accounted for nearly two thirds of the skin and/or nail mycoses and had a prevalence rate among the patients with suspected skin or nail candidiasis of 38.9%. These skin/nail sites was more common among women (72%) than men (28%), and slightly more than half of them (50,1%) were adults aged 31 to 60 years. The duration of candidiasis exceeded a full year for 76.3%. Onychomycoses were found more frequently (65.24%) than epidermomycoses, and both sites were infected in 5.17%. Candida albicans was the species isolated most frequently, accounting for 80% of Candida specimens. CONCLUSION: Our results reinforce the importance of mycological confirmation of the diagnosis. The mycology laboratory has a crucial role in making the differential diagnosis with other dermatoses of similar clinical appearance and thus in guiding the choice of treatment.
Assuntos
Candidíase/epidemiologia , Dermatomicoses/epidemiologia , Dermatoses da Mão/epidemiologia , Onicomicose/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Candidíase/diagnóstico , Criança , Pré-Escolar , Dermatomicoses/diagnóstico , Feminino , Dermatoses da Mão/diagnóstico , Hospitais Universitários , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Onicomicose/diagnóstico , Estudos Retrospectivos , Senegal/epidemiologia , Adulto JovemRESUMO
INTRODUCTION: Fungal interdigital tinea pedis (ITP) is a common pathology mainly due to dermatophytes and yeasts. Fusarium sp. is rarely incriminated in the genesis of intertrigo. In Dakar, a recent study conducted in 2016 on fungal ITP showed that Fusarium were more involved in the etiology of ITP than dermatophytes, coming just after yeasts dominated by Candida. Following this, we wanted to draw attention to the increasing incidence of ITP resulting from Fusarium spp., in Dakar, Senegal, and to analyze the epidemiological and mycological particularities of these ITP due to Fusarium spp. PATIENTS AND METHODS: A retrospective study including all patients received at the laboratory for suspicion of ITP between January 1st, 2014 and June 30th, 2017 was conducted. Diagnosis was based on mycological examination, including direct examination and culture. Mycological analysis was considered positive when direct examination and culture were positive after at least one repeat. RESULTS: Twenty-nine cases of Fusarium ITP accounting for 44.6% of all ITP in the study period were diagnosed in 15 men and 14 women. The mean age of the patients was 48.4 years. Fusarium ITP were diagnosed in immunocompetent patients except in two diabetics. The mean duration of the lesions was 6.83 years. The most frequent species isolated belonged to the Fusarium solani complex with 19 cases. CONCLUSION: Fusarium ITP in a healthy subject requires regular monitoring because any subsequent decrease in immune defenses could lead to fatal hematogenous spread.
RESUMO
Pityriasis versicolor (PV) is a superficial mycosis caused by yeast of the genus Malassezia. The most common isolated Malassezia species in PV lesions differ among M. furfur, M. globosa and M. sympodialis. We purpose to determine the distribution of Malassezia species in PV patients at the seafarers' medical service in Dakar, Senegal and to examine whether any association between identified Malassezia species and patients' profile. From May 2017 to August 2017, first a questionnaire was filled to get informative data before collection of skin scrapings taken from most scaly site using sterile scalpel blade and application of scotch® for direct examination (DE). At the laboratory, DE, culture and identification by MALDI-TOF MS were done. One hundred patients with PV - all men - were included with a mean age of 34 years. Among seafarers, 81% were sailors. Clinical prevalence of PV was highest in aged adults patients with ages of 31 to 60 years (56%). Seafarers with high level of education were less representative with only 2%. The mean duration of the PV was 26.83 months. 20% of subjects suffered lesions in more than one location. The chest was the most affected anatomical site. Furthermore, possible predisposing factors associated with PV were also detected. DE was positive in 95% but culture growth only in 46%. MALDI-TOF MS analysis of the positive cultures could be performed in 84.8% (39/46). Only M. furfur was identified in 100% (39/39). In definitive, M. furfur is the only causative agent of PV in Dakar.
