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 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.
Department of Medical Parasitology and Entomology, Faculty of Medicine, Weill-Bugando University College of Health Sciences, Mwanza, Tanzania.
H D
HD
Mazigo
E
E
Bahemana
E T
ET
Konje
O
O
Dyegura
L L
LL
Mnyone
E J
EJ
Kweka
B R
BR
Kidenya
J
J
Heukelbach
D000293:Adolescent; D000328:Adult; D000818:Animals; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D058267:Flea Infestations / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D011204:Poverty Areas; D015995:Prevalence; D011634:Public Health; D012307:Risk Factors; D012423:Rural Health / Q000706:statistics & numerical data; D012424:Rural Population / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D013636:Tanzania / Q000453:epidemiology; D058253:Tunga; D058285:Tungiasis / Q000453:epidemiology* / Q000276:immunology; D055815:Young Adult