Tinea capitis among schoolchildren in Ethiopia: A systematic review and meta analysis

Abstract

Background: Tinea capitis accounts for25 to 30% of all fungal infections, but it is often ignored because it is not life threatening in nature. It is more common among schoolchildren particularly in developing countries. Due to the presence of significant variability among the previous studies, this study was conducted to provide a pooled prevalence and associated factors of tinea capitis in Ethiopian schoolchildren.

Method: We conducted a systematic search in five major databases for articles similar to our topic. This review included school-based cross-sectional studies that were reported in English and conducted from 2006 through 2022. The data were extracted using Microsoft Excel and further analysis was done using StataTM Version 17.0 statistical software. Forest plots were used to assess the presence of heterogeneity with 95% confidence intervals. A random effects meta- analysis model was used to pool primary estimates. To declare the presence or absence of association, 95% confidence interval with odds ratio was used.

Results: Fourteen studies with a total of 9465 schoolchildren were included. The pooled prevalence was 29.03% (95%CI: 15.37-42.71). There was observed heterogeneity, which could be explained by publication bias (P = 0.04). Family history of tinea capitis (OR: 9.18, 95%CI: 3.5-24.02), under the age of 10 years (OR: 1.65, 95%CI: 1.17-2.33) were factors increasing the development of tinea capitis among schoolchildren and schoolchildren who had hair wash at least once a week (OR: 0.31, 95%CI: 0.24-0.42) was significantly associated with reduced risk for tinea capitis.

Conclusion: One of the most prevalent childhood health condition in Ethiopia is tinea capitis, which affects over one in every four schoolchildren. Schoolchildren who had family history of tinea capitis and under the age of 10 years were the identified risk factors but they had hair wash at least once a week was the protective factor of tinea capitis among schoolchildren. Clinical and public engagement activities are needed to overcome the burden of the disease.

Fig 1. PRISMA flow diagram of the included studies for tinea capitis among schoolchildren in Ethiopia.

Fig 2. The subgroup analysis of tinea ccapitis over region in Ethiopia.

Fig 3. Subgroup meta analysis of tinea capitis using study setting in Ethiopia.

Fig 4. Subgroup meta analysis of tinea capitis over publication year.

Fig 5. Subgroup meta nalysis of tinea capitis on sample size of Ethiopian schoolchildren.

Fig 6. Funnel plot of tinea capitis to check publication bias.

Fig 7. The contour _enhanced funnel plot.

Fig 8. Association of tinea capitis with age of schoolchildren.

Fig 9. Association of tinea capitis with hair washing experience of schoolchildren.

Fig 10. Association of tinea capitis with family history of schoolchildren.

Fig 11. Association of tinea capitis with family history of schoolchildren.