EPIDEMIOLOGICAL STUDIES AND MOLECULAR CHARACTERISATION OF DERMATOPHYTES AMONG ALMAJIRAI IN MAKARFI LOCAL GOVERNMENT AREA OF KADUNA STATE

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ABSTRACT

 

Dermatophytes are fungi that have the capacity to invade keratinised tissues of humans and animals to produce an infection. The study was conducted to determine the epidemiology and molecular characterisation to identify of the dermatophytes associated with almajirai in Makarfi Local Government Area (L. G. A.) of Kaduna State. Samples were collected from the almajirai that had lesions on their scalps. The sites of infection were cleaned with 70% alcohol and followed by the collection of scalp scrapings using sterile scalpel blades. Sabouraud‘s dextrose agar (DibenDiagnostics, U.K) containing cycloheximide and chloramphenicol was used. Identification of isolates was through observation of colonial morphology and microscopic appearance of lactophenol cotton blue stained fungal specimen obtained from culture. Molecular identification was carried out using primers which contained the ITS1-2, 18S rRNA and 28S rRNA regions. A total of 408 almajirai were selected and examined, out of which 153 (37.5%) were found to be infected with different species of dermatophytes. From the 153 samples collected 119 (78.1%) were culture positive while no growth was observed in 34 samples (21.9%). Dermatophytes identified were members of Trichophyton (T.) and Microsporum (M.) genera. The species isolated include Trichophyton rubrum45 (29.4%), Trichophyton mentagrophytes 16 (10.5%), Trichophyton violaceum 3 (2.0%), Trichophyton soudanense 2 (1.3%), Trichophyton tonsurans 17 (11.1%) Trichophyton concentricum 4 (2.6%), Trichophyton quickeanum 01 (0.7%), Trichophyton megninii 01(0.7%), Trichophyton verrucosum 01 (0.7%), Microsporum canis 05 (3.3%), Microsporum fulvum 07 (4.6%), Microsporum gallinae 10 (6.5%), Microsporum audouinii 01 (0.7%), Microsporum equinum 05 (3.3%), and Microsporum nanum 01 (0.7%). Highest rate of infection occurred in the almajirai of 5 - 7years (54.67%) and the least infection was found among 17-19 age group (P< 0.05). Those that reside with their parents or guardians had low infection rate (29.17%) compared to those that reside in the tsangaya. Based on the number of rooms in a house, rate of infection was higher among almajirai that live in houses that have one or two rooms (31.25%). Participants that share beddings had higher infection rate (31.17%) than those that do not share beddings (31.12%). The almajirai that shaved at the Barber‘s shop had the less infection (27.45%) than those that barb at home (31.37%). Contact with pets and livestock accounted for 29.35% infection while those that were not in contact with pets and livestock had an infection rate of 28.70%. From PCR result, regions of amplification consisting of expected sizes of between 200 and 500 base pairs were obtained for Microsporum canis, Microsporum audouinii, Trichophyton rubrum, Trichophyton tonsurans and Trichophyton mentagrophytes using a dermatophyte specific primer (ITS1-2). Using 18S ribosomal RNA primer, approximately 500 base pairs band on ITS1-2 was observed in M. canis, T. rubrum, and T. tonsurans while band patterns of 560 base pairs band on ITS1-2 were observed in M. audoinii and T. mentagrophytes. M. canis, M. audouinii, T. violaceum, T. rubrum, T. mentagrophytes and T. verrucosum were visible around 200 base pair long band. A 300 base pair long band was identified with the 28S ribosomal RNA primer PCR on M. canis, T. violaceum, T. mentagrophytes T. tonsurans, T. verrucosum and M. gypseum. A 300 base pair-long was observed in M. audouinii, T. rubrum and M. fulvum on the 18S ribosomal RNA primer. It is therefore necessary that the Mallams, parents/guardians as well as the almajirai are educated on maintaining adequate personal, community and environmental hygiene through general sanitation. Contact with pets and livestock should be minimised and also there is need for provision of good infrastructure and upgrading of the informal settlements by the government so as to improve the living conditions of the almajirai.

