*1,2Zafindraibe, N. J., 2Andriambao, H. M. R., 2Rasamindrakotroka, A., and 2Razanakolona, L. R. S.
1Bacteriology, Parasitology-Mycology Laboratory, University Center Hospital Joseph Ravoahangy Andrianavalona (CHU JRA), Antananarivo, Madagascar
2Department of Biology, Faculty of Medicine, Antananarivo University, Madagascar
*Correspondence to: juliemail_21@yahoo.fr; njzafindraibe@gmail.com
Abstract:
Background: Superficial and cutaneous fungal infections are among the most common dermatological conditions worldwide, particularly in tropical and subtropical regions. Caused by a variety of fungi (yeasts, dermatophytes, and molds), they can result in significant morbidity. In resource-limited settings such as Madagascar, their true burden remains underestimated due to limited access to diagnostic facilities and frequent empirical treatment. Local epidemiological data are essential for improving diagnosis and management strategies. The objectives of this study are to determine the prevalence, species distribution, affected anatomical sites and demographic characteristics of patients with superficial and cutaneous mycoses diagnosed at the University Center Hospital Joseph Ravoahangy Andrianavalona (CHU JRA) in Antananarivo, Madagascar.
Methodology: This was a descriptive retrospective review of the register of all patients with cutaneous mycoses at the parasitology-mycology laboratory of CHU JRA over a period of 6 years (January 2015 to December 2020). Data on demographic and clinical characteristics of included patients were collected with designed form and these included age, sex, patient location/department (outpatient or inpatient), year of request for mycological examination, macroscopic examination results according to lesion topography, type of samples (pus, nails, scalp, scales), class of fungi (yeasts, dermatophytes, moulds) and results of mycological culture. Data were analysed on Microsoft Excel and EPI INFO. Chi-squared and Fisher’s Exact tests were used to determine the relationship between categorical variables, and p≤0.05 was considered significant.
Results: Of the samples of 914 patients examined, 287 (31.4%) tested positive for cutaneous fungal infection, giving a prevalence of 31.4%. Yeasts accounted for 57.7% of isolates, dermatophytes for 25.8%, molds for 12.1% and others 4.4%. The most common fungi species involved in cutaneous infections were Candida spp (36.9%, n=106), Trichophyton spp (21.6%, n=62), and Aspergillus spp (5.9%, n=16). The most commonly affected sites were glabrous skin and nails, with Trichophyton spp and non-albicans Candida species being predominant, respectively. Clinically, the most frequent cutaneous findings were scaly lesions (skin), onycholysis (nails), and tinea capitis (scalp).
Conclusion: Superficial fungal infections are a major health concern in Madagascar. Improved clinical awareness and systematic mycological testing are critical for accurate diagnosis and management.
Keywords: Cutaneous mycoses, Candida spp, Trichophyton spp, Prevalence. Madagascar
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