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Tinea capitis in California children: a population-based study of a growing epidemic
M N Lobato1, D J Vugia, I J Frieden
1Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Insights
Tinea capitis is an epidemic among California children, with incidence increasing significantly from 1984-1993. African-American and white children show the highest risk for this fungal infection.
Area of Science:
- Pediatric Dermatology
- Infectious Diseases Epidemiology
- Public Health Surveillance
Background:
- Tinea capitis, a fungal infection of the scalp, affects children globally.
- Understanding incidence trends and at-risk populations is crucial for public health interventions.
Purpose of the Study:
- To analyze trends in tinea capitis incidence among California children.
- To identify specific subpopulations at higher risk for the infection.
Main Methods:
- Retrospective population-based study utilizing California Medi-Cal data (1984-1993).
- First-time prescriptions of oral griseofulvin suspension were used as a proxy for tinea capitis incidence.
- Incidence rates and risk ratios were calculated for various demographic groups.
Main Results:
- Overall incidence of tinea capitis prescriptions increased by 84.2% from 1984 to 1993.
- African-American children experienced the highest incidence rates (252.1 per 10,000 in 1993), a 209.7% increase.
- White children also showed a significant increase (140.4%), with rates of 23.1 per 10,000 in 1993.
Conclusions:
- Tinea capitis is an epidemic in California children, particularly in northern counties.
- African-American children are disproportionately affected, but increased rates are also observed in white children.
- The study highlights the need for targeted prevention and treatment strategies for at-risk pediatric populations.
Objective:
To describe trends in tinea capitis incidence among California children and to determine subpopulations at increased risk.
Design:
Retrospective population-based study.
Setting:
California, 1984 through 1993.
Population:
Children < 10 years of age enrolled in Medi-Cal.
Outcome Measures:
California Medi-Cal provider data for first-time prescriptions of oral griseofulvin suspension were used to estimate annual incidence of tinea capitis and calculate risk ratios.
Results:
From 1984 through 1993, the incident rate for prescriptions of oral griseofulvin suspension increased by 84.2% for all children, 140.4% for white children, and 209.7% for African-American children. In 1993, incidence rates (per 10,000 enrolled) were 252.1 claimants for African-American children, 23.1 for white, 17.5 for Hispanic, and 14.3 for Asian/Pacific Islander. The highest rate by location was San Francisco County (172.2). In age groups < 5 years and 5 to 9 years, African-American children were 13.1 and 17.6 times more likely to be prescribed griseofulvin than Hispanic children. Since 1987, incidence rates for children 5 to 9 years of age were higher compared with children ages < 5 years.
Conclusions:
Tinea capitis is epidemic among California children with higher rates in the northern counties studied. African-American children are the most affected by this epidemic; however, white children have also experienced increased rates.