{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T17:27:41Z","timestamp":1785432461355,"version":"3.56.0"},"reference-count":35,"publisher":"AOSIS","issue":"1","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background:\u00a0Although onychomycosis is common worldwide and often significantly impairs the quality of life of patients, local epidemiological and mycological data are lacking. We therefore investigated the risk factors, clinical features and mycological aspects of onychomycosis in KwaZulu-Natal.\nMethods:\u00a0This study had two components. In the retrospective arm, positive fungal nail cultures from 2018 to 2024 were analysed. Prospectively in 2025, clinical and mycological data were collated. Descriptive statistical methods were used to summarise the dataset.\nResults:\u00a0Out of a total of 301 patients, 229 patients with positive cultures were analysed. The retrospective analysis (n\u00a0= 177) showed\u00a0Candida\u00a0species were the most common (66.7%), followed by moulds (13.6%) and\u00a0Trichophyton\u00a0species (11.9%). Prospectively, 124 patients were included; 51.6% females and 48.4% males with a median age of 58.0 years.\u00a0Candida\u00a0species (40.4%), moulds and\u00a0Trichophyton\u00a0species (25.0% each) were most frequent in 52 patients with positive cultures. All\u00a0Candida\u00a0species were susceptible to fluconazole. Most patients had subungual hyperkeratinisation. Immunosuppression (other than human immunodeficiency virus [HIV] infection and diabetes mellitus) was the most common risk factor.\nConclusion:\u00a0Candida\u00a0species were the commonest cause of onychomycosis; therefore fluconazole is an appropriate treatment modality. However, revision of the existing essential drug list is recommended to include itraconazole or terbinafine for patients with confirmed infection with moulds or dermatophytes.\nContribution:\u00a0This is the first detailed analysis of onychomycosis in KwaZulu-Natal and contributes to the limited body of data in South Africa. Our results may be used to inform therapeutic recommendations.<\/jats:p>","DOI":"10.4102\/jcmsa.v4i1.409","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T14:29:23Z","timestamp":1784298563000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Onychomycosis in KwaZulu-Natal: Clinical spectrum, risk factors and fungal susceptibility"],"prefix":"10.4102","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-2416-9301","authenticated-orcid":false,"given":"Jaya","family":"Jhoomuck","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04qzfn040","id-type":"ROR","asserted-by":"publisher"}],"name":"University of KwaZulu-Natal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8101-7194","authenticated-orcid":false,"given":"Yesholata","family":"Mahabeer","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00znvbk37","id-type":"ROR","asserted-by":"publisher"}],"name":"National Health Laboratory Service"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9825-6191","authenticated-orcid":false,"given":"Antoinette","family":"Chateau","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04qzfn040","id-type":"ROR","asserted-by":"publisher"}],"name":"University of KwaZulu-Natal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2580","published-online":{"date-parts":[[2026,7,20]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"Aggarwal R, Targhotra M, Kumar B, Sahoo PK, Chauhan MK. 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Mycoses. 2024;67(4):e13725. https:\/\/doi.org\/10.1111\/myc.13725","DOI":"10.1111\/myc.13725"}],"container-title":["Journal of the Colleges of Medicine of South Africa"],"original-title":[],"link":[{"URL":"https:\/\/jcmsa.org.za\/index.php\/jcmsa\/article\/view\/409\/1131","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T14:29:37Z","timestamp":1784298577000},"score":1,"resource":{"primary":{"URL":"https:\/\/jcmsa.org.za\/index.php\/jcmsa\/article\/view\/409"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,20]]},"references-count":35,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,1]]}},"URL":"https:\/\/doi.org\/10.4102\/jcmsa.v4i1.409","relation":{},"ISSN":["3105-4331","2960-110X"],"issn-type":[{"value":"3105-4331","type":"print"},{"value":"2960-110X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,20]]},"article-number":"a409"}}