Jigger flea infestation (tungiasis) in rural western Tanzania: high prevalence and severe morbidity

Epidemiologic and clinical data on the parasitic skin disease tungiasis are limited from sub-Saharan Africa, and virtually nonexistent from the East African region. We performed a community-based cross-sectional study in two villages in Kasulu district, western Tanzania. Study participants were exam...

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Published in:	Transactions of the Royal Society of Tropical Medicine and Hygiene Vol. 106; no. 4; pp. 259 - 263
Main Authors:	Mazigo, H.D., Bahemana, E., Konje, E.T., Dyegura, O., Mnyone, L.L., Kweka, E.J., Kidenya, B.R., Heukelbach, J.
Format:	Journal Article
Language:	English
Published:	Oxford Elsevier Ltd 01-04-2012 Oxford University Press
Subjects:	Adolescent Adult Africa Animals Biological and medical sciences Child Cross-Sectional Studies Female Flea Infestations - epidemiology General aspects Human parasitic diseases due to arthropods Humans Infectious diseases Male Medical sciences Middle Aged Morbidity Needs Assessment Parasitic diseases Poverty Areas Prevalence Public Health Risk Factors Rural Health - statistics & numerical data Rural Population - statistics & numerical data Severity of Illness Index Tanzania Tanzania - epidemiology Tunga Tungiasis Tungiasis - epidemiology Tungiasis - immunology Young Adult Africa Tanzania Prevalence Morbidity Africa Tanzania Tungiasis Infection Rural environment Prognosis Tropical medicine Parasitosis Epidemiology
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Summary:	Epidemiologic and clinical data on the parasitic skin disease tungiasis are limited from sub-Saharan Africa, and virtually nonexistent from the East African region. We performed a community-based cross-sectional study in two villages in Kasulu district, western Tanzania. Study participants were examined for the presence of tungiasis and disease-associated morbidity. In total, 586 individuals >5 years of age were enrolled, and 249 (42.5%; 95% CI: 38.5–46.5) diagnosed with tungiasis. The ≥45 year-olds showed highest prevalence of tungiasis (71.1%) and most severe parasite load (median number of embedded fleas: 17.5; interquartile range: 15–22.5). Prevalence was slightly, but not significantly, higher in males than in females (45.3 vs 39.7%; p=0.17). Itching (68.3%), pain (38.6%) and ulcers (30.1%) were common; 22.1% of individuals found it difficult to walk due to tungiasis, and in 21.3% loss of toenails was observed. Considering the high prevalence and considerable morbidity in the population, we conclude that tungiasis is a public health threat in the study villages and that the disease needs to be recognized by health authorities. Future studies on risk factors, animal reservoirs and evidence-based control measures are needed.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0035-9203 1878-3503
DOI:	10.1016/j.trstmh.2011.12.001