Figure 6 - uploaded by Avneet Singh Kalsi
Content may be subject to copyright.
Source publication
Background: Onychomycosis is a fungal disease of the toenails or fingernails that may include any part of the nail unit, including the matrix, bed, or plate. The causative organisms of onychomycosis are dermatophytes, Candida (yeasts), and non- dermatophytic molds, associated with different clinical presentations.
Methods: A retrospective study was...
Citations
... Rights reserved. [2], few studies highlighted high frequencies in the elderly [16,20,27,31,35]. Regarding the paediatric age group, as seen in studies from other regions [55], onychomycosis was rarely encountered in children. ...
Purpose of Review
Onychomycosis is commonly reported in Africa, but data on its prevalence and spectrum of incriminated pathogens is fragmented in the literature. Understanding its epidemiology and profiling of the incriminated fungal pathogens would be very useful in managing patients as they are often difficult to treat, especially with the global emergence of antifungal resistance.
Recent Findings
We identified a total of 44 well-documented studies in 13 (24.1%) of the 54 African countries amounting to a total of 6773 cases of nail fungal infections: 4609 (68.0%) from North Africa, 1338 (19.6%) from West Africa, 524 (7.7%) from East Africa, 243 (3.6%) from Central Africa, and 59 (0.9%) from Southern Africa, with a pooled prevalence of 19.6% (6773/34604). Identification of fungal pathogens was mainly by conventional methods: microscopy (n = 43, 97.7%), culture (n = 42, 95.5%), and periodic acid-Schiff staining (n = 1, 2.3%). Advanced diagnostics with improved sensitivity were also deployed in some studies: PCR (n = 2, 4.5%), sequencing (n = 2, 4.5%), and matrix-assisted laser desorption/ionization time of flight mass spectrometry (n = 1, 2.3%). The most frequent fungal pathogens identified in North and Central Africa were Trichophyton rubrum (80.4% and 49.3%), followed by Candida albicans (12.2% and 27.4%), respectively, while in the West and East African regions, it was Candida albicans (63% and 47.3%) followed by Trichophyton rubrum (19.1% and 18.9%), respectively. Antifungal susceptibility testing was performed in only five studies and showed varied outcomes with high resistance of dermatophytes to ketoconazole, itraconazole, and fluconazole and non-dermatophyte moulds to caspofungin and 5-flucytosine, respectively.
Summary
Onychomycoses are frequent but of less cognizance as data was found from only 13 of the 54 African countries. The emergence of drug-resistant onychomycosis is of concern and informs the need to prioritize research in this area to improve diagnostics and the availability of antifungal susceptibility testing.
... This infection is usually caused by dermatophytes, yeasts, and non-dermatophyte molds (NDM). [1][2][3] In different regions of the world, different dermatophytes are responsible for various clinical types of onychomycosis. It also depends upon the predominant species prevalent in that particular geographical region. ...
... 10 Multiple or ten fingernails involvement due to T. violaceum is a typical sign of HIV/AIDS. 1 [ Figure 1A] The prevalence of onychomycosis in the Canadian and Brazilian samples from patients, who were HIV positive, was 24.0% (96 of 400) and 20.0% (20 of 100) respectively. 11 In an Indian study, the prevalence was found to be 24% (60 of 250). ...
High prevalence of HIV/AIDS in sub-Saharan Africa is responsible for very high burden of mycotic infections. Also, most of the countries here have highly burdened health system compared to their health budget.
Onychomycosis is a chronic fungal infection of fingers and toenails. It is usually caused by dermatophytes, yeasts, and non-dermatophyte molds (NDM). Prevalence and severity of infection is more in immunosuppressed individuals, especially with HIV/AIDS. The laboratory diagnosis of the causative organism is very important to initiate the specific treatment. Persistence of infection can be the source of infection to the patient himself by autoinoculation and to others. The treatment of HIV/AIDS is mandatory. Onychomycosis in HIV/AIDS patients is usually due to Trichophyton rubrum and involve the toenails. The reports of onychomycosis due to dermatophytes from sub-Saharan Africa are scanty. There are only two reports, which have mentioned onychomycosis due to (T.violaceum) and involvement of fingernails in HIV/AIDS.
