Comparison of hairbrush, toothbrush and cotton swab methods for diagnosing asymptomatic dermatophyte scalp carriage.

BACKGROUND: Tinea capitis may also present as a minimal infection, termed carrier state. Anthropophilic dermatophytes (i.e. Trichophyton tonsurans and Trichophyton violaceum) have been generally associated with high rates of asymptomatic carriage. OBJECTIVES: The aim of this study was to compare the efficacy of the hairbrush, toothbrush and cotton swab methods for diagnosing scalp carriage as well as to determine the prevalence and related dermatophyte species for both asymptomatic and symptomatic tinea capitis in Adana Province, Turkey. PATIENTS AND METHODS: A screening study was carried out between February 2006 and May 2006, covering three schools and a total of 1560 children with 857 (54.9%) boys and 703 (45.1%) girls, aged between 7 and 17 years (10.6 +/- 2.3 years). The diagnosis was made by using three of the methods mentioned above with inoculation onto Sabouraud glucose agar. RESULTS: Symptomatic tinea capitis was not detected in the study; however, 21 (1.3%) asymptomatic carriers, with 9 (42.9%) boys and 12 (57.1%) girls, aged 7 to 13 years (9.7 +/- 1.9 years) were detected. The diagnosis was made via hairbrush in 13, via cotton swab in 4 and via toothbrush in 4. The mean age (P = 0.075) and gender differences were found to be statistically insignificant (P = 0.26). The most common isolated species was Trichophyton mentagrophytes var. mentagrophytes (90.4%) followed by Trichophyton audouinii (4.8%) and Microsporum gypseum (4.8%). Nine children had Arab origin (P = 0.005), and 12 had immigrated from the south-eastern region of Anatolia, Turkey. The screening of 32 households of 21 children with asymptomatic carriage enabled the researchers to detect the carrier state in three mothers and one sister, resulting in a total of four households (12.5%), with T. mentagrophytes var. mentagrophytes isolated, by hairbrush method in three cases and cotton swab in one case. If the methods were to be used alone, the prevalence of asymptomatic carriage would be found as 1.0% (16 of 1592) in the hairbrush, 0.3% (4 of 1592) in the toothbrush and 0.3% (5 of 1592) in the cotton swab methods; whereas the combined use of these three methods could reveal a total prevalence of 1.6% (25 of 1592). The hairbrush method was significantly found to be more effective in detecting dermatophyte fungi than the toothbrush (P < 0.01) and the cotton swab methods (P < 0.05). There was also a statistically significant difference between the use of a single method and the combination of all other three methods (P < 0.005). CONCLUSIONS: In summary, it was found that the prevalence of asymptomatic carriage did not cover symptomatic tinea capitis prevalence (1.6% vs. 0%), and the dominant species was zoophilic T. mentagrophytes (92%, 23 of 25). Asymptomatic carriage was not found to be related to age, gender and the coexistence of other dermatophytoses; however, race (Arab origin) was found to be the only risk factor. For laboratory diagnosis, no method was found to be nominated as a gold standard; hence, a combined use of diagnosing methods was suggested.

Etiological and demographical characteristics of acute adult poisoning in Adana, Turkey.

The objective of this study is to define the etiological and demographical characteristics of the patients applying to the emergency department in Faculty of Medicine, Cukurova University because of poisoning. This retrospective study was carried out by examining the records of 491 people who applied to the main emergency department in Faculty of Medicine, Cukurova University, with the complaint of poisoning between January 1, 2004 and December 31, 2004. It was determined that the reason why 491 of 20 817 persons (2.4%) applied during this term was because of poisoning: 159 (32.4%) of such patients were male and 332 of them (67.6%) were female. It was found that the average age of men was 27.1 +/- 10.5 years and that of women was 24.4 +/- 9.5 years (P = 0.005); 427 of poisoning cases (87.0%) happened intentionally as suicide attempts and 64 of them (13.0%) were accidental. The rate of suicide-purposed poisoning was higher in women and the rate of unintentional poisoning was higher in men (P +/- 0.001). The drugs were accountable for 71.1% of all poisoning cases and the pesticides were accountable for 18.9% of such cases. Poisonings increase during summers. The mortality rate in poisonings was found as 0.8%. The drugs and pesticides in Ckurova region constitute 90.0% of all poisoning cases. The mortality rate in poisoning will be decreased by training the physicians employed in the emergency department about poisoning by drugs and pesticides.