Spatial Epidemiology and Risk Factors Associated with Surficial Fungal Infection in Schoolchildren of North Pakistan

Background and Objective: Superficial fungal infections (SFIs) pose a significant public health challenge, particularly among school-age children worldwide, including in Pakistan, with a specific focus on Gilgit-Baltistan. The objective of this study was to investigate the spatial epidemiology of SFIs in various schools and identify associated risk factors, to implement evidence-based strategies in fragile regions. Materials and Methods: A descriptive, geostatistical, and GIS mapping approach was used in this research. Five valleys in Gilgit-Baltistan were selected, with a total of 50 schools, from which 10 were randomly chosen per valley. A total of 850 primary schoolchildren were assessed for SFI infections, and the types of fungal species were determined. To analyze risk factors, infected students were randomly selected and surveyed using a structured questionnaire. Thematic maps were created using ArcMap 10.8 with ArcGIS software’s Spatial Analyst function, employing the Inverse Distance Weight (IDW) interpolation method. Results: The study revealed varying spatial patterns of SFI prevalence across the region, with prevalence ranging from 60 to 80% and incidence from 14.98 to 26.42%. The most common species were T. faciei, T. capitis, and T. corporis, with T. manuum being the least frequent. Geo-statistical analysis showed moderate spatial dependency for overall SFI prevalence (67.51) and incidence (72.81), with stronger dependencies observed for specific species. Risk factors identified included joint family systems, pit latrines, pet interactions, sharing personal items, and low socioeconomic status. Conclusion: This study highlights the urgent need for health education programs to reduce SFI prevalence and mitigate its long-term health and socioeconomic impacts among schoolchildren.