Prevalence, aetiology and predisposing factors for tinea capitis amongst pupils in rural communities in the Brong Ahafo Region of Ghana

Tinea capitis remains a common superficial fungal infection among school-aged children in sub-Saharan Africa. However, up-to-date data on its burden and aetiological agents in many regions of Ghana are limited. This study determined the prevalence, aetiology, and predisposing factors for tinea capitis among primary school children in rural communities in the Brong Ahafo Region of Ghana. A school-based cross-sectional study was conducted between July and September 2019 among 708 pupils selected through multistage sampling from six rural basic schools in Sunyani, Techiman, and Kintampo North municipalities of the Brong Ahafo Region. Data were collected using structured questionnaires and clinical scalp examinations. Scalp scrapings and hair samples from clinically suspected cases were examined using potassium hydroxide microscopy and cultured on Sabouraud’s agar for fungal identification. Logistic regression analyses were performed to identify factors associated with tinea capitis. The overall prevalence of tinea capitis was 15.0% (95% CI: 12.4–17.8), with the highest prevalence observed in Kintampo North Municipality (19.5%). The grey patch variant was the most common clinical presentation (76.8%). Of the 106 samples cultured, 30.2% yielded dermatophytes, predominantly Trichophyton tonsurans (68.8%), followed by Trichophyton rubrum (15.6%). Aspergillus niger was the most common non-dermatophyte isolate. Significant predictors of infection included residence in Kintampo North (aOR = 2.62; 95% CI: 1.66–4.15) and presence of scalp complaints (aOR = 9.10; 95% CI: 5.88–14.29). Not having family members with scalp lesions was protective (aOR = 0.69; 95% CI: 0.52–0.93). Tinea capitis is moderately prevalent among pupils in rural communities of the Brong Ahafo Region of Ghana. The predominance of the anthropophilic dermatophyte T. tonsurans indicates that person-to-person transmission is the principal route of spread, emphasizing the need for school- and household-based control measures. Geographic location, scalp complaints, and a family history of infection were significant predictors of disease. Strengthened surveillance, early case detection, and improved access to systemic antifungal therapy are essential to reduce transmission and the burden of tinea capitis among Ghanaian school children.