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

• 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
• DOI: 10.1016/j.trstmh.2011.12.001
• EISSN: 1878-3503
• ISSN: 0035-9203

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.