Tinea capitis is a highly contagious dermatophytosis and a frequent cause of scalp infection in school-aged children. Updated data from Burkina Faso are needed to guide prevention and control.

To describe the prevalence, clinical patterns, and mycological profile of tinea capitis among schoolchildren in the Centre and Plateau Central regions of Burkina Faso, and to describe exposure characteristics among culture-confirmed cases.

We conducted a school-based cross-sectional study of 7946 primary schoolchildren in 28 schools across four communes of the Centre and Plateau Central regions. Children with clinically suspected scalp lesions underwent direct microscopy and fungal culture for confirmation and species identification (based on conventional phenotypic criteria). A structured interview on sociodemographic and hairdressing-related characteristics was administered to children with clinically suspected lesions only. Group comparisons used the chi-square test or Fisher’s exact test, with p < 0.05 considered significant.

The clinical-suspicion prevalence was 4.59% (365/7946; 95% CI 4.15–5.08%) and the culture-confirmed prevalence was 3.80% (302/7946; 95% CI 3.40–4.24%). Among suspected cases, direct microscopy was positive in 44.65% (163/365; 95% CI 39.64–49.79%) and culture in 82.74% (302/365; 95% CI 78.53–86.27%). Among culture-confirmed cases (n = 302), 75.83% were boys and small-patch alopecia was the predominant clinical presentation (69.60% among suspected cases). Trichophyton species predominated (92.72% of isolates), and T. mentagrophytes was the most frequently isolated species (55.96%), followed by T. tonsurans (16.56%) and a group of T. rubrum -complex species ( T. rubrum, T. soudanense, T. violaceum, T. gourvilii ; 19.87% combined). Microsporum species were strongly associated with large-patch lesions (Fisher’s exact OR 41.1, 95% CI 14.1–120.1, p  <  0.001); no significant association was found between Trichophyton species and lesion morphology once species were grouped to avoid sparse cells (p = 0.38). Because the exposure questionnaire (sex, hairdressing practices, pet ownership, contact history) was administered only to children with clinically suspected lesions, the study design does not allow the exposure frequencies compared across regions among cases to be interpreted as associations with tinea capitis occurrence; these findings are therefore reported descriptively.

Tinea capitis remains present among schoolchildren in the Centre and Plateau Central regions of Burkina Faso and is dominated by Trichophyton species, particularly T. mentagrophytes on conventional phenotypic identification — a finding that should be interpreted cautiously given the methodological limits of morphology-based identification and the regional predominance of T. soudanense reported elsewhere in West Africa. A case-versus-non-case study, incorporating clustering by school, is needed before hairdressing practices, pet ownership, or household contact can be established as risk factors in this population.