Assuntos
Malassezia/classificação , Malassezia/isolamento & purificação , Tinha Versicolor/microbiologia , Adolescente , Adulto , Humanos , Malassezia/genética , Masculino , Pessoa de Meia-Idade , Militares/estatística & dados numéricos , Prevalência , Fatores de Risco , Senegal/epidemiologia , Pele/microbiologia , Pele/patologia , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz , Tinha Versicolor/epidemiologia , Tinha Versicolor/patologia , Adulto JovemRESUMO
To identify the protozoa responsible for intestinal parasitosis diagnosed at Le Dantec University Hospital in Dakar, Senegal. The retrospective study included 2578 patients for whom stool samples were analyzed from 2011 to 2015. The sex ratio was 1.1. Patients' mean age was 28.5 years, with a range of 11 days to 91 years. Direct examination and the Ritchie technique were performed to search for parasites. In total, 317 patients had intestinal protozoa, for a prevalence of 12.3 %. Infections involved one (91%) or two parasites (9%). The most common species found alone were Entamoeba coli (51.5%), E. histolytica/E. dispar (17 %), and Giardia intestinalis (10.5%). The most common associations were E. coli with G. intestinalis (3.6 %) and with E. histolytica (2.4%). These infections affected significantly more outpatients than inpatients (65 %, p = 0.0049) and slightly more women (51.1%, p = 0.22) than men. Adults accounted for 67% of the confirmed intestinal protozoa: 39% aged 31-60 years, 28% aged 15-30, and only 7% older than 60 (p = 0.5). Most of the protozoa isolated were non-pathogenic. However, health education should be promoted in addition to the mass treatment program already begun to limit and even halt the spread of these neglected diseases.
Assuntos
Enteropatias Parasitárias/epidemiologia , Enteropatias Parasitárias/parasitologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Hospitais Universitários , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Senegal/epidemiologia , Distribuição por Sexo , Adulto JovemRESUMO
Recently in Senegal, a case of Plasmodium ovale malaria had led to a diagnostic difficulty due to the ignorance of this parasite and the neglect of it. The objective of this study was to actively investigate cases of P. ovale malaria that would be misdiagnosed in the health centre structures of Senegal. The study was conducted in three areas that reflect different epidemiological strata of malaria. Microscopy was performed by microscopy experts on suspected malaria patients. The results were validated by Rougemont real-time PCR. Positive P. ovale cases were genotyped by nested PCR targeting the potra gene. A total of 406 samples were taken. Microscopy of Giemsa stained thick and thin smears recorded 228 cases of Plasmodium falciparum (97%), 3 cases of Plasmodium malariae (1.3%), and 4 cases of P. ovale (1.7%). The cases of P. ovale observed at microscopy were confirmed by real-time PCR. Genotyping of P. ovale revealed 3 cases of P. ovale wallikeri and 1 case of P. ovale curtisi. The prevalence of P. ovale malaria remains low in Senegal. However, malaria microscopists should be trained to recognize non-falciparum species in order to avoid the diagnostic delays and unnecessary investigations. National malaria control program should consider those species for the better management of malaria control in the country. Simplified molecular methods like, loop-mediated isothermal amplification (LAMP) may be useful to better characterize the epidemiology of non-falciparum malaria.
Assuntos
Malária/diagnóstico , Malária/epidemiologia , Malária/parasitologia , Plasmodium ovale , Adolescente , Estudos de Coortes , DNA de Protozoário/análise , Humanos , Malária/genética , Masculino , Tipagem Molecular/métodos , Plasmodium ovale/classificação , Plasmodium ovale/genética , Plasmodium ovale/isolamento & purificação , Reação em Cadeia da Polimerase em Tempo Real , Senegal/epidemiologiaRESUMO
Fungal interdigital tinea pedis (FITP) is the most frequent dermatomycosis in industrial countries. In African tropics, it's a rare motive of consultation and is discovered while complicated. The aims of this article were: to determine the frequency of interdigital tinea pedis among overall mycological analysis in our laboratory; to study epidemiological, clinical and mycological aspects of FITP in outpatients attending the Le Dantec mycology laboratory in Dakar. A total of 62 males (60%) and 42 females (40%), mean age: 43.15 years (range: 11-81 years), were received from January 2011 to December 2015 for suspicion of FITP. Skin specimens were taken from all patients for microscopy and fungal culture. The frequency of ITP represents 5.6% (104/1851) among our overall mycological analysis. FITP was confirmed in 68 patients (SPI=65.38%), mainly located between the 4th and 5th toes and 71 fungal species were isolated (CPI=68.27%). Among patients with confirmed FITP, there were 38 males (56%) and 30 females (44%). The prevalence was highest in patients between 44 and 54 years (26%). Candida albicans, Fusarium solani and Trichophyton interdigitale were shown to be the most common pathogens respectively for yeasts (39%), non-dermatophytic filamentous fungi (NDFF; 21%) and dermatophytes (11%). So FITP isn't a common reason for consultation in Dakar but its simple parasitic index (SPI) is still very high and dermatophytes formerly the main causative agents are being relegated to third place behind yeasts and NDFF.
