Katsina Journal of Natural and Applied Science VOL. 5 No. 2 September 2016 (ISSN: )

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1 PREVALENCE OF RINGWORM INFECTION AMONG CHILDREN IN MALUMFASHI COMMUNITY, IDENTIFICATION OF THEIR ETIOLOGICAL AGENTS AND THE POSSIBLE HERBAL THERAPY Wagini N.H. and Mahuta, A.U. Corresponding author Department of biology Umaru Musa Yaradua University Katsina, Katsina State Nigeria ABSTRACT Dermatophytic infections have been known to impact negatively on health and well-being of human and animals in Nigeria. This study was undertaken to determine the prevalence, the etiological agents of the dermatophyte infection among school children aged 4-12 years in Malumfashi community in Katsina state and also to document the herbal therapy used against the infection by the people of the community. Field survey was conducted in the community to investigate and document the herbals used by the members of the community to treat the infection and to study the prevalence of the infection among children between 4-12 years old of some randomly selected schools (conventional school, private school and almajiri school).samplles from children was collected by tooyh brush technique. The samples were cultured using dermatophytes media. Moreover questionnaires were distributed for the documentation of the herbal remedies used by the people of the community against the infection. The prevalence of the infection was recorded to be higher in Almajiri school which accounted for 42.2%, followed by conventional school with 37.7% and least in private school with 20.0%. The etiological agents identified to be responsible for the infection belongs to Microsporun and Trichophyton genera. Finally 8 different plants were identified and documented as herbal remedies used for the infection by the people of the community, with Citrus aurantifolia being the most commonly used. Conclusively, there is significant difference between the age groups (4-6, 7-9, and years of age) of the children affected and the school categories (public, private and Almajiri) in the prevalence of ringworm infection in Malumfashi community. KEY WORDS: prevalence, children, dermatophyte, etiological agents and herbal therapy. INTRODUCTION Ringworm infections also called dermatophytosis are one of the most common infectious diseases in the world and are among the most commonly diagnosed skin diseases in Africa (Adefemi, et al., 2011). It is caused by a particular group of fungi called dermatophytes. Ringworm infections have been known to impact negatively on health and well-being of children 1. Dermatophytes are known to grow best in warm and humid environments and are therefore more common in tropical and subtropical regions especially in Africa. However, some species of dermaophytes such as Trichophyton mentagrophytes, Microsporum canis, Epidermophyton floccosum and Trichophyton rubrum are distributed all over the world. However, other species probably have partial geographic restriction examples of which are Trichophyton schoenleiniii is found in Africa and Europe while Trichophyton soudanense is also restricted within Africa 2. Others are Trichophyton violaceum which are associated to Asia, Africa, Europe and Trichophyton concentricum is known to be in India and Pacifics (Weitzman and summerbell, 1995). Dermatophytes are keratinophilic, meaning that they mainly affect keratinized tissues of the body of human or animals, example they grow on nails, hairs and the outer layer of the skin of both man other animals. The skin condition is particularly common among children. Although, the clinical signs of dermatophytoses may vary depending on the affected region of the body, Umaru Musa Yar adua University, Katsina NIGERIA. All Rights Reserved... Page 167

