Epidemiology, diagnostic methods, and available treatments for tinea capitis in Ethiopia: A narrative review

Abstract

Tinea capitis is a common fungal infection of the skin and hair follicles of the scalp, primarily affecting the pediatric population. It is caused by dermatophytes, mainly from the Trichophyton and Microsporum genera, and clinical diagnosis can be confirmed through microscopic examination, culture, or molecular techniques. Adequate treatment should involve systemic antifungal drugs. Ethiopia, the second most populous country in Africa, also reports the second-highest prevalence of tinea capitis on the continent. However, fungal diseases remain largely neglected in public health initiatives. This narrative review aims to synthesize current epidemiological data, risk factors, and diagnostic and therapeutic approaches, to estimate the disease burden, guide clinical practice, and inform future public health strategies. A systematic literature search was conducted in open-access databases. Data on study populations, prevalence, risk factors, diagnosis, and treatment were extracted and analyzed. A total of 14 studies were included, encompassing 7077 patients with tinea capitis in Ethiopia. The condition was found to be highly prevalent among Ethiopian children, mirroring trends seen in other African regions. The predominance of urban-based studies reveals a critical gap in data from rural areas, limiting a full understanding of the national disease burden. Clinical diagnosis alone may overestimate prevalence, potentially leading to inappropriate treatments and increased antifungal resistance. Transmission is strongly influenced by socioeconomic and hygiene-related factors. Trichophyton species are the main etiological agents. While national efforts have improved hygiene and sanitation, significant challenges persist. Moreover, despite the existence of diagnostic and treatment guidelines, their uneven application, often due to economic and logistical constraints, continues to hinder effective disease management.