Evaluation of Antifungal Activity of CalvatiaCraniiformis and IverMectin as Novel Alternative Therapies for Aspergillus Niger Associated Acute Otitis Media with Special Refer to SocioDemographic Factors Among Rural Children of Diyala Province-Iraq

Objectives are to determine antifungal activity of Ivermectin and Calvatiacraniiformis as a novel alternative therapy for aspergillus niger associated acute otitis media (AOM) among rural children of Diyala province; correlation of sociodemographic factors with frequency of infection. Ear swabs taken from 58 infected children and cultured onSabouraud dextrose agar for 7-14 days .Macroscopic and microscopic criteria used for diagnosis of A.niger .High isolation rate for A.niger (27.59%) among children of (4-6) years with significant difference between age groups ( p value 0.039); genders ( p value 0.004);house status(p value=0.018);family size (p value =0.00006334) and month of infection (p value=0.000). A.niger infection negatively correlated with patients age (p value =0.039), family economy and house status (p value =0.000),family size (p value =0.000). Alcohol extract of C.craniiformis (100mg, 200mg, 400mg, 500mg, 600mg, 800mg and 1000 mg) and ivermectin (0.5%,1 % and 2%) restricted the growth of A. niger after 3 days .Significance difference reported between all concentrations except 100 mg and 200 mg ; 600 mg and 800 mg. Significance difference in inhibitory activity between concentration 1% and 2%,0.5% and 2% of Ivermectin respectively. Conclusions: A.niger infections positively correlated with family size and inversely with age and family economy. The growth of A nigersignificantly restricted by alcohol extract of C.craniiformis and Ivermectin in concentration dependent manner. The powerful concentration was 1000mg, for C.craniiformis and 2% for Ivermectin. Thus, C.craniiformis and Ivermectin consider a novel antifungal agents that can be used in clinical practice for treatment of A.niger associated otitis media that represents a clinical problem in children and need serious attention from clinicians.