2 pruritis is the most symptoms in humans (Nweze 2010). The lesions on the skin are often characterized by inflammation. Severity of the lesions is often obvious at the edges scaling. Scaling, erythema and sometimes, blister formation are evident thus indicating presence of the infection, example as seen in Tinea corporis often resembling a central clearance. Hair loss often results, especially on the facial hair and the scalp. It is contagious disease that needs utmost care (Chastain et al., 2001). The etiological agents of ringworm infection generally belong to one of the three genera of the dermatophytes which are Microsporum, Trichophyton, Epidermophyton. Their characterization is based on the nature of their sexual and asexual spores which may be cleavate or multiseptate. Moreover, the commonly recurring species of fungi that causes ringworm can either be transmitted by humanhuman contact (Anthrophilic) examples, T. rubrum, M. audouinii, or by animal-human contact (Zoophilic) examples M. canis which is transmitted through contact with dogs or cats, M. nanum which is transmitted through contact with pigs, and by human-soil contact (Geophilic) examples M. gypseum, M. fulvum (Ogunbiyi et al., 2005). Plant-derived medicines have been part of traditional health care in most parts of the world for thousands of years and there is increasing interest in them as sources in the treatment of diseases 7. Recent study by Joshua Rogers in 2015 showed that garlic, apple cider vinegar, tea tree oil, turmeric, vinegar and salt, Aloe vera, colloidal silver, lavender oil, lemon grass tea, myrrh and olive leaf are the best home remedies for ringworm infection (Bergson et al., 2011). METHODOLOGY Herbal medicine used for the treatment of ringworm infection by the members of the community Questionnaires were distributed to residents in different s of the community so as to ascertain and document the herbal remedies used against the ringworm infection in the community (Aiyeloja et al., 2006). However, some of the questions asked in the questionnaire were: Name, sex, age, occupation, name of plants used for the remedy, part of the plants used and method of application among others. The responses of the respondents were corded and documented in the results and discussion. Prevalence of the infection Field survey was conducted in the school categories involving children between 4-12 years of age. Consent for the study from parents and school managements was obtained from the different Parent Teachers Associations and schools managements of the randomly selected schools. The study was carried out between July and November. The susceptible children affected by the infection were identified. Tooth brush technique was applied to scrap the ringworm sample from s; a piece of white paper was placed under to obtain the scrapped sample. The samples were folded and stored in medicine packet and conveyed to the laboratory of biology department Umaru Musa Yar adua University for the identification. FIRST MICROSCOPIC EXAMINATION Portion of some of the samples were added on glass slides and stained with 20% KOH and then viewed using 10 objective of a light microscope. After then each sample was cultured in S.D.A (sabraoud s dextrose agar) culture media (Uneke et al., 2006). Umaru Musa Yar adua University, Katsina NIGERIA. All Rights Reserved... Page 168

3 Preparation of the culture media and culture of the sample The S.D.A media was prepared in accordance with the instruction of the manufacturer as follow, 65g is to 1000ml of distilled water. 9.1g of the S.D.A was added to a 250ml conical flask containing 140ml of distilled water, which is covered using foil paper and cotton wool. The solution was heated on a hot plate for five minutes and then autoclaved for 15mins at c. The solution was then allowed to cool for 10 mins and then 6 plates were placed in a sterilized surface (using ethanol). A spirit lamp was placed to avoid microbial contamination. The conical flask was opened and the solution was poured into six petridish plates [which already contained chloronphenicol (antibiotic)]. The ringworm samples were added to each plate containing the prepared culture media using sterilized forceps. The plates were incubated at room temperature for three days(uneke et al., 2006). After the initial result was observed and recorded another media was prepared using 8.125g (in accordance with manufacturer s instruction) of S.D.A which was dissolved in 125ml of distilled water in a conical flask covered with cotton wool and coil paper, which was heated and sterilized in autoclave at c for 15mins. The media was allowed to cool, and then poured in four plates [which already contained chloronphenicol (antibiotic)] with the aid of spirit lamp for proper disinfection of the environment. The ringworm samples were added to each plate