 

 

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TABLE OF CONTENTS

 

 

 

Cover Page .......................................................................................................................................

i

Fly Leaf ……………………………………………………………………………………….......

ii

Title Page...................................................................................................................................

iii

Declaration......................................................................................................................................

iv

Certification.....................................................................................................................................

v

 

Dedication     ………………………………………………………………………………………vi

 

Acknowledgement.........................................................................................................................

vii

Abstract...........................................................................................................................................

ix

Table of Contents.............................................................................................................................

x

List of Figures................................................................................................................................

xv

List of Tables................................................................................................................................

xvi

List of Plates................................................................................................................................

xvii

CHAPTER ONE: INTRODUCTION. .......................................................................................

1

1.0

INTRODUCTION ………………………………………………………………………… 1

1.1

Statement of Research Problem ………………………………………………………….. 6

1.2

Justification ………………………………………………………………………………... 8

1.3

Aim of the Study …………………………………………………………………………... 9

1.4

Objectives of the Study ……………………………………………………………………. 9

1.5

Hypotheses ………………………………………………………………………………... 10

CHAPTER TWO: LITERATURE REVIEW …………………………................................. 11

2.0

 

General Properties of Fungi ……………………………………………………………. 11

2.1

 

Historical Background …………………………………………………………………. 12

2.2

 

Etiology of Dermatophytosis …………………………………………………………... 14

2.2.1.

Trichophyton …….……………………………………………………………………... 14

2.2.2

Microsporum …………………………………………………………………………… 15

2.2.3

Epidermophyton ………………………………………………………………………... 15

2.3.

Ecological Classification ………………………………………………………………. 15

2.3.1

Anthropophilic …………………………………………………………………………. 16

 

 

 

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2.3.2     Zoophilic: ………………………………………………………………………………. 16

 

2.3.3 Geophilic ………………………………………………………………………………. ...17

 

2.4 Clinical manifestation of dermatophytes ………………………………………………...... 17

 

2.4.1 Tinea capitis (ringworm of scalp): ……………………………………………………….. 18

 

2.4.2 Tinea barbae ……………………………………………………………………………… 18

 

2.4.3 Tinea faciei ……………………………………………………………………………….. 18

 

2.4.4 Tinea manuum (hands) ……………………………………………………………………19

 

2.4.5 Tinea unguium ……………………………………………………………………….……19

 

2.4.6 Tinea cruris (ringworm of the groin) ……………………………………………….……..19

 

2.4.7 Tinea pedis (athlete's foot) …………………………………………………………….…. 20

 

2.4.8 Tinea corporis (ringworm on the trunk) ……………………………………………..…… 20

 

2.5     Identification of dermatophytes ……………………………………………………….… 21

 

2.5.1   Conventional method …………………………………………………………………... 21

 

2.5.1.1 Cultural Characteristics ………………………………………………………………... 21

 

2.5.1.2 Macroscopic morphology …………………………………………………………..…. 23

 

2.5.1.3 Microscopic morphology ……………………………………………………………… 23

 

2.5.2     Molecular Biological Methods ………………………………………………………... 25

 

2.6         Transmission of dermatophytes ……………………………………………………..… 27

 

2.7         Prevalence of dermatophytosis ……………………………………………………...… 27

 

2.8        Geographical distribution of dermatophytes species …………………………………... 27

 

2.9        Epidemiology ………………………………………………………………………    … 29

 

2.9.1 Reports in Nigeria …………………………………………………………………….…. 29

 

2.8      Social economic impact of dermatophytosis ………………………………………….… 35

 

 

CHAPTER THREE: MATERIALS AND METHODS ……………………………………. 36

 

3.0 Materials and Methods ………………………………………………………………..…… 36

 

3.1 Study Area …………………………………………………………………………………. 36

 

3.2 Study Design …………………..…………………………………………………………… 38

 

3.3 Study Population ………...………………………………………………….……………… 38

 

3.4 Sample Size Determination………………………………………………………………… 39

 

3.5 Sampling technique and Specimen Collection ……………………………………………...39

 

 

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3.6 Inclusion Criteria …………………………………………………………………….…..… 40

 

3.7 Exclusion Criteria …………………………………………………………………….….… 40

 

3.8 Administration of Structured Questionnaire ………………………………………..……… 40

 

3.9  Laboratory Investigation ………………………………………..……………………..……40

 

3.10 Preparation of Media ………………………………………………………………….....…41

 

3.11 Isolation of Dermatophytes using Cultural Techniques ……….…………………..….…....41

 

3.11.1 Identification of the Isolated Dermatophytes ……………………………………….….. 42

 

