Tinea infections in prison – Recurrence

Title : Tinea infections in prison – Recurrence

Abstract:

Background: Dermatophyte infections carry significant recurrence rates, particularly in closed institutional settings. Prisons represent high-risk environments due to overcrowding, shared personal items, and limited healthcare access. Quantitative data on recurrence rates and predictors specifically within prison populations remain scarce.

Methods: A cross-sectional observational study was conducted among 73 male inmates at a Baghdad prison (January–August 2023). Patients with clinically diagnosed tinea infections received standardised antifungal treatment and were followed for three months. Baseline demographic, clinical, behavioural, and environmental data were collected. Univariate logistic regression and chi-square analyses evaluated predictors of recurrence.

Results: The three-month recurrence rate was 53.4% (39/73; 95% CI: 41.4–65.0%). Environmental exposures were near-universal: 86.3% had a cellmate with tinea infection, 82.2% shared towels, and 76.7% shared razors. No individual-level factors significantly predicted recurrence, including age (OR 0.99; p=0.375), diabetes mellitus (OR 0.63; p=0.371), prior tinea history (OR 0.61; p=0.296), shower frequency (OR 1.22; p=0.501), and baseline disease severity (OR 0.76; p=0.507). Notably, diabetic patients showed numerically lower recurrence rates than non-diabetic patients (45.5% vs. 56.9%).

Conclusions: Tinea infections demonstrate exceptionally high recurrence rates in prison settings despite standard treatment. The near-universal environmental exposure and absence of individual-level predictors suggest a “saturation of exposure” phenomenon, where facility-level transmission overwhelms individual risk factors. These findings argue for prioritising institutional interventions — including provision of personal hygiene items, environmental disinfection, and concurrent contact treatment — over individual-risk-based approaches in correctional settings.

Biography:

Dr Abdullah Abdullah is an Internal Medicine Trainee at Newham University Hospital, Barts Health NHS Trust, London. He graduated from the College of Medicine, University of Baghdad in 2015 and holds MRCP Parts 1 and 2. He has broad clinical experience across internal medicine and dermatology, having trained in both the UK and Iraq. His research interests span inflammatory and infectious dermatological conditions, with published case reports in pemphigus vulgaris and fungal cellulitis, as well as cross-sectional studies examining tinea infections and pityriasis versicolor. He has conducted a network meta-analysis comparing biologic therapies for moderate-to-severe plaque psoriasis, evaluating IL-17 and IL-23 inhibitors across Phase III randomised controlled trials — the findings of which are presented at this conference. He has also conducted quality improvement work evaluating service delivery and equity of access to biologic therapy initiation in inflammatory bowel disease across different healthcare settings.