Assuntos
Tinha dos Pés/epidemiologia , Dedos do Pé/microbiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Senegal/epidemiologia , Tinha dos Pés/microbiologia , Adulto JovemRESUMO
A Senegalese lady of 17 years old presented right hand tinea unguium on all fingernails except the thumb lasting for 10 years. Mycological analysis showed with the direct examination 20% KOH mount numerous septate hyphae. Culture revealed Microsporum langeronii at a first time. The mycological analysis resumption with sampling scalp revealed a tinea capitis with M. langeronii then culture of nail pieces confirmed in a second time M. langeronii also associated with Trichophyton soudanense in the tinea unguium.
Assuntos
Microsporum/isolamento & purificação , Onicomicose/microbiologia , Tinha do Couro Cabeludo/diagnóstico , Trichophyton/isolamento & purificação , Adolescente , Diagnóstico Diferencial , Feminino , Humanos , Onicomicose/diagnóstico , Senegal , Tinha do Couro Cabeludo/microbiologiaRESUMO
INTRODUCTION: Superficial fungal infections, particularly of the skin, scalp and nails are very common and have been reported worldwide. The most common causative agents of these mycoses are dermatophytes, yeasts and molds. However, these agents vary with time and depend on many factors including the geography. The objective of this study was to identify the causative agents of superficial mycoses diagnosed at the Le Dantec University Hospital in Dakar (Senegal). MATERIAL AND METHODS: The study concerned 1851 outpatients received in the parasitological and mycological laboratory of Le Dantec hospital during the period from January 2011 to December 2015. Every patient benefited from direct examination and mycological culture. RESULTS: Among the 1851 patients, 633 were confirmed with superficial mycoses and the prevalence was 34.2 %. The age of patients ranged from two months to 81 years with a mean age of 31 years. Superficial mycoses were found more in women (70.3 %) than men (29.7 %) and a little more than thirty-nine percent (39.3 %) were adults. The causative agents identified were: dermatophytes (58 %), yeast (36.7 %) and non-dermatophytic filamentous fungi (NDFF, 5.3 %). The most isolated species were: Candida albicans (26.9 %), Trichophyton soudanense (24.9 %) and T. rubrum (13.7 %). These fungi were responsible for different clinical aspects, isolated and other associated. Among the isolated clinical aspects, those affecting hair (tinea capitis) were by far the largest with 44.8 %, followed by tinea unguium (34.5 %). Associations were especially type of tinea capitis and tinea manuum (2.4 %) and toenails onychomycosis associated with interdigital tinea pedis (2.7 %). Tinea capitis agents were exclusively dermatophytes and the predominant agent was T. soudanense with 47,8 %. Tinea unguium agents were yeast (79 %), dermatophytes (18 %) or NDFF (3 %) and the most found species was C. albicans (63.9 %). Dermatophytes, yeasts and molds were respectively found more in children and young adults, older adults and young adults and older adults and the elderly. CONCLUSION: In definitive, these epidemiological data should enable better diagnostic and therapeutic management of superficial mycoses.
Assuntos
Arthrodermataceae/classificação , Dermatomicoses/epidemiologia , Dermatomicoses/microbiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Arthrodermataceae/isolamento & purificação , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Senegal/epidemiologia , Adulto JovemRESUMO
A patient presented with intertrigo at the second, third and fourth interdigitals spaces lasting for four years in which Fusarium solani was highlighted. The search for contributing factors revealed a concept of foot washing with water at least five times a day for ablutions, associated with wearing closed shoes all day and the absence of immunosuppression and diabetes. The diagnosis of Fusarium was made on the basis of direct examination and culture. Combined treatment with griseofulvin oral and topical ciclopirox was introduced and allowed healing after 45 days at which an antifungal powder was prescribed for relay. This case adds to the rare cases of intertrigo Fusarium sp. and confirms the frequent practice of ablutions as favoring factor.
