Epidemiology of dermatophytoses in Sfax, Tunisia
Laboratory of Parasitology-Mycology, HU Habib Bourguiba Sfax, Sfax, Tunisia.Mycoses (Impact Factor: 2.24). 02/2009; 52(6):534-8. DOI: 10.1111/j.1439-0507.2008.01651.x
The distribution of dermatophytes varies in different countries and geographical areas depending on several factors. To determine the frequency of aetiological agents and the clinical variants of dermatophytoses, we carried out a study between 1998 and 2007. Out of 25 432 subjects suspected to have superficial mycoses, 9960 (39.2%) were affected with dermatophytoses; 14957 positive samples were obtained. The mean age was 35.7 years (range: 21 days to 97 years). Sex ratio was 0.9. Our patients were from urban regions in 81.9% of cases. The most common type of infection was onychomycosis (30.3%), followed by tinea pedis (24.8%), intertrigo (21.7%), tinea corporis (11.4%) and tinea capitis (9.6%). Fifteen patients had generalised dermatophytosis. Hadida and Schousboe disease was diagnosed in one case with lethal evolution. The most isolated dermatophyte was Trichophyton rubrum (74.5%), followed by T. violaceum (7.9%), T. mentagrophytes (7.5%), Microsporum canis (3.8%), Epidermophyton floccosum (0.7%) and T. verrucosum (0.54%). Other species were occasionally isolated: T. schoenleinii, T. tonsurans, M. audouinii and M. ferrugineum. The prevalence of dermatophytoses remains high in our country (996 cases/year). Trichophyton rubrum is the predominant causal agent. However, zoophilic agents become more prevalent. Epidemiological surveys are an essential tool for developing strategies for infection control.
Conference Paper: Universal protection and control applied to a 3-breaker transfer scheme[Show abstract] [Hide abstract]
ABSTRACT: A new modular hardware and software based protection and control system has been developed to be more flexible and economical than conventional relay platforms for the development of custom protection and control schemes. The system includes a computer aided engineering (CAE) package to permits rapid customization of the scheme's logic and protective elements. An embedded virtual test system allows for rapid debugging and testing. To demonstrate the system, a 3-breaker transfer scheme was developed to replace an older, existing transfer scheme based on discrete protective and logic device. This scheme integrates the transfer logic and the protective relaying functions in to one microprocessor based device
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ABSTRACT: Background The aim of the retrospective study reported here was to evaluate the real importance of tinea capitis (TC) among central Tunisian patients attending the Service of Dermatology in Sousse, Tunisia, and at assessing the dermatophytes that cause TC and their dynamics over a period of 16 years. Patients and methods From 1990 to 2005, 1137 patients, aged between 1 and 75 years (median: 8.63 years) were referred to the laboratory of Parasitology-Mycology of Farhat Hached hospital by the Service of Dermatology in Sousse, for clinical suspicion of TC. All patients underwent a direct examination of hair specimens together with culture on Sabouraud dextrose agar medium. Results Direct examination and culture confirmed to TC in 1137 patients. Out of 1048 whose age was known, 801 (76.4%) were younger than 10 years old. Sixty were adults with a median age of 34.5 years. The dermatophytes isolated were as follows: Trichophyton violaceum in 565 cases (53.4%), Microsporum canis in 395 cases (37.3%), T. mentagrophytes in 37 cases (3.5%), T. schoenleinii in 26 cases (2.5%), T. ochraceum in 24 cases (2,3%), T. rubrum in four cases (0,37%), M. gypseum in four cases (0.37%), M. langeronii in two cases (0.17%) and T. tonsurans in one case (0.09%). T. violaceum was more frequently reported in females than M. canis. Out of 60 adults, 42 were females. The distribution of the causal species throughout the study period showed a dramatic decrease in favus, and a decreasing trend in T. violaceum. In contrast, the incidence of M. canis steadily increased. Nearly all patients were treated with griseofulvin. A total of 1123 patients were cured by 6 to 12 weeks; while 14 showed a persistent alopecia. Conclusion T. violaceum is still the leading species among central Tunisian patients with TC. The incidence of M. canis has been rising lasting recent decades. T. ochraceum is evolving as a main causative agent of inflammatory TC.
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ABSTRACT: Tinea capitis favosa, a chronic inflammatory dermatophyte infection of the scalp, affects over 90% of patients with anthropophilic Trichophyton schoenleinii. T. violaceum, T. verrucosum, zoophilic T. mentagrophytes (referred to as 'var. quinckeanum'), Microsporum canis, and geophilic M. gypseum have also been recovered from favic lesions. Favus is typically a childhood disease, yet adult cases are not uncommon. Interestingly, favus is less contagious than other dermatophytoses, although intrafamilial infections are reported and have been widely discussed in the literature. Clinical presentation of T. schoenleinii infections is variable: this fungus can be isolated from tinea capitis lesions that appear as gray patches, but symptom-free colonization of the scalp also occurs. Although in the past T. schoenleinii was the dominant fungus recovered from dermatophytic scalp lesions, worldwide the incidence has decreased except in China, Nigeria, and Iran. Favus of the glabrous skin and nails are reported less frequently than favus of the scalp. This review discusses the clinical features of favus, as well as the etiological agents, global epidemiology, laboratory diagnosis, and a short history of medical mycology.
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