Onychomycosis in diabetic patients in Fako Division of Cameroon: prevalence, causative agents, associated factors and antifungal sensitivity patterns

Background

Onychomycosis is an infection of the nail unit by a fungus. This is a very common infection amongst diabetics. Its occurrence among diabetics in Fako division is unknown. In this study we provide information on the characteristics of onychomycosis in diabetics in Fako division, Cameroon.

Methods

A cross-sectional descriptive and analytical hospital-based study was conducted in two diabetic clinics in the Buea and Limbe regional hospitals. We recruited 152 consenting diabetics into the study. Demographic, behavioural, and clinical data of patients were obtained through the use of structured questionnaires. Toenail, finger nail, skin scrapings and nail clippings were collected from participants, KOH mounts were prepared and observed under the microscope and cultured on Sabouraud Dextrose Agar supplemented with chloramphenicol to isolate causative fungi. Identification of isolates was done to species level using the cello tape flag method and slide culture. The presence of a dermatophyte by either microscopy or culture or both methods was considered positive for onychomycosis. Antifungal susceptibility testing was carried out using selected antifungals by the Kirby–Bauer disk diffusion method on Sabouraud Dextrose Agar.

Results

Clinical onychomycosis was found in 77 of the 152 diabetics tested giving a prevalence of 50.7% (95% CI 42.4–58.9) in diabetics in Fako. No socio-demographic or clinical factor studied was significantly associated with onychomycosis. Trichophyton rubrum was the most common isolate (62%). Other isolates included Trichophyton metagraphyte (22%) and Trichophyton tonsurans (16%). Dermatophytes were sensitive to miconazole (66%), amphotericin B (19%) and ketoconazole (14%).

Conclusion

Onychomycosis is common in diabetics in Fako signifying the need for regular screening by either microscopy or culture. Infected nails could be treated with miconazole.

Electronic supplementary material

The online version of this article (doi:10.1186/s13104-016-2302-1) contains supplementary material, which is available to authorized users.

Prevalence and factors associated with urogenital schistosomiasis among primary school children in barrage, Magba sub-division of Cameroon

BACKGROUND

The purpose of this study was to determine the prevalence and intensity as well as the factors associated with urogenital schistosomiasis (US) in Barrage, a rural community around the Mape΄ dam, in the West region of Cameroon not previously documented for transmission.

METHODS

In this cross sectional parasitological survey, 382 children were enrolled from three primary schools in the study area between March and May 2016. A semi-structured questionnaire was used to collect information on demographics, clinical and predisposing factors. The syringe filtration technique was used to analyse urine samples. Samples with visible or gross haematuria were recorded prior to filtration. The Pearson chi-square, the student T-test and logistic regression were all performed as part of the statistical analyses.

RESULTS

The overall prevalence of US was 41.1% (95% CI: 36.1-46.2). Infection was more common in children below 10 years (p = 0.009), in males (p = 0.029), and in children who frequently come into contact with water from the dam (p < 0.001). Furthermore, US was more common in children attending Ecole Public (EP) Manbonko Bord (81.1%, p < 0.001) which is very close to the dam and in children from a fishing background (80.9%, p < 0.001). On the contrary, knowledge about schistosomiasis was not observed to be associated with prevalence. In this study, the intensity of infection was observed to be higher in children below 10 years (p < 0.001), in males (p = 0.001), and in children attending EP Manbonko Bord (p < 0.001). The intensity of infection was also highest in children presenting with haematuria (p < 0.001). Frequent contact with water from the dam and having parents whose occupation was fishing were identified as the associated factors for US.

CONCLUSION

A high prevalence of US was observed in school-aged children in the study area especially in those attending EP Manbonko Bord. Limiting contact with water from the dam, control of the snail intermediate host, provision of portable water and mass treatment of the entire population are proposed as some of the measures to reduce and eventually eliminate transmission in the area.