Assuntos
Fusarium/isolamento & purificação , Tinha dos Pés/microbiologia , Adulto , Antifúngicos/administração & dosagem , Ciclopirox , Griseofulvina/administração & dosagem , Humanos , Masculino , Piridonas/administração & dosagem , Senegal , Tinha dos Pés/tratamento farmacológicoRESUMO
INTRODUCTION: In hospitals, the quality control of the air is a key element. Indeed airborne fungi constitute a real danger for patients hospitalized in wards at risk of nosocomial infections especially when they are immunocompromised. OBJECTIVES: The objective was to determine the qualitative fungal flora composition of wards at risk of nosocomial infections at Le Dantec teaching hospital. MATERIALS AND METHODS: Between April and May 2013, 73 samples were collected from 45 compartments within seven services at risk of nosocomial infection at Aristide Le Dantec teaching Hospital (Dakar). Samples were made once by sedimentation method and the percentage of positive cultures was 100%. The most represented species were Cladosporium spp. (91.1%), Aspergillus spp. (86.6%), Penicillium spp. 71.1% and Candida spp. (57.7%). Candida albicans and Aspergillus fumigatus were isolated respectively at 15.5% and 11.1%. Wards have been classified according to the number of species isolated; 11 species in pediatric oncology, 10 species in pediatric surgery/neonatal and intensive care, nine species for oncology, eight species in general surgery and dermatology, and four species in internal medicine. CONCLUSION: This study shows that fungi causing nosocomial infections are present in hospital and their monitoring should be included in the program of Nosocomial Infections Prevention Committees (CLIN).
Assuntos
Infecção Hospitalar/microbiologia , Fungos/isolamento & purificação , Hospitais de Ensino , Microbiologia do Ar , Aspergillus/isolamento & purificação , Candida/isolamento & purificação , Infecção Hospitalar/epidemiologia , Estudos Transversais , Contaminação de Equipamentos/estatística & dados numéricos , Fungos/classificação , Hospitais de Ensino/estatística & dados numéricos , Humanos , Penicillium/isolamento & purificação , Fatores de Risco , Senegal/epidemiologiaRESUMO
INTRODUCTION: Tinea capitis is considered as a public health problem in Senegal. The aim of this study was to investigate trends in the incidence, the mycological and epidemiological aspects of tinea capitis diagnosed at Le Dantec Hospital in Dakar. METHOD: Our work is a retrospective study concerning all scalp samples taken by the parasitology laboratory, over a 6-year period (2008-2013). RESULTS: A total of 1640 specimens were examined. Of these, 566 were positive with direct examination and after culture. We noted the reduction of patients and of the incidence of tineas during 6 years with variations of 147 (46.82%) to 37 (22.02%). The average incidence of the tineas during six years was 34.51%. Patients' age varied between 1 to 83 years with a mean of 27.33 years. Prevalence varied between age groups, with 10.61 % in adults between 20 to 29 years, 7.19% in children between 0 to 9 years, 6.04% between 10 to 19 years, and 5.91% in adults between 30 to 39 years. Women were more infected 469 (82.9%) than men 97 (17.1%). The main dermatophytes isolated were: T. soudanense in 318 cases (56.18%), T. rubrum in 104 cases (18.37%), M. langeronii in 72 cases (12.72%), M. canis in 36 cases (6.36%), and T. mentagrophytes in 26 cases (4.60%). CONCLUSION: Our study showed a decrease in the annual incidence of tinea capitis over the study period with an evident increase in trichophytic tinea. This study showed that tinea is endemic in Senegal mainly among women between 20 and 29 years.
