Tinea pedis et unguium in the Muslim community of Durban, South Africa

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Abstract

Background

In a pilot study performed in eight mosques in the Durban area, it was found that the prevalence of tinea pedis et unguium in the adult Muslim male population regularly attending mosques was higher than in the non-Muslim male population. The aims of the present study were: (i) to determine the prevalence of tinea pedis et unguium in the adult Muslim male population regularly attending mosques; (ii) to investigate the role of mosque carpets and ablution areas in the spread of infection; and (iii) to develop strategies to combat the infection.

Method

Seventy-eight regular worshippers comprising adult Muslim males, chosen at random from five mosques in the Durban area, were examined for clinical evidence of tinea pedis et unguium. Skin scrapings and nail clippings were taken from clinically infected individuals and submitted for microscopy and culture for fungal organisms. A control group, comprising 72 nonMuslim adult male office workers from the administration departments of King Edward VIII Hospital, was similarly examined. In addition, scrapings from high traffic areas of the mosque carpets and swabs from the ablution areas were cultured for fungi.

Results

In the mosque group, it was found that the prevalence of tinea pedis et unguium was 85%, taking either microscopy or culture positivity as indicative of infection. In the control group, the prevalence was 41%. Thus a statistical difference of 44% (P < 0.0001) between the two groups was demonstrated. Dermatophytes and yeasts were isolated from the carpets and/or floors of the ablution areas in all the mosques under investigation.

Conclusions

The high prevalence of tinea pedis et unguium among regular male worshippers in the Muslim community can be attributed to the spread of fungal organisms in the communal ablution areas and prayer carpets of the mosques. Strategies to combat this spread of infection are being developed. These strategies are expected to find important practical applications in other communal environments, such as gymnasia, health spas, swimming pools, changing rooms of sports clubs, public showers, and even hotels.

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