Asymptomatic dermatophyte scalp carriage in school children in Adana, Turkey

The aim of this study was to determine the prevalence of asymptomatic dermatophyte scalp carriage and symptomatic tinea capitis in Adana Province, Cukurova region, Turkey. For this purpose, a screening study was performed in five schools, between January 2004 and May 2005, covering a total of 5143 children with 2740 (53.3%) boys and 2403 (46.7%) girls, aged 7-14 years (9.6 +/- 2.0). The diagnosis was made using the cotton swab method with inoculation onto Sabouraud glucose agar amended with cycloheximide, chloramphenicol and gentamicin. Among 10 (0.2%) cases, six asymptomatic carriers (mean age 10.7 +/- 2.3) and four symptomatic cases (mean age 8.3 +/- 0.5) were detected, all of whom were boys and had immigrated from the south-eastern and eastern region of Anatolia, Turkey. The mean age differences were found to be statistically significant (Mann-Whitney U=3.000, P=0.046). Boys were found to be more prone to asymptomatic carriage (P=0.033), but not tinea capitis (P>0.05). Zoophilic dermatophytes, namely Microsporum canis (40%) and Trichophyton mentagrophytes var. mentagrophytes (40%) were the most commonly isolated species, followed by anthropophilic Trichophyton tonsurans (10%), while no causative agent was detected in a case (10%) with tinea capitis superficialis. Scalp cultures were found to be dermatophyte-negative after 3- to 8-month follow-up in cases with asymptomatic carriage. As a conclusion, the prevalence of asymptomatic carrier state was similar with the prevalence of symptomatic cases, and we found a predominance of zoophilic species.