Assuntos
Tinha do Couro Cabeludo/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Senegal/epidemiologia , Tinha do Couro Cabeludo/microbiologia , Adulto JovemRESUMO
In recent years, the incidence of superficial fungal infections involving nondermatophytic and noncandidal fungi increased considerably. The objective of this work was to analyze the epidemiological, clinical and mycological fungal infections due to nondermatophytic and noncandidal fungi diagnosed in the laboratory of parasitology-mycology of Le Dantec hospital in Dakar. With a retrospective study of the various cases of nondermatophytic and noncandidal fungi isolated in the laboratory of parasitology-mycology during the period of November 2013 to December 2014, we collected 22 cases of infections in 11 men and 11 women; age ranging from 17 to 75 years with a mean of 45.3 years (sex ratio=1): eight cases of intertrigo, seven cases of onychomycosis, four cases of palmoplantar keratoderma (KPP), a case of onychomycosis associated with interdigital intertrigo, a case of infectious myositis and one case of African histoplasmosis. We have isolated and identified a total of 22 nondermatophytic and noncandidal fungi: ten Fusarium, five Trichosporon, two Chrysosporium, two Geotrichum, one Rhodotorula, one Neoscytalidium dimidiatum and one Histoplasma capsulatum var. duboisii. So we are seeing the emergence of nondermatophytic and noncandidal increasingly isolated from superficial and local lesions. These fungi, generally contaminants or commensal, cause a problem regarding their direct involvement in pathological processes in which they are isolated. So we should respect the recommendations proposed for their involvement in pathological processes and, by a collaboration between clinician and biologist, demonstrate their real involvement through effective, targeted treatment.
Assuntos
Dermatomicoses/epidemiologia , Dermatomicoses/microbiologia , Adolescente , Adulto , Idoso , Feminino , Dermatoses do Pé/epidemiologia , Dermatoses do Pé/microbiologia , Fungos/isolamento & purificação , Histoplasmose/epidemiologia , Histoplasmose/microbiologia , Hospitais Universitários/estatística & dados numéricos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Onicomicose/epidemiologia , Onicomicose/microbiologia , Estudos Retrospectivos , Senegal/epidemiologia , Adulto JovemRESUMO
In developing countries where systemic antifungal are often unavailable, treatment of filamentous fungi infection as Fusarium is sometimes very difficult to treat. We report the case of a keratomycosis due to Fusarium oxysporum treated by povidone iodine eye drops and oral fluconazole. The diagnosis of abscess in the cornea was retained after ophthalmological examination for a 28-year-old man with no previous ophthalmological disease, addressed to the Ophthalmological clinic at the University Hospital Le Dantec in Dakar for a left painful red eye with decreased visual acuity lasting for 15 days. The patient did not receive any foreign body into the eye. Samples by corneal scraping were made for microbiological analysis and the patient was hospitalized and treated with a reinforced eye drops based treatment (ceftriaxone+gentamicin). The mycological diagnosis revealed the presence of a mold: F. oxysporum, which motivated the replacement of the initial treatment by eye drops containing iodized povidone solution at 1% because of the amphotericin B unavailability. Due to the threat of visual loss, oral fluconazole was added to the local treatment with eye drops povidone iodine. The outcome was favorable with a healing abscess and visual acuity amounted to 1/200th. Furthermore, we noted sequels such as pannus and pillowcase. The vulgarization of efficient topical antifungal in developing countries would be necessary to optimize fungal infection treatment.
Assuntos
Úlcera da Córnea/tratamento farmacológico , Infecções Oculares Fúngicas/tratamento farmacológico , Fluconazol/administração & dosagem , Fusarium/isolamento & purificação , Povidona-Iodo/administração & dosagem , Administração Oral , Adulto , Úlcera da Córnea/microbiologia , Quimioterapia Combinada , Infecções Oculares Fúngicas/microbiologia , Fusarium/fisiologia , Humanos , Masculino , Soluções OftálmicasRESUMO
OBJECTIVE: Onychomycosis are a mycose of nail due to fungi. According to published data, they stands for half of all nail abnormalities. This survey was carried out to determine the frequency and the fungi involved in onychomycosis in Dakar. MATERIAL AND METHODS: This study was carried out at the laboratory of parasitology and mycology at Le Dantec Hospital, in Senegal from January 2008 to December 2012 and includes 507 patients. RESULTS: Onychomycosis were mycologically proved in 58.78% (298/507) of patients. Patient's age varies between 02 years to 82 years with a mean of 34.24 years. Women were more infected than men (sex-ratio was 2.38). Onychomycosis due to dermatophyte represented 37.92% (113/298) of patients and were essentially located on toes (60.71%). Distal and lateral subungual onychomycosis was the most frequent clinical form. Trichophyton rubrum and Trichophyton interdigitale were isolated respectively in 53.6% and 26.1% on toes. Yeasts represented 59.06% (176/298) of onychomycosis and were essentially located on fingernails (80.11%). Candida albicans represented 90.86% of isolated yeasts. Molds were isolated in nine cases (3.02%) and predominated in toenails. CONCLUSION: Among 507 patients with onychopathy, this study identified 298 cases of onychomycosis. T. rubrum was the main dermatophytes and was isolated on toenails whereas on fingernails C. albicans was more often observed.