3.11.2 Macroscopical Examination of the Cultures ……………………………………………. 42

 

3.11.3 Microscopical Examination of the Cultures ……………………………………………. 42

 

3.12 Molecular Identification of Dermatophytes ……………………………………………… 43

 

3.12.1 Genomic DNA Extraction from Dermatophyte Cultures …………………….………… 43

 

3.12.2 Polymerase Chain Reaction (PCR) Procedure ………………………………………….. 44

 

3.12.3 Cyclic Parameters for PCR Amplification………………………………………………. 44

 

3.12.4 Agarose Gel Electrophoresis ……………………………………………….…….……...44

 

3.13 Data Management……………………………………………………………….………… 45

 

3.14 Ethical Approval and Informed Consent ………………………………………….….……45

 

CHAPTER FOUR: RESULTS ………………………………………….…………………… 47

 

4.0 Results ……………………………………………………………………………………… 47

 

4.1 Number of Samples collected from each tsangaya ………………………………………….47

 

4.2 Frequency of Dermatophyte Species Isolated ……………………………………………….49

 

4.3 MORPHOLOGICAL AND MICROSCOPIC CHARACTERISTICS….……….……….. 53

 

4.3.1 Trichophyton rubrum………………………………………………………...…………… 53

 

4.3.2 Trichophyton mentagrophytes…………………………………………………………… 53

 

4.3.3 Trichophyton tonsurans………………………………………………...………………….53

 

4.3.4 Microsporum gallinae……………………………………………………………………. 53

 

4.3.5 Microsporum canis…………………………………………….……….………………… 54

 

4.3.6 Trichophyton violecium……………………………………………...…………………… 54

 

4.3.7 Microsporum fulvum……………………………………………………………………… 54

 

4.3.8 Microsporum equinum……………………………………………….…………………… 54

 

4.3.9 Trichophyton soudanense………………………………………………………………… 54

 

4.3.10 Trichophyton concentricum………...…………………………………………………….55

 

 

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4.3.11 Trichophyton verrucosum……………………….……………………….……………… 55

 

4.4.1 Distribution of Dermatophytes Based on the Age Groups of Almajirai………………….. 67

 

4.4.2 Distribution of Dermatophytes Based on the Occupation of Parents/Guardians….........… 67

 

4.4.3 Distribution of Dermatophytes Based on Number of Rooms in the House………….…… 67

 

4.4.4 Distribution of Dermatophytes Based on their Nature of Residence…………………….. 68

 

4.4.5 Distribution of Dermatophytes Based on Type of Living Quarters………………………. 68

 

4.4.6 Distribution of Dermatophytes Based on Number of adults in the house…………….….. 68

 

4.4.7 Distribution of Dermatophytes Based on Number of Almajirai in the House……………. 69

 

4.4.8 Sharing of Beddings…………………………………………………………………….… 69

 

4.4.9 Type of Bed.……...……………………………………………………….………….…… 69

 

4.4.10 Participants Bathing Frequency……..…………………………………………...……….70

 

4.4.11 Frequency of Soap Use in Bathing……….……………………….…………………….. 70

 

4.4.12 Frequency of Shaving………………….………………………………………….…….. 70

 

4.4.13 Place of Shaving………………………………………….………….……………….…..71

 

4.4.14 Relationship with Pets and Livestock…..………………………….……………….…… 71

 

4.4.15 Type of Pet or Livestock Kept……………………………………………………...…… 71

 

4.5 Distribution of Dermatophyte Species Based on the Ages of Almajirai …...……………… 78

 

4.6 Molecular Identification of Dermatophyte Species ……………………………...………… 82

 

4.6.1 Identification of Dermatophyte Species using PCR ………………………….………….. 82

 

CHAPTER FIVE: DISCUSSION…………………………………………………………….. 86

 

5.0 Discussion ………………………………………………………………………………….. 86

 

5.1 Prevalence of Dermatophytes Infection …………………………………………………… 86

 

5.2 Isolation and Identification of Dermatophyte Species ………………………………….…. 89

 

5.3 Identification of Dermatophyte Species using PCR …………………………………….…. 93

 

 

CHAPTER SIX: CONCLUSION AND RECOMMENDATIONS ……………………..… 94

 

6.0 CONCLUSION………………………………………………………………………….…. 94

 

