Sepahvand Asghar, Behzadifar Meysam, Raiesi Omid, Yarahmadi Mohammad
Department of Medical Parasitology and Mycology, Lorestan University of Medical Sciences, Khorramabad, Iran.
Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran.
BMC Public Health. 2025 Sep 24;25(1):3116. doi: 10.1186/s12889-025-24308-5.
Tinea pedis, commonly known as athlete's foot, is a fungal infection caused by dermatophytes, affecting the skin of the feet. It is prevalent in various populations, but military personnel are particularly vulnerable due to their unique environmental and behavioral factors. These include living in close quarters, exposure to humid conditions, and wearing tight, non-breathable footwear for prolonged periods. This systematic review and meta-analysis aim to estimate the global prevalence of tinea pedis among military personnel and explore factors contributing to its high occurrence in this population. METHODS: A comprehensive literature search was conducted in multiple databases, including PubMed, Scopus, and Web of Science, for studies published in English up to 21 March 2025. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of the included studies, evaluating aspects such as the selection of participants, comparability, and the assessment of exposure. The prevalence rates were pooled using a random-effects model, and heterogeneity among studies was evaluated. Studies employing various diagnostic methods, including microscopy and fungal culture, were analyzed to identify variations in prevalence estimates. A subgroup analysis was performed based on geographic regions to explore the influence of environmental factors on prevalence. RESULTS: A total of 25 studies, involving military personnel from different regions, were included in the analysis. The pooled prevalence of tinea pedis among military personnel was estimated at 17% (95% CI: 12-23%). Subgroup analysis revealed regional variations, with the highest prevalence observed in the Americas and Australia, where hot and humid climates are prevalent. The lowest prevalence was observed in European studies, which may be attributed to milder climates. Studies using both microscopy and fungal culture reported higher prevalence rates (20%) compared to those relying solely on microscopy (9%). CONCLUSION: Tinea pedis remains a significant health concern among military personnel, with a global prevalence of 17%. Military environments, characterized by high physical activity, shared living conditions, and poor foot hygiene practices, exacerbate the risk of fungal infections. Preventive strategies, including improved foot hygiene, better footwear design, and enhanced access to antifungal treatments, are essential to reduce the prevalence of tinea pedis in military settings.
足癣，俗称运动员脚，是一种由皮肤癣菌引起的真菌感染，影响足部皮肤。它在不同人群中都很普遍，但由于独特的环境和行为因素，军人尤其容易感染。这些因素包括居住空间狭小、暴露于潮湿环境以及长时间穿着紧身、不透气的鞋子。本系统评价和荟萃分析旨在估计军人中足癣的全球患病率，并探讨导致该人群中足癣高发的因素。方法：在多个数据库中进行了全面的文献检索，包括PubMed、Scopus和Web of Science，检索截至2025年3月21日以英文发表的研究。使用纽卡斯尔-渥太华量表（NOS）评估纳入研究的质量，评估参与者选择、可比性和暴露评估等方面。使用随机效应模型汇总患病率，并评估研究之间的异质性。分析采用多种诊断方法（包括显微镜检查和真菌培养）的研究，以确定患病率估计值的差异。基于地理区域进行亚组分析，以探讨环境因素对患病率的影响。结果：共有25项涉及不同地区军人的研究纳入分析。军人中足癣的汇总患病率估计为17%（95%CI：12-23%）。亚组分析显示存在区域差异，在美洲和澳大利亚观察到的患病率最高，那里炎热潮湿的气候很普遍。在欧洲的研究中观察到的患病率最低，这可能归因于气候较为温和。与仅依靠显微镜检查（9%）的研究相比，同时使用显微镜检查和真菌培养的研究报告的患病率更高（20%）。结论：足癣仍然是军人中的一个重大健康问题，全球患病率为17%。以高体力活动、共同生活条件和不良足部卫生习惯为特征的军事环境加剧了真菌感染的风险。包括改善足部卫生、改进鞋类设计以及增加抗真菌治疗的可及性在内的预防策略对于降低军事环境中足癣的患病率至关重要。
