Prevalence of Tinea pedis in military personnel: a systematic review and meta-analysis

Tinea pedis, commonly known as athlete's foot, is a fungal infection caused by dermatophytes, affecting the skin of the feet. It is prevalent in various populations, but military personnel are particularly vulnerable due to their unique environmental and behavioral factors. These include living in close quarters, exposure to humid conditions, and wearing tight, non-breathable footwear for prolonged periods. This systematic review and meta-analysis aim to estimate the global prevalence of tinea pedis among military personnel and explore factors contributing to its high occurrence in this population.  METHODS: A comprehensive literature search was conducted in multiple databases, including PubMed, Scopus, and Web of Science, for studies published in English up to 21 March 2025. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of the included studies, evaluating aspects such as the selection of participants, comparability, and the assessment of exposure. The prevalence rates were pooled using a random-effects model, and heterogeneity among studies was evaluated. Studies employing various diagnostic methods, including microscopy and fungal culture, were analyzed to identify variations in prevalence estimates. A subgroup analysis was performed based on geographic regions to explore the influence of environmental factors on prevalence.  RESULTS: A total of 25 studies, involving military personnel from different regions, were included in the analysis. The pooled prevalence of tinea pedis among military personnel was estimated at 17% (95% CI: 12-23%). Subgroup analysis revealed regional variations, with the highest prevalence observed in the Americas and Australia, where hot and humid climates are prevalent. The lowest prevalence was observed in European studies, which may be attributed to milder climates. Studies using both microscopy and fungal culture reported higher prevalence rates (20%) compared to those relying solely on microscopy (9%).  CONCLUSION: Tinea pedis remains a significant health concern among military personnel, with a global prevalence of 17%. Military environments, characterized by high physical activity, shared living conditions, and poor foot hygiene practices, exacerbate the risk of fungal infections. Preventive strategies, including improved foot hygiene, better footwear design, and enhanced access to antifungal treatments, are essential to reduce the prevalence of tinea pedis in military settings.