6.1 RECOMMENDATIONS…………………………………………………………….…….. 94

 

REFERENCES ………………………………………………………………………..………..95

 

APPENDICES …………………………………………………………………………..…… 109

 

 

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LIST OF FIGURES

 

Figure          Title                                                                                                                                                                Page

 

I: Map of Makarfi L. G. A. showing sampling areas ……………………………………….. 37

 

II: Dermatophytes species isolated ……………………………………………………………50

 

III   : Distribution of Dermatophytes Based on the Age Groups of Almajirai…...............….. 72 IV: Distribution of Dermatophytes based on Occupation of Parents/Guardians………..... 73 V: Distribution of Dermatophytes based on their Nature of Residence……..…………..… 74

 

VI: Distribution of Dermatophytes based on their source ot water for Domestic use….… 77

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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LIST OF TABLES

 

Table                    Title                                                                                                                                                          Page

 

3.1: Nucleotide sequences of the primers used in this study ………………….………………. 46

 

4.1: Samples collected from participants in each tsangaya ……………………………..…….. 48

 

4.2: Distribution of dermatophytes infection among almajirai in

 

Makarfi L. G. A. in Respect to Risk factors …….…………………………………...…..……. 73

 

4.3      Distribution       of     dermatophyte      species     based     on       the       age       of      participants

 

…………………………………………………...………………………………………..…….. 80

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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LIST OF PLATES

 

Plate                                                                                                                                                                                          Page

 

I: Showing scalp lesions on a participant ……………………………………...………………51

 

II: Showing (arrow) scalp lesions on a participant.............................................................................................. 52

 

III: Trichophyton rubrum …………………………………………………………..…………………… 56 IV: Trichophyton mentagrophytes…….. ……………………………………….…………………….. 57

 

V:  Trichophyton tonsurans ………………………………………………………….…………………. 58.

 

VI: Microsporum gallinae ……………………………..………………………….……………………. 59

 

VII: Microsporum canis ……………………………………..…………………….……………………. 60

 

VIII: Trichophyton violecium ……………………………………..……………….…………………… 61

 

IX: Microsporum fulvum ……………………………………………….………………….……………. 62

 

X:  Microsporum equinum ………………………………………………..……………...……………… 63 XI: Trichophyton soudanense ……………………………………………………..…………………… 64 XII: Trichophyton concentricum ……………………………………………….……………………… 65 XIII: Trichophyton verrucosum ………………………………………………….…………………….. 66 XIV: PCR amplification from dermatophyte strains with the ITS1-2 region. ………………… 83 XV: PCR amplification from dermatophyte strains with the 18S ribosomal RNA region……... 84 XVI: PCR amplification from dermatophyte strains with the 28S ribosomal RNA region……. 85

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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CHAPTER ONE

 

1.0         INTRODUCTION

 

The word dermatophyte literally means ―skin plant‖. The suffix ‗phyte‘ implies that these organisms are plants and therefore in the present context, it is a misnomer because the fungi are phylogenetically not related to plants (Chander, 2002). Dermatophytoses are commonly referred to as ringworm or tinea infections. The name ringworm was coined to describe the circular lesion produced by the dermatophytes on skin or scalp (Wetizman and Summerbell, 1995). The term ‗tinea‘ is derived from Latin word meaning ―worm‖ or ―moth‖ (Wetizman and Summerbell, 1995) and the second part of the name identifies the part of the body infected (Fisher and Cook,

 

1998). Hair, fur, skin cells and nail are the most important parts of human body that are enriched with keratin (Abdul and Al-Janabi, 2014). Therefore, dermatophytic infections are generally cutaneous and restricted to the non-living cornified layers because of the inability of the fungi to penetrate the deeper tissues (Wetizman and Summerbell, 1995). The serum fungal inhibitory factors in the extravascular space prevent the penetration of the fungi in the living tissues (Sehgal, 2004), also their inability to tolerance human body temperature (37ºC) and the antifungal activity of blood proteins (Rodwell et al., 2008). Diseases caused by fungi known as mycoses can be clinically classified as superficial, deep, or systemic mycoses (Kwon-Chung et al., 1992). Dermatophytes are the most important microorganisms causing superficial mycosis (Lacaz et al., 1998; Monod et al., 2002). Dermatophytosis lesion takes a ring shape with inflammatory edges and clear center of normal skin. The lesions are often roughly circular with raised border, but may coalesce to form confluent areas of dry, scaling skin, inducing itching and scratching which in severe cases may ulcerate (Abdul and Al-Janabi, 2014). Fungal elements are always found in active state in the edge of lesion and that is why it is preferable to take scraping

