Rate of Potassium Hydroxide Test Positivity among Clinically Suspected Primary Onychomycosis Patients and Associated Factors at ALERT Addis Ababa, Ethiopia: A prospective study
No Thumbnail Available
Date
2023-12
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Addis Ababa University
Abstract
Background: Onychomycosis is a fungal infection of nails caused by dermatophytes, yeasts or nondermatophyte molds and one of the mostcommon nail diseases seen in dermatology (1). Onychomycosis clinically presents with nail discoloration which could be yellow, white or, brown, detachment of the distal nail plate from the nail bed, easy fragility, nail plate thickening, and subungual hyperkeratosis (2). To arrive on accurate diagnosis of onychomycosis, mycological laboratory testing and confirmation is the optimal way and it is cost effective for the patient than treating the patient without confirming the diagnosis (3). Even though we usually use potassium hydroxide mount (KOH) as a diagnostic test for clinically suspected
onychomycosis cases in our setting, the few studies done in Ethiopia gave emphasis on identification of the etiologic agents by culture.
Objectives: The objective of this study was to determine the rate of KOH positivity among clinically suspected primary onychomycosis cases and the associated factors in patients visiting Dermatology unit of All African Leprosy Rehabilitation Training Center (ALERT) Hospital, Addis Ababa, Ethiopia, from March to August, 2023.
Methods: A facility-based, prospective, cross-sectional study was conducted among patients with clinically suspected primary onychomycosis attending the dermatology clinic of ALERT Center in Addis Ababa, Ethiopia from March to August, 2023. A structured questionnaire was used to collect the data from patients. Data was analyzed by using Statistical package for social science version 26. Frequency distributions, percentages, tables and charts were used to show descriptive results. Chi square test was used to see the relation between dependent and independent variables. 11
Result: 100 patients with clinically suspected onychomycosis were included in the study. The mean age was 32.38 years, and the sex ratio (female/male) was 2.4:1. The rate of KOH positivity was 67%. The mean duration of nail abnormality was 3.57 years. Finger nails were commonly affected (50%) followed by toe nails (33%). Most patients had only 1 nail involvement (36%) followed by 2 nails (16%). Almost all had discoloration (98%) and 65% of them had subungual hyperkeratosis and nail plate thickening. DLSO was the most common type of onychomycosis identified (44%) followed by TDO (42%). Site of involvement and nail discoloration were associated with KOH positivity in bivariate analysis.
Conclusion: According to our study the rate of KOH positivity in clinically suspected cases is relatively low. The finger nails are affected more by onychomycosis than the toe nails. Nail discoloration is the predominant presenting complaint of patients with onychomycosis. Site of involvement and nail discoloration are associated with KOH positivity.
Description
Keywords
Rate of Potassium Hydroxide