containing the prepared culture media using sterilized forceps. The plates were incubated at room temperature for three days. After obtaining the second result, the samples were subjected to sub culture in order to obtain pure culture for proper identification g (in accordance with manufacturer s instruction) of S.DA was dissolved in 250ml of distilled water. The media was autoclaved at c for 15mins. The media was allowed to cool, and then poured in 6 plates [which already contained chloronphenicol (antibiotic)] with the aid of spirit lamp for proper disinfection of the environment, the samples (each colony) were added to the centre of the media plates using sterilized wireloop. FINAL IDENTIFICATION AND SECOND MICROSCOPY After observing the result of the pure culture, each colony (as seen in the result) was gently scrapped using sterilized wire loop and put upon a glass slide and stained with lactophenol and then viewed using 10 and 40 objective of a microscope after which the images were observed and snapped. RESULTS AND DISCUSSION SURVEY ON THE PREVALENCE OF THE RINGWORM INFECTION IN THE CASE STUDY AND SAMPLES COLLECTED A total of 45 primary school pupils were physically identified to be susceptible to ringworm infection from three schools in Malumfashi town, majority of which were infected on their heads which claimed up to 38 pupils followed by face which claimed four pupils, two on their hands and one on his body surface and samples from all pupils investigated were obtained. Table 1 Age categories and percentage of the affected pupils Age category Number of infected pupil Percentage 4-6 years old 2 4.4% 7-9 years old % years old % Umaru Musa Yar adua University, Katsina NIGERIA. All Rights Reserved... Page 169

4 Table 2 Percentage differences in age categories of the affected pupils among the different schools surveyed AGE GROUP CONVENTIONAL SCHOOL PRIVATE SCHOOL ALMAJIRI SCHOOL PERCENTAGE 4-6years % 7-9years % 10-12years % TOTAL The analysis of variance shows that there is significant difference between the age groups (4-6, 7-9, and 10-12years of age) affected by ringworm and the school categories (public, private and Almajiri) at 0.05 level of significance with computed ANOVA significant level 0.00, conclusively there is no variation among the age groups and school categories. Herbal Therapies A total number of 34 respondents answered the questionnaires distributed in the community. 8 plants were recorded to be commonly used by the people of the community. The table below shows the information about the herbal remedies used by the people in the community. Table 3. Herbal remedies used by the members of the community for the treatment of ringworm infection S/No. Scientific name 1 Citrus aurantifolia 2 Mitracarpus hirtus 3 Ficus thonningii 4 Dichrostachys cinerea 5 Phoenix dactylifera 6 Tamarindus indica 7 Calotropis procera 8 Jatropha curcas Common name Key lime Button grass Hausa name plant Lemon tsami of No.of responses Percentage part of Plant used Fruit s juice Mode of application Rubbing on Gogamasu The leaves Rubbing on Chediya The watery fluid Rubbing on Sarkakiya The leaves Rubbing on Date Dabino The processed seed Rubbing on Tamarind Tsamiya The stem Decoction Sodom apple Physic nut Tumpapiya The leaves Rubbing on Cindazugu The leaves Rubbing on Umaru Musa Yar adua University, Katsina NIGERIA. All Rights Reserved... Page 170

5 Table 4 Percentage differences in school category of the affected pupils SCHOOL CATEGORY NUMBER INFECTED PERCENTAGE CONVENTIONAL SCHOOL % PRIVATE SCHOOL % ALMAJIRI SCHOOL % Table 5 Percentage differences in gender category GENDER NUMBER INFECTED PERCENTAGE Male % Female % DISCUSSION Table 3 shows that Citrus aurantifolia (Christm.) has the highest percentageof citation, indicating that it is the most commonly used herbal remedy of ringworm infection by the people of the. In a paper titled Antimicrobial activity and chemical composition of citrus aurantifolia Swingle essential oil from italian organic crops it was showed that the major components of lime essential oil are proved to b- pinene (12.6%), limonene (53.8%), y-terpinene (16.5%), terpinolene (0.6%), a-terpineol (0.4%) and citral (2.5%), which are very likely to be responsible for the good antimicrobial activity (Fathi and Al Samarai 2000). Calatropis procera