 

 

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sample for microscopical diagnosis from the lesion edges and not from the clear zone (Hainer, 2003). The ring shape of dermatophytosis can also be used to differentiate it from other skin diseases, such as psoriasis or lichen planus in which the inflammatory responses tend to be uniform over the lesion (Hainer, 2003). The etiologic agents of the dermatophytoses are classified in three anamorphic (asexual or imperfect) genera, Trichophyton, Microsporum and Epidermophyton. World Health Organization (WHO) survey on the incidence of dermatophytic infections shows that about 20% the people worldwide come down with cutaneous infections (Marques et al., 2000). Based on their ecological characteristics, dermatophytes are divided into geophilic (from soil sources), zoophilic (from animal sources) and anthrophilic (from human sources) species (Chander, 2009). Anthropophilic species are responsible for the majority of human infections (Maraki et al., 2007) spreading from one individual to another either by exposure to infected macerated skin cells, direct inoculation through breaks in the skin more often in persons with depressed cell mediated immunity or direct contact with infected person. Geophilic where some species of dermatophytes live in keratinous materials of soil as saprophytes and transmitted to human on contact with contaminated soil (Rahbar et al., 2010), and the third source of dermatophytosis are from animals especially domestic and some wild animals which called zoophilic source (Abdul and Al-Janabi, 2014) and also indirect transmission can occur from fomites such as upholstery, hair brushes, hats, clothing, under wears etc (Srinivasan et al., 2012). The different types of dermatophytosis are classified according to body sites or anatomical locations involved (Hay and Moore, 2004). Several anatomic sites may be infected by a single dermatophyte species and different species may produce clinically identical lesions (Weitzman and Summerbell, 1995). The conditions include ringworm of the scalp (Tinea capitis); ringworm of the body (Tinea corporis); ringworm of the beard (Tinea

 

 

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barbae); ringworm of the groin (Tinea cruris); ringworm of the foot (Tinea pedis); ringworm of the hand (Tinea manuum); ringworm of the nail (Tinea unguium); and ringworm of the face (Tinea faciei) (Degreef, 2008). The Mycoses caused by fungal infections of the skin and nails are widespread, the most numerous group amongst all Mycoses (Havlickova et. al., 2008) and are found worldwide (Bindu, 2002) becoming a significant health problem affecting children, adolescents and adults (Beena and Singh, 2003). There has been an increase in the incidence of fungal infection (Madhavi, et al., 2011). The increase could be as a result of frequent usage of antibiotics and immunosuppressive drugs (Mishra et al., 1998). Studies have shown great correlation of dermatophytoses with immune-depression as evidenced by increased incidence of dermatophytoses in patients with HIV/AIDS and cancers as well as people on long term cytotoxic drugs and organ/stem cell transplantation patients (Weitzman and Summerbell, 1995). Reactions to a dermatophyte infection usually range from mild to severe as a result of the immune status of the host, host‘s reactions to the metabolic products of the fungus, virulence of the infecting strain or species, anatomic location of the infection, as well as local environmental factors (Prasad and Chayani, 2013). The estimated life-time risk of acquiring dermatophytoses is 10 to 20% (Sumathi et al., 2013). Though neither life threatening nor debilitating, dermatophytoses may be recurrent and require long term skin treatment with attendant skin depigmentation (Panackal et al., 2009) producing a dermal inflammatory response with intense itching and also of cosmetic importance (Mishra et al., 1998). The relative occurrence of the etiological agents and predominating anatomical infection patterns vary with geographical location and environmental and cultural factors (Havlickova, et al., 2008) as well as socioeconomic status and contact with animals (Mikali, et al., 2012), flooring, clothing, linens, furniture and barbers‘ shops instruments (Farzana, 2007). Dermatophytes thrive at surface

 

 

