2007年度全国高等学校総合体育大会における柔道競技者の Trichophyton tonsurans 感染症検診  [in Japanese] Screening Examination of Trichophyton tonsurans among Judo Practitioners at the All Japan Inter High School Championships, Saga 2007  [in Japanese]

2007年度に佐賀県で開催された全国高等学校総合体育大会における，柔道競技者のTrichophyton tonsurans（T. tonsurans）感染症を目的としたhair brush sampling法（HB法，スパイク90本）による検診を行った．競技参加者951名の中で検診希望者487名（男265名，女222名）を対象とした．陽性率の高い地域は九州21%（73名中15名），東北17%（77名中13名），近畿16%（89名中14名），中部13%（89名中12名）であった．さらにHB法でコロニー数30個以上の強陽性者は九州４名，東北４名，中部２名，近畿２名でありHB法陽性率の高い４地域と一致した．アンケート調査の回答ではT. tonsurans感染の存在を90%は知っており，HB法検診の経験者は11％であった．37%（486名中178名）は検診結果の報告を不要と回答した．HB法検診の経験が少ない理由としては，皮膚科医によるHB法検診がまだ充分浸透していないことや，HB法などによってT. tonsurans感染者が判明し，試合への参加が制限されることを懸念するためHB法検診への参加に消極的であることなどが考えられた．したがって監督指導者に対するT. tonsurans感染症の啓発も重要であるが，我々皮膚科医も自主的に学校や団体に赴き，HB法などを用いた検診を積極的に行うべきである．検診結果報告不要の理由として，検診結果が監督や仲間に公表される危惧をあげる選手も多く，このことがHB法検診への不参加につながっていることが推測され，結果報告時の個人情報の取り扱いには充分なる配慮が必要と考えた．

This paper presents the results of an examination for Trichophyton tonsurans(T. tonsurans)performed by the hairbrush(HB; 90 bristles)method at the All Japan Inter High School Championships, Saga 2007. Samples were taken from 487 Judo practitioners(265 males and 222 females)out of a total of 951. The areas with the highest positive rates were: Kyushu 21%(15 participants out of 73 sampled), Tohoku 17%(13 out of 77), Kinki 16%(14 out of 89), and Chubu 13%(12 out of 89). Four participants from Kyushu, four from Tohoku, two from Kinki, and two from Chubu were strongly positive carriers, their samples developing more than 30 colonies per dish. This finding is in concordance with the high HB-positive rates in these areas. The results of a questionnaire distributed during sampling showed that 90% of the examinees had heard of T. tonsurans infection, 11% had been sampled by the HB method previously, and 37% declined to receive the results of the medical examination. The low percentage of participants who had experienced a HB sampling before could be explained by the insufficient penetration of this test among dermatologists, as well as by the fact that team trainers are reluctant to expose their athletes to sampling. Although trainers education concerning T. tonsurans is also an important factor, we strongly recommend that dermatologists take the initiative to perform medical examinations such as HB sampling in schools or at other public organizations. As for the reason why so many practitioners refused to be informed about the diagnosis, many of them mentioned being afraid that it might be overheard by trainers or fellow practitioners. It can be easily inferred that this type of concern leads Judo practitioners to avoid participation in sampling. Therefore, we concluded that substantial care to protect personal information is essential when communicating the results of the examination.