A controlled field trial in Yugoslavia of the efficacy of griseofulvin in the mass treatment of tinea capitis.
The introduction of the orally administered antibiotic griseofulvin has wrought a dramatic change in the prospects for controlling ringworm of the scalp. With the assistance of the World Health Organization, a field trial was carried out in Yugoslavia to determine the most suitable schedule of dosage with this drug for mass treatment and to ascertain what measures are necessary to reduce the reservoir of infection to a level where the disease ceases to be a public health problem. The value of supplementing griseofulvin administration by local treatment of the scalp was also investigated.In the endemic area selected for the trial, 495 cases of tinea capitis due to infection with Trichophyton violaceum were detected and treated among a total population of 4106. It was found that a relatively low dose (25 mg of griseofulvin per kg of body-weight, given once a week for 4 weeks) was sufficient to produce clinical cure, confirmed by microscopy, in some 95% of cases, as determined at a resurvey 6 months after the end of the treatment period. Treatment of household contacts of infected persons had no significant influence on the rate of cure. Local treatment of the scalp, on the other hand, did significantly enhance the recovery rate.An unexpected finding was that patients treated in the field trial showed consistently better recovery rates than patients given similar treatment in hospital. A controlled trial to test this finding is planned.