J. is the second most commonly used herbal remedy against ringworm infection in malumfashi community. C. procera ethanolic extract was scientifically proved to be active against dermatophytes causative fungus of many superfacial infections. This is contained in an online research article titled Antifungal Activity of Calotropis Procera Towards Dermatophytes of international journal of advances in pharmacy, biology and chemistry. The extract was tested against many strains of E. floccussum that produces arthoconidia, which survives for a longer time than other dermatophytes, therefore constituting an environmental source of contagion, sometimes leading to outbreak of dermatophytosis in individuals and in institution (Hainer 2003) and T. rubrum and T. mentagrophytes, which are the main cause of athlete s foot and onichomycoses in human beings. The ethanolic extract of C. procera leaves, inhibited all the species of dermatophyte genus tested,with MIC values between 250 and 1000ug/ml (MIC 90 and MIC 50 values =1000 and 500ug/ml, respectively). The MFC values of three compounds were between ug/ml. Phoenix dactylifera L. is the third most commonly used herbal remedy for ringworm infection by the people of malumfashi community. P dactilyfera has been cultivated for its fruits by the Arabs, in Nigeria it is commonly found in the northern region and sparsely found in the southern and western region. In an article titled Phytochemical, Proximate and Antifungal studies on Phoenix dactylifera (Nweze 2001) contained in the Journal of Pharmacy and biological Sciences, the Phytochemical screening of P. dactylifera showed that there was the presence of alkanoids, flavinoids, tamin, saponin, tetrapenoid, steroids and phenol while the proximate analysis showed the abindance of carbohydrates as well as the low concentrations of protein, crude fat and moisture. Antifungal studies using varying concentrations (200mg/ml,400mg/ml,1000mg/ml) of the aqueous extract of the fruit showed that increase Umaru Musa Yar adua University, Katsina NIGERIA. All Rights Reserved... Page 171

6 in concentration of the extract is directly proportional to the increase in the zones of inhibition observed in the fungi tested (Wagini et al., 2014). Mitricarpus hirtus, Ficus thorningii, Dichrostyches cinerea were the 4 th most commonly used herbal remedy used for ringworm infection by the people of Malumfashi community with a percentage ratio of 8.82%. K. Mitricarpus sp. was proved to have good potentials for the development of new antifungal drugs this was contained in a research journal of Microbiology research, vol4 No pp The phytochemical screening of the powdered plant part revealed that the presence of tannins, saponins, flavinoids, terpenes, phenols and resins while alkanoids, sugars, carbohydrates, balsams and anthraquinones were not detected. Antifungal susceptibility testing of crude tannin, crude saponins and crude phenol were proved to be active against T. mentagrophytes, T. saponins,tannins,verrucossum, C. Albicans, Aspergilus niger at different inhibitory zones and concentration. While phytochemical screening of F. thorningii revealed the presence of alkanoids, cardenolides, terpenoids, flavonoids. Crude extracts of F. thorningii demonstrated inhibitory activity on moulds and yeast but none against dermatophytes (Trichophyton and Microsporum specie) (Hillier1861). Jatropha curcas was also documented as a herbal remedy used against ringworm infection by the people of malumfashi community. J. curcas seeds and pulp extracts have higher antifungal activities than the whole fruit extract (Hischmann 2007) with growth inhibition zone of 5.6mm or equivalent to 72.07% i.e for the seed followed by pulp with zone of 7.4mmor equivalent to 72.07% and whole fruits with zone of 14.2mm or equivalent to 46.42% as compared to the control with zone of 26.5mm or equivalent to 100%. Tamarindus indica happened to be the least among the herbal remedies against ringworm infection used by the people of malumfashi community with 2.94%. However, in related research Tamarindus indica L. shows excellent inhibitory activity against Alternaria citri (87.59%), Gibberella avenaceum (51.67%), Fusarium incarnatum (42.11%) (Satpute and Vanmare 2016). Meanwhile, T. indica is a plant that is used in traditional medicine