# Epidemiology and Three-Month Recurrence of Tinea Infections in a Prison: A Cross-Sectional Study

## TL;DR

This study finds that tinea infections have a high recurrence rate in prisons, likely due to shared living conditions rather than individual factors.

## Contribution

The study identifies facility-level environmental risk factors as key drivers of tinea recurrence in prisons, suggesting targeted interventions at the institutional level.

## Key findings

- Tinea infections had a 53.4% recurrence rate in a prison population over three months.
- Environmental risk factors like sharing towels and razors were nearly universal among inmates.
- No individual-level factors like age or diabetes significantly predicted recurrence.

## Abstract

Background

Tinea infections are common dermatophyte infections with high recurrence rates, particularly in crowded institutional settings. Limited data exist on the epidemiology and recurrence patterns in prisons where environmental and behavioral risk factors are highly prevalent.

Objective

The objective of this study is to describe the epidemiology of tinea infections and characterize risk factor distribution in an incarcerated population with high recurrence rates.

Methods

A cross-sectional study was conducted among 73 inmates at a prison in Baghdad, Iraq. Patients with clinically diagnosed tinea infections were enrolled and followed for three months post-treatment. Baseline demographic, clinical, behavioral, and environmental data were collected. Univariate logistic regression and chi-square analyses were performed to evaluate potential predictors of recurrence.

Results

The overall three-month recurrence rate was 53.4% (39/73). Environmental risk exposures were nearly universal: 63 (86.3%) had a cellmate with tinea infection, 60 (82.2%) shared towels, and 56 (76.7%) shared razors. In univariate analysis, no individual-level factors significantly predicted recurrence, including age (OR 0.99, 95% CI 0.96-1.02, p=0.375), diabetes mellitus (OR 0.63, 95% CI 0.23-1.73, p=0.371), and prior tinea history (OR 0.61, 95% CI 0.24-1.54, p=0.296).

Conclusions

Tinea infections demonstrate extremely high recurrence rates (53.4%) in prisons despite standard treatment. The near-universal exposure to environmental risk factors and absence of individual-level predictors suggest that facility-level interventions, including provision of personal hygiene items, environmental disinfection, and concurrent treatment of contacts, may be more effective than targeting individual risk factors.