Postgraduate medicine · 2025
Nutritional deficiencies as risk factors for incidence and treatment response of tinea capitis in children: a prospective clinical cohort study.
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Seetan Khaled, Khamees Almu'atasim, Yassin Raghad Yousef, Ba-Shammakh Saleh A, Moh'd Amir Majdi
Аннотация
OBJECTIVES: Tinea capitis is one of the most common fungal infections in children around the world. However, the relationship between nutrition and the risk of infection, as well as treatment outcomes, has not been thoroughly studied. This study aimed to explore the relationship between certain micronutrient deficiencies and the occurrence, severity, and treatment response of tinea capitis in children.
METHODS: This prospective cohort study included 280 children aged 2-12 years, with 140 confirmed cases of tinea capitis and 140 matched controls from three clinical locations. Detailed nutritional assessments included growth measurements and lab tests for zinc, iron, vitamin D, and protein-energy levels. The cases received standard antifungal treatment and were monitored for 6 months to evaluate treatment results. We employed multivariate analyses to identify relationships between nutritional factors and the occurrence, severity, and treatment outcomes of the disease.
RESULTS: Even after controlling for other variables, zinc deficiency (OR = 2.87, 95% CI [1.71, 4.84], p < 0.001) and vitamin D deficiency (OR = 2.11, 95% CI [1.25, 3.58], p = 0.005) were found to increase the risk of tinea capitis independently. The symptoms and outcomes of treatment were worse in children with multiple nutritional deficiencies. At 8 weeks, children with nutritional deficiencies had a significantly lower rate of clinical cure (44.2%) than those without (71.4%, p < 0.001). The relationship between treatment response and socioeconomic status was significantly influenced by nutritional status.
CONCLUSIONS: Low levels of certain micronutrients, especially zinc and vitamin D, are key risk factors for children developing tinea capitis and not responding well to treatment. These findings suggest the potential benefits of integrated nutritional assessment and focused supplementation strategies, which should be evaluated in future interventional trials for pediatric tinea capitis, especially in resource-limited settings.
METHODS: This prospective cohort study included 280 children aged 2-12 years, with 140 confirmed cases of tinea capitis and 140 matched controls from three clinical locations. Detailed nutritional assessments included growth measurements and lab tests for zinc, iron, vitamin D, and protein-energy levels. The cases received standard antifungal treatment and were monitored for 6 months to evaluate treatment results. We employed multivariate analyses to identify relationships between nutritional factors and the occurrence, severity, and treatment outcomes of the disease.
RESULTS: Even after controlling for other variables, zinc deficiency (OR = 2.87, 95% CI [1.71, 4.84], p < 0.001) and vitamin D deficiency (OR = 2.11, 95% CI [1.25, 3.58], p = 0.005) were found to increase the risk of tinea capitis independently. The symptoms and outcomes of treatment were worse in children with multiple nutritional deficiencies. At 8 weeks, children with nutritional deficiencies had a significantly lower rate of clinical cure (44.2%) than those without (71.4%, p < 0.001). The relationship between treatment response and socioeconomic status was significantly influenced by nutritional status.
CONCLUSIONS: Low levels of certain micronutrients, especially zinc and vitamin D, are key risk factors for children developing tinea capitis and not responding well to treatment. These findings suggest the potential benefits of integrated nutritional assessment and focused supplementation strategies, which should be evaluated in future interventional trials for pediatric tinea capitis, especially in resource-limited settings.