Cohen A D, Wolak A, Alkan M, Shalev R, Vardy D A
Dermatology Center, Clalit Health Services, Southern District, Internal Medicine E and Infectious Diseases Institute, Soroka University Medical Center, Faculty of Health Sciences, Ben-Guion University of the Negev, Beer-Sheva, Israel.
Int J Dermatol. 2005 Dec;44(12):1002-5. doi: 10.1111/j.1365-4632.2005.02281.x.
Tinea pedis is a common infection in soldiers. However, prevalence and risk factors for tinea pedis in soldiers were investigated in only a few studies.
To investigate the prevalence and risk factors for tinea pedis in Israeli soldiers.
A cross-sectional study including interviews, clinical skin examination and mycological tests was performed in Israeli soldiers. The presence of tinea pedis was assessed using the Athlete's Foot Severity Index (AFSI), a scoring system that was developed in order to evaluate the presence and severity of tinea pedis. In soldiers with clinical evidence of tinea pedis (AFSI > 1), scrapings were taken for direct microscopic examination (20% KOH preparation) and fungal culture. Statistical analyses were performed using chi-square or Fisher's exact test for dichotomous variables (as needed), or t-tests for continuous variables. Logistic regression was used for multivariate analyses of dichotomous variables.
Two hundred and twenty-three soldiers were included in the study: 205 men (91.9%) and 18 women (8.1%). Mean age was 19.6 years (SD 1.0 year). Clinical point prevalence was 60.1%. Mycological point prevalence was 27.3%. Further analyses were performed using the clinical point prevalence. Univariate analyses demonstrated that the prevalence of tinea pedis varied with the setting of military training (basic training: 70.3%, advanced infantry training: 81.5%, armor commander training: 56.4% and armor officer training: 34.8%) and was associated with male gender, frequency of sock changes and the length of military service. A multivariate analysis demonstrated that tinea pedis was associated with the setting of the military training (OR 1.6, 95% CI 1.2-2.1) and male gender (OR 4.3, 95% CI 1.4-13.8); however, there was no association with hygiene measures (e.g. frequency of changing socks or sleeping with socks) or the length of military service.
Tinea pedis is highly prevalent in Israeli soldiers. Association of tinea pedis with the setting of military training suggests that contagious spread may be an important risk factor. We suggest that environmental interventions should be planned to in order to decrease the morbidity of tinea pedis among soldiers.
足癣是士兵中常见的感染。然而，仅有少数研究调查了士兵中足癣的患病率及危险因素。
调查以色列士兵中足癣的患病率及危险因素。
对以色列士兵进行了一项横断面研究，包括访谈、临床皮肤检查和真菌学检测。使用足癣严重程度指数（AFSI）评估足癣的存在情况，该评分系统是为评估足癣的存在及严重程度而制定的。对于有足癣临床证据（AFSI > 1）的士兵，采集皮屑进行直接显微镜检查（20%氢氧化钾制剂）和真菌培养。对二分变量使用卡方检验或费舍尔精确检验（按需）进行统计分析，对连续变量使用t检验。对二分变量进行多变量分析时使用逻辑回归。
223名士兵纳入研究：205名男性（91.9%）和18名女性（8.1%）。平均年龄为19.6岁（标准差1.0岁）。临床时点患病率为60.1%。真菌学时点患病率为27.3%。使用临床时点患病率进行进一步分析。单变量分析表明，足癣患病率因军事训练环境而异（基础训练：70.3%，高级步兵训练：81.5%，装甲指挥官训练：56.4%，装甲军官训练：34.8%），并与男性性别、换袜子频率和服役时长相关。多变量分析表明，足癣与军事训练环境（比值比 [OR] 1.6，95%置信区间 [CI] 1.2 - 2.1）和男性性别（OR 4.3，95% CI 1.4 - 13.8）相关；然而，与卫生措施（如换袜子频率或穿着袜子睡觉）或服役时长无关。
足癣在以色列士兵中高度流行。足癣与军事训练环境的关联表明接触传播可能是一个重要危险因素。我们建议应规划环境干预措施以降低士兵中足癣的发病率。
