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Prevalence, aetiology and factors associated with onychomycosis among patients with diabetes at a Tertiary Care Centre in Galle, Sri Lanka

J. G. M. A. Thilakarathna iD, H. K. T. A. Gunasekera iD, B. Perera iD, H. H. P. M. J. Thabrew iD

Sri Lankan Journal of Infectious Diseases 14(2) · 2024

https://doi.org/10.4038/sljid.v14i2.8672

Abstract

Introduction: Epidemiological data of onychomycosis, a common fungal nail infection found in diabetics, is scarce in Sri Lanka. Objective: To determine the prevalence, aetiological agents and associated factors of onychomycosis among patients with clinically suspected diabetics in southern Sri Lanka. Method: A cross-sectional study was done using a sample of 97 diabetic patients suspected of having onychomycosis in a tertiary diabetes care centre in Galle. Nail clippings were collected, and microscopic and cultural examinations were done. Both microscopic and culture positive cases were considered as having onychomycosis. Results: The prevalence of onychomycosis was 18.6% (95% CI: 11.38%, 27.73%). Non-dermatophyte moulds (NDMs) (55.7%) and yeast (30.9%) were the dominant aetiological agents. The leading pathogens found among NDMs were Aspergillus sp. (35.1%) and Fusarium sp. (1.4%) and Candida albicans (8.2%). Aspergillus niger (20.6%) was the most frequently isolated Aspergillus sp. in the NDMs. Frequent use of detergents and walking bare foot were the significant risk factors of onychomycosis. Only 15.5% of the participants were aware of onychomycosis. Conclusion: Onychomycosis is prevalent to a considerable level among diabetics. Regular dermatological investigations of nails and health education are needed to combat the disease. Large scale research is warranted to confirm these assertions.

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