Abstract: The objective of this study is to investigate the prevalence and risk factors for tinea pedis in soccer players. This study was done in summer 2002 on 180 soccer players of the 8 first league clubs of Esfahan. Samples were collected from two forth-interdigital toe web spaces and cultured on Scc agar medium and incubated for 3 weeks. The results showed that a bout 3.33% (n = 6) of players were positive in 3 out of 8 teams. Trichophyton rubrum had a most frequency (4 cases). Trichophyton mentagrophytes and Epidermophyton floccosum isolated from 2 cases. Besides, some factors include exercise hours, kind of stockings and shoes, amount of foot perspiration and route of showering detected by questionnaire. There were not any significant differences between these factors and frequency of infection (p>0.05). However significant relation was observed between different clubs and the frequency of infection in players (χ2 = 0.035).
INTRODUCTION
Tinea pedis is a fungal infection of the skin between toes sometimes spreading to other areas of the foot. This infectious disease is produced by Dermatophytic fungi such as Trichophyton sp. and Epidermophyton floccosum (Perea et al., 2000).
Repeated exposure, macerating conditions due to ill-fitting shoes and sweaty socks and possibly genetic factores are suggested as the most likely predisposing conditions for the disease (Rippon, 1988).
Athletes have the chance to acquire dermatological lesions including those of fungal etiology. The athlete's synthetic clothing and shoes retain sweat, favoring fungal development. During soccer practice, feet are subjected to intense battering, that may predispose to the development of mycoses (Adams, 2002; Bukhart, 1999).
This study evaluates the frequency and risk factors for tinea pedis among soccer players.
MATERIALS AND METHODS
This study was done in summer 2002 on 180 soccer players of the 8 first league clubs of Esfahan. In order to assess the prevalence of subclinical infection, sampling was done in fourth interdigitate space of both feet. Some scales of these areas were scraped by sterile scalpel blade and sent to the laboratory in sterile plates. Gathered samples (360 ones) were cultured on the Sabouraud- Dextrose agar media in the presence of chloramphenicol (0.05 g L-1) and cycloheximide (0.5 g L-1) and maintained at 25 degrees centigrade for three weeks. After incubation period the grown fungi were identified via the colony form and the characters of fungus after staining with lactophenol cotton blue dye.
The needed epidemiological informations were collected by questionnaire and ultimately data were analyzed using descriptive statistics and Chi-square (χ2) test.
RESULTS
Out of 180 sampled players, six ones were positive and contaminated with dermatophytic fungi isolated on SD Agar midia. The most prevalent fungus was Trichophyton rubrum (4 cases). Also one case from each of Trichophyton mentagrophytes and Epidermophyton Floccosum species was observed. Five of the infected players had on pruritus or scaling. This result shows that 2.7% of study subjects had occult tinea pedis.
In this survey no significant correlation was observed between exercise hours, kind of stockings and shoes, amount of foot perspiration and route of showering with the tinea pedis prevalence rate (Table 1).
The positive subjects all were from three of eight studied teams and in the five remaining teams no positive subject was seen (Table 2). The results of the Chi-square test demonstrated that correlation between the club and the frequency of positive cases is statistically significant (p<0.05).
| Table 1: | The correlation between exercise hours, kind of stockings and shoes, amount of foot perspiration and route of showering with tinea pedis prevalence rate |
| Table 2: | The correlation between the club and the frequency of positive cases |
| Conclusion p<0.05 df = 7 χ2 = 0.035 | |
DISCUSSION
The result say that in some sport clubs the dermatophyte infection is endemic. The most prevalent fungus found in this research was Trichophyton rebrum (66.6% of all isolated fungi). This is in contrast to other researchers’ findings in Iran. Chadeganipour et al. (1997) in their study on general population of Esfahan found that Trichophyton verrucosum is the most frequent one (32.8%). Also Mahmoudabadi (2005) in his survey on the people of south west of Iran found Trichophyton mentagrophytes as the most prevalent one.
However this study results are in accordance with Djeridane et al. (2006), Perea et al. (2000) and Hapcioglu et al. (2006) survey. The prevalence rate of contamination resulted from our study is accounted a low rate comparing other researchers' results.
Cohen et al. (2006) reported the mycological prevalence rate of tinea pedis among 223 Israeli soldiers to be 27.3%. Also Rosseuw (1999) determined the rate 22%, 15% (Djeridane et al., 2006), in South-African muslims 85% (Raboobee et al., 1998), in Turkey worshipers 29.5% (Ilkit et al., 2005) and 15% (Hart et al., 1999).
It’s suggested that the low rate of this study is due to differences in study region, population, climate and better hygienic behaviors of study subjects. Because Esfahan is regionally warm and dry and at the other hand most to all of subjects (93.3%) were taking showers after exercise.
Also in Purium et al. (2005) study, the frequency of tinea pedis among soccer players was lower than the other groups. He supposed that health education and professional feet care were the most important factors for the lower incidence in soccer players.
Statistical analysis shows that factors other than exercise site and club do not affect the disease incidence. So, education of athletes about this kind of disease, hygienic behaviors and timely treatment of infection with drags such as clotrimazole is very effective in reducing disease prevalence rate.