PLoS Neglected Tropical Diseases (2017) 11 (10 - e0005925)

Susanne Wiese, Lynne Elson, Felix Reichert, Barbara Mambo and Hermann Feldmeier (2017)
Prevalence, intensity and risk factors of tungiasis in Kilifi County, Kenya: I. Results from a community-based study
PLoS Neglected Tropical Diseases 11 (10 - e0005925)
Abstract:
Background
Tungiasis is a neglected tropical disease caused by female sand fleas (Tunga penetrans) embedded in the skin. The disease is associated with important morbidity. Tungiasis is endemic along the Coast of Kenya with a prevalence ranging from 11% to 50% in school-age children. Hitherto, studies on epidemiological characteristics of tungiasis in Africa are scanty.
Methods
In a cross-sectional study 1,086 individuals from 233 households in eight villages located in Kakuyuni and Malanga Sub-locations, Kilifi County, on the Kenyan Coast, were investigated. Study participants were examined systematically and the presence and severity of tungiasis were determined using standard methods. Demographic, socio-economic, environmental and behavioral risk factors of tungiasis were assessed using a structured questionnaire. Data were analyzed using bivariate and multivariate regression analysis.
Results
The overall prevalence of tungiasis was 25.0% (95% CI 22.4–27.5%). Age-specific prevalence followed an S-shaped curve, peaking in the under-15 year old group. In 42.5% of the households at least one individual had tungiasis. 15.1% of patients were severely infected (> 30 lesions). In the bivariate analysis no specific animal species was identified as a risk factor for tungiasis. Multivariate analysis showed that the occurrence of tungiasis was related to living in a house with poor construction characteristics, such as mud walls (OR 3.35; 95% CI 1.71–6.58), sleeping directly on the floor (OR 1.68; 95% CI 1.03–2.74), the number of people per sleeping room (OR = 1.77; 95% CI 1.07–2.93) and washing the body without soap (OR = 7.36; 95% CI 3.08–17.62). The odds of having severe tungiasis were high in males (OR 2.29; 95% CI 1.18–44.6) and were very high when only mud puddles were available as a water source and lack of water permitted washing only once a day (OR 25.48 (95% CI 3.50–185.67) and OR 2.23 (95% CI 1.11–4.51), respectively).
Conclusions
The results of this study show that in rural Kenya characteristics of poverty determine the occurrence and the severity of tungiasis. Intra-domiciliary transmission seems to occur regularly.
(The abstract is excluded from the Creative Commons licence and has been copied with permission by the publisher.)
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Research topic(s) for pests/diseases/weeds:
surveys/sampling/distribution

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Pest and/or beneficial records:

Beneficial	Pest/Disease/Weed	Crop/Product	Country	Quarant.
	Tunga penetrans		Kenya