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temperatures of 25 – 28oC and infection of human skin is supported by warm and humid conditions. For these reasons, superficial fungal infections are relatively common in tropical countries and are exacerbated by the wearing of occlusive clothing (Blanka et al., 2008). Although dermatophytic infections can be diagnosed by clinical presentation, the fungus can be demonstrated by easy laboratory procedures like microscopic examination of samples (KOH mount), biochemical characteristics and culture (Arbatzis, 2007). Species responsible for the infection can be identified based on demonstration of hyphae and both macroconidia and microconidia by colony characteristic and pigment production (Kim, 1997). Important characteristics are the rate of growth, shape and texture of the culture on solid media, color, dif-fusion of pigments into the agar and sporulation (Ninet et al., 2003). However, this system of identification is time-consuming and the same strains may show morphologically diverse colonies making it difficult to identify the dermatophyte species (Ninet et al., 2003). Moreover, the phenotypic features can be easily influenced by outside factors such as temperature variation, medium and chemotherapy (Liu et al., 2000). In recent years, dermatophytes responsible for the infection can be identified with great precision by molecular methods such as Random amplified polymorphic DNA analysis- Polymerase Chain Reaction (RAPD-PCR), Nested-Polymerase Chain Reaction (Nested-PCR), Polymerase Chain Reaction - Restriction Fragment Length Polymorphism (PCR-RFLP), and Real-time Polymerase Chain Reaction (Real-time PCR) (Rezaei-Matehkolaei et al., 2012). These novel molecular methods have advantages such as rapid identification of dermatophytes at genus and species level either directly in clinical samples or in fungal colonies (Kanbe et al., 2003; Mochizuki et al., 2003). The Internal Transcribed Spacer (ITS) regions of ribosomal DNA gene (rDNA) in the dermatophyte species used as a

 

 

 

 

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reliable marker for species identification provide simple and precise method for dermatophyte species characterisation (Rezaei-Matehkolaei, 2012).

 

The word Almajiri is the adultrated spelling of the Arabic word Almuhajir which means somebody who migrates for the purpose of learning or seeking for knowledge (Yusha‘u, 2013). The ancient culture of migration is tied to a system in which yearly, people inhabiting a given neighborhood gather their male children of school age usually after harvest and hand them to a teacher (Mallam). The purpose is for the Mallam to teach these children the basics of Islam through the Qur‘anic schools where they are tutored how to read the Qur‘an and write the Arabic alphabet. A pupil of any of these Qur‘anic schools is known as Almajiri (Almajirai plural) (Alkali, 2001). According to Bambale (2003), almajirai are categorized into 3 classes:

 

i.  Adult (Gardi): (17-25 years)

 

ii.   Adolescent (Titibiri): (11-16 years) and

 

iii.   An infant (Kolo): (5-10 years)

 

In order to escape domestic distractions, the Mallam may relocate his pupils to a distant area such as a city or another village and camp them there. It is at this camp that the Almajirai learn self-reliance and discipline as well as the essence of life (Alkali, 2001). To support the Mallam and his Almajirai, the local population provides accommodation and food for pupils and their teacher (Alkali, 2001). The place where they settle and take lessons is known as tsangaya which literally means learning centre in Hausa. A typical tsangaya has alaramma as the head, who is supported by other scholars such as mahiru, gwani and gangaran who have all memorized the Holy Qur‘an and can write it off hand. About 15-20 houses with occupants being either learners or teachers make up a tsangaya (Hassan, 2015).

 

 

 

 

 

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1.1         Statement of Research Problem

 

Dermatophytoses is one of the most common cutaneous infections worldwide (Havlickova et al., 2008), posing a great public health problem to humans and animals (Ameen, 2010; Ghojoghi et al., 2015). The prevalence of dermatophytosis varies from place to place throughout the globe and reported to vary in different parts of same continent (Havlickova et al., 2008). In tropical and subtropical countries, it occurs in increased frequencies (Havlickova et. al., 2008) due to warm and humid climate, poor nutrition, poor hygiene, overcrowding and poor sanitary conditions all promote the spread of these infections (Nweze, 2001). During the last decades, mycotic infections have increased to more than 20% - 25% of the world‘s population (Havlickova, et al., 2008; Sharma et al., 2015). Nigeria being a developing nation located in the tropic with wet humid climate fall into the category of regions with high prevalence of dermatophytosis, especially in school children of rural, suburban and urban extract (Gugnani and Njoku-Obi, 1995; Rudy, 1999). Socio-economic predisposing factors include; children‘s interaction patterns, poor living conditions marked by poor sanitation, housing (congestion), limited water supply as well as low economic power. Children living in informal settlements are more at risk to such skin diseases spread through contact as a result of living conditions and overcrowding both in school and at home (Chepchirchir et al., 2009). The almajirai represent an accepted informal educational system that is widespread in the nation with several centres in the Northern Nigeria. The system is an integral part of the cultural and religious education that is meant to instill religious discipline in growing children. The increase in population as well as the desire/quest for the childhood training has led to overcrowding and establishment of multiple centres for the education. This has led to some centres housing many children often crowded with insufficient housing accommodation where they spend the night as well as share other materials such as

