Risk Factors for Tungiasis in Nigeria: Identification of Targets for Effective Intervention

Abstract

BackgroundThe parasitic skin disease tungiasis (caused by the flea Tunga penetrans) affects resource-poor communities in Latin America, the Caribbean and sub-Saharan Africa. Prevalences in endemic areas are high, and severe pathology occurs commonly. However, risk factors for infestation have never been assessed in Africa.Methods and FindingsA cross-sectional study was conducted in Erekiti, a rural community in Lagos State (Nigeria), where tungiasis is endemic. Individuals were examined clinically for the presence of tungiasis, and a questionnaire was applied. Data from 643 individuals (86.6% of the target population) were analyzed; 252 (42.5%) were infested with T. penetrans. In the multivariate logistic regression analysis, presence of pigs on the compounds (adjusted odds ratio = 17.98; 95% confidence interval: 5.55–58.23), sand or clay floor inside houses (9.33; 5.06–17.19), and having the common resting place outside the house (7.14; 4.0–14.29) were the most important risk factors identified. The regular use of closed footwear (0.34; 0.18–0.62) and the use of insecticides indoors (0.2; 0.05–0.83) were protective against infestation. The population attributable fractions associated with tungiasis were: sand or clay floor inside the house (73.7%), resting usually outside the house (65.5%), no regular use of closed footwear (51.1%), and pigs on the compound (37.9%).ConclusionThe presence of tungiasis in Erekiti is determined to an important extent by a limited number of modifiable variables. Effective and sustainable intervention measures addressing these factors need to be implemented in this and other West African communities with high disease burden.

Tungiasis infestation in Tanzania

“…The report indicates that, similar to recent accounts from other African countries such as Nigeria [2,16], Madagascar [17] and Cameroon [18,19], the disease may also reach high parasite loads in individuals in Tanzania, with consequently severe pathology, in contrast to milder cases reported by returning tourists. The patient was living under conditions previously described as risk factors in studies from Brazil and Nigeria [20,21]: i.e., people living under poor conditions, usually in houses with floors made of sand or mud. The type of soil in the area is red clay soil which gives much dust during the dry season.…”

Tungiasis in Northern Tanzania: a clinical report from Qameyu village, Babati District, Manyara Region

“…To date, very few studies on tungiasis epidemiology in Africa have been published [3][4][5][6][7][8]. In 1981, Ejezie reported that 49.5% of primary schoolchildren in the Lagos State (Nigeria) were affected by tungiasis [4].…”

Tungiasis, una enfermedad tropical emergente en Chile: Comunicación de tres casos clínicos importados

“…La infección en el ser humano se ve favorecida por importantes factores socioculturales asociados con la pobreza, la costumbre de caminar descalzo o con sandalias, la falta de higiene y la entrada de animales libremente en las casas como cerdos, perros y ratas 7 . La transmisión de la pulga suele producirse como consecuencia de la deambulación sin calzado sobre suelos contaminados por heces de animales infestados.…”