Epidemiological changes in tinea capitis over the sixty years of economic growth in China

Background: Tinea capitis is a fungal infection of the scalp occurring commonly in children. Historical data indicate that clinical manifestations and the spectrum of etiologic agents vary greatly with geography, as well as socioeconomic affected populations. Objective: To study the possible connect...

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Published in:Medical mycology (Oxford) 2015-09, Vol.53 (7), p.691-698
Main Authors: Zhan, Ping, Li, Dongmei, Wang, Chong, Sun, Jiufeng, Geng, Chengfang, Xiong, Zhiwei, Seyedmousavi, Seyedmojtaba, Liu, Weida, de Hoog, G. Sybren
Format: Article
Language:English
Subjects:
China - epidemiology
DNA, Fungal - genetics
DNA, Ribosomal Spacer - genetics
Economic Development
Fungi - classification
Fungi - cytology
Fungi - genetics
Fungi - isolation & purification
History, 20th Century
History, 21st Century
Humans
Microbiological Techniques
Microsporum canis
Socioeconomic Factors
Tinea Capitis - epidemiology
Tinea Capitis - history
Tinea Capitis - microbiology
Trichophyton violaceum
Urbanization
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Summary:Background: Tinea capitis is a fungal infection of the scalp occurring commonly in children. Historical data indicate that clinical manifestations and the spectrum of etiologic agents vary greatly with geography, as well as socioeconomic affected populations. Objective: To study the possible connection between socioeconomic status, the disease patterns and the variability of etiological agents. Methods: We reviewed tinea capitis in China through literature since 1956. The disease pattern was correlated with economic and public health management protocols. Historical data on fungal identification were mostly obtained by morphology. The accuracy of these historical results was further confirmed by use of both morphological and ITS identification on a control set of 90 isolates collected recently from local hospital. Results: Full agreement of the two identification methods implies that data from the literature were sufficiently reliable to allow comparison across reported cases. In sum, 88 papers involving 25 administrative provinces and municipalities with 38,962 clinical strains met the inclusion criteria of this review. Zoophilic species Microsporum canis is the most prevalent agent within large, modernized cities in China today accounting for over 80% of infections. In contrast, anthropophilic dermatophytes, particularly Trichophyton violaceum, are geographically endemic only in some southeastern and northwestern regions. Conclusion: Economic development and urbanization of cities favor a shift of etiological agents from anthroponoses to zoonoses in contemporary China. Pets are becoming the most likely sources of infection in modern lifestyles, replacing the earlier human-to-human transmission mode. However, the latter transmission mode is still prevalent in less developed areas lacking adequate social and public health facilities.
ISSN:1369-3786
1460-2709
DOI:10.1093/mmy/myv057