for the treatment of cold, fever, stomach disorder, diarrhea and jaundice and as skin cleanse. However there is inadequate published study on the action of T. indica against dermatophytes. Table 2 above indicated that children of 7 years and above had greater risk of ringworm infection this may probably be due to their poor hygienic condition and inadequate parental care in children belonging to the age category. In an article titled Prevalence of dermatophytosis among primary school children in oke-oyi community by SA Adefemi et al. it was shown that out of 180 respondents of suspected clinically to have dermatophytosis 72 (i.e 40%) are between age category of 9-12 years. The organisms identified on the image 1, 2 and 3 belonged to the two of the three dermatophyte genera (microsporun and trichophyton) While the last one is a non-dermatophytic. CONCLUSION Conclusively, there is significant difference between the age groups (4-6, 7-9, and years of age) of the children affected and the school categories (public, private and Almajiri) in the prevalence of ringworm infection in Malumfashi community. The etiological agent identified to be responsible for the infection belongs to Microsporun and trichophyton genera. Finally 8 different plants were identified and documented as herbal remedies used for the infection by the people of the community, with Umaru Musa Yar adua University, Katsina NIGERIA. All Rights Reserved... Page 172

7 Citrus aurantifolia being the most commonly used. REFERENCES Adefemi SA. Study of dermatophytic skin infection among primary school pupils in Oke-Oyi. A dissertation submitted to the West African College of Physicians in partial fulfillment of the requirements for the award of fellowship of the college in family medicine Aiyeloja A. A. and O. A. Bello, Ethnobotanical potentials of common herbs in Nigeria: a case study of Enugu state, Educational Research and Review, vol. 1, no. 1, pp , Anosike JC, Keke IR, Uwaezuoke JC, Anozie JC, Obiukwu CE, Nwoke BE. Prevalence and distribution of ringworm infections in primary school children in parts of eastern Nigeria. J Appl Sci Environ Manage 2005;9:21-5. Bergson CL, Fernandez NC. Tinea capitis: Study of asymptomatic carriers and sick adolescents, adults, and elderly who live with children with the disease. Revista do Instituto de Medicina Tropical de Sao Paulo 2011;43: Bergson CL, Fernandez NC. Tinea capitis: Study of asymptomatic carriers and sick adolescents, adults, and elderly who live with children with the disease. Revista do Instituto de Medicina Tropical de Sao Paulo 2001;43: Chastain MA, Reed RJ, Pankey GA. Deep dermatophytosis: Report of 2 cases and review of the literature. Cutis 2001;67: D. C.Mohana, S. Satish, andk.a.raveesha, (2008) Antibacterial evaluation of some plant extracts against some human pathogenic bacteria, Advances in Biological Research, vol. 2, no. 3-4,pp , of Plants in Nigeria, Ibadan University Press, de Hoog, G.S., Guarro, J., Figueras, Gene & M.J Atlas of Clinical Fungi, 2 nd ed. Centraalbureau voor Schimmelcultures. Utrecht, The Netherlands. East-Innis A, Rainford L, Dunwell P, Barret- Robinson D, Nicholson AM. The changing pattern of tinea capitis in Jamaica. West Indian Med J 2006;55:85-8. Nweze EI. Etiology of dermatophytoses amongst children in northeastern Nigeria. Med Mycol 2010;39: Ogunbiyi AO, Owoaje E, Ndahi A. Prevalence of skin disorders in school children in Ibadan, Nigeria. Paediatr Dermatol 2005;22:6. Satpute SB and Vanmare DJ In vitro antifungal activity of Tamarindus indica L. extract against pathogenic fungi International Journal of Botany Studies Volume 2; Issue 3; May 2016; Page No Uneke CJ, Ngwu BA, Egemba O. Tinea Capitis and Pityriasis Versicolor Infections among School Children in the South-Eastern Nigeria: The Public Health Implications. Int J Dermatol 2006;4:2. Wagini N H, Mohamed Said Abbas, Amira Shawky Soliman, Yasser Adel Hanafy, El- Saady Mohamed Badawy. In Vitro and in Vivo Anti Dermatophytes Activity of Lawsonia Inermis L. (Henna) Leaves against Ringworm and Its Etiological Agents. American Journal of Clinical and Experimental Medicine. Vol. 2, No. 3, 2014, pp doi: /j.ajcem Weitzman I, Summerbell RC. The dermatophytes. Clin Microbiol Rev 1995;8: Umaru Musa Yar adua University, Katsina NIGERIA. All Rights Reserved... Page 173