Assuntos
Dermatoses do Pé/microbiologia , Dermatoses da Mão/microbiologia , Onicomicose/microbiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Dermatoses do Pé/epidemiologia , Dermatoses da Mão/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Onicomicose/epidemiologia , Estudos Retrospectivos , Senegal/epidemiologia , Adulto JovemRESUMO
INTRODUCTION: Dermatophytosis is a disease caused by dermatophytes, filamentous fungi adapted to human and animal keratin, colonizing and infecting human skin. The goal of this study was to identify dermatophytes responsible for dermatophytosis among patients, seeking for care in Dakar. Material and methods This study was carried out at the laboratory of parasitology and mycology at Le Dantec Hospital, in Senegal between June 2007 and December 2011, and included 2026 patients. RESULTS: Among these 2026 patients, 796 patients presented a dermatophytosis, confirmed after direct examination and/or culture in 1044 specimens. Patients' age varied between 3months to 89years with 25.5 years of age average; the infestation index was 39.3%. Patients between 20-29years were more infested with 15.3%, followed by 10-19years (9.1%), 0-9years (8.7%), 30-39years (2.7%), 40-49years (1.5%), 50-59years (1.3%), 60-69years (0.4%), 70-79years (0.2%), and 80-89years (0.1%). Women were more infected (77%) than men 23%. The main species isolated were Trichophyton soudanense (52.78%), Trichophyton rubrum (30.94%), Microsporum canis (4.89%), Trichophyton mentagrophytes var. interdigitale (4.50%), Microsporum langeronii (3.54%), Trichophyton mentagrophytes var. mentagrophytes (1.82%). CONCLUSION: This study shows that dermatophytes and dermatophytosis are endemic to Senegal.
Assuntos
Doenças Endêmicas , Tinha/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Hospitais Urbanos/estatística & dados numéricos , Humanos , Lactente , Masculino , Microsporum/isolamento & purificação , Pessoa de Meia-Idade , Onicomicose/epidemiologia , Onicomicose/microbiologia , Prevalência , Estudos Retrospectivos , Dermatoses do Couro Cabeludo/epidemiologia , Dermatoses do Couro Cabeludo/microbiologia , Senegal/epidemiologia , Distribuição por Sexo , Especificidade da Espécie , Tinha/microbiologia , Trichophyton/isolamento & purificação , Adulto JovemRESUMO
This is a prospective, descriptive and analytic study conducted from July 2011 to September 2011 at the Children National Hospital Albert Royer of Dakar and at the Vélingara Health District. It was focused on children under 15 without reference to HIV status. For each child, a sample of stool was examined by the Ziehl-Neelsen modified staining and by ELISA using the "Cryptosporidium Antigen Detection Microwell ELISA kit" designed to detect Cryptosporidium spp antigens. The aim of our study was to determine the prevalence of cryptosporidiosis in rural and hospital areas and to measure the performance of the ELISA kit that we used. Out of the 375 stool examinations performed with the Ziehl-Neelsen modified staining, 17 had revealed the presence of Cryptosporidium spp (4.53%). The prevalence in rural areas was 2% while the hospital prevalence was 7.4%, of which 1.8% (1/57) were from urban areas and 9.8% (12/122) from suburban areas. No positive case was observed in children over 10 years. By ELISA, 23 positives cases were reported corresponding to a prevalence of 6.13% (1.8% in children living in urban areas, 13.1% in children from suburban areas and 3%living in rural areas).The correlation of this assay with the Ziehl-Neelsen modified staining, considered as the reference method, found that this assay had a sensitivity of 58.82% and a high specificity reaching 96.37%. The positive predictive value (PPV) was 43.4% while the negative predictive value was 98%. Cryptosporidiosis is a significant cause of parasitic infection among children in Senegal. Antigen detection of Cryptosporidium spp by ELISA in stool can be a complementary tool in the diagnosis of cryptosporidiosis.