 

 

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beds/beddings. This overcrowding has also overstretched the few available facilities in these centres and in most cases due to lack of funding these facilities are absent. It is these situations that provide suitable environment for the spread of dermatophytes and establishment of infection in these centres. There are efforts by the Government to integrate these centres with formal educational system and this is yet to be implemented in many centres. The poor infrastructural facilities found in the centres often has led to poor hygiene, dirty environment, poor health concern, a suitable environment for the spread of various pathogenic organisms including dermatophytes. Also, they have little or no access to medical facilities. Dermatophyte infections are often untreated or unreported. The inadequate health attention accorded this infection allows it to continue in the population unnoticed and spread to others. They are often overlooked as they do not produce severe debilitating illness and their treatment is not pursued vigorously. Molecular studies on dermatophytes are still scarce and not much work has been done on it in Nigeria. Some of these centres are attached to The Integrated Islamiya, Qur‘anic and Tsangaya Schools.

 

 

1.2         Justification

 

Dermatophytosis is highly contagious and represents a significant public health problem in Nigeria and Africa at large, particularly among children. The study will establish the prevalence and predominant dermatophyte species that are associated with the almajirai system with a view to making recommendation on its control. It also intends to identify the risk factors associated with the disease spread within the study population. Since plans are on the way by the Government to get the system integrated with the formal educational system, the study on the risk factors will provide information on areas that need to be addressed to prevent its spread.

 

 

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Though the disease poses no apparent health challenges, this study will bring to fore its prevalence and serve as framework for further studies and development of its control programmes. Distribution pattern and causative agents of infection continuously change therefore it is essential to update our knowledge in regard to the epidemiology of dermatophytes. The dermatophytosis caused by various dermatophyte species cannot be easily differentiated on the basis of clinical manifestations methods and for many years, conventional laboratory methods based on the detection of phenotypic characteristics, such as microscopy and in-vitro culture, have played an essential role in dermatophyte identification. However, these procedures generally suffer from the drawbacks of being either slow or non-specific (Liu et al., 2000). More so, due to the high degree of phenotypic similarity between dermatophyte species, identification problems are imminent. Conventional approaches for identification down to the species level in the diagnostic laboratory are based on morphological and physiological criteria, need several days or weeks to be concluded and are frequently unspecific. Therefore, alternative molecular tools with sufficient specificity, reproducibility and sensitivity are necessary (Mohammadi et al., 2015). The use of ITS regions of ribosomal DNA gene (rDNA) in the dermatophyte species are reliable marker for species identification (Rezaei-Matehkolaei et al., 2012). For an effective control management strategy of dermatophytosis in Nigeria, adequate information on the epidemiology of dermatophytosis is indispensible. This study therefore will investigate the epidemiology of dermatophytic infection among almajirai in Makarfi Local Government Area relative to nature of school facilities, interaction with domestic animals and their play pattern with the aim of assessing a correlation and also carry out molecular studies on dermatophytes in the country and possible strains that circulate within the system.

 

 

 

 

 

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1.3         Aim of the Study

 

To assess the epidemiology and characterisation of dermatophytes among almajirai in Makarfi Local Government Area of Kaduna State using molecular method.

 

 

1.4          Objectives of the Study

 

1.  To determine the prevalence of dermatophytes among almajirai in relation to age.

 

2.    To determine the associated risk factors for dermatophytosis among almajirai in Makarfi Local Government Area.

 

3.  To isolate and conduct a molecular characteristic of dermatophytes from infected almajirai.

 

 

 

 

1.5          Hypotheses

 

1. There is no difference in the prevalence of dermatophytes among the various age groups of almajirai.

 

2.   There are no associated risk factors for dermatophytosis among almajirai in Makarfi Local Government Area.

 

3.   There is no difference in the isolated dermatophytes from infected almajirai using molecular tools.

 

 

 

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