title: Animal Reservoirs of Zoonotic Tungiasis in Endemic Rural Villages of Uganda.
abstract: BACKGROUND
  Animal tungiasis is believed to increase the prevalence and parasite burden in humans. Animal reservoirs of Tunga penetrans differ among endemic areas and their role in the epidemiology of tungiasis had never been investigated in Uganda.
  
  
  RESULTS
  To identify the major animal reservoirs of Tunga penetrans and their relative importance in the transmission of tungiasis in Uganda, a cross sectional study was conducted in animal rearing households in 10 endemic villages in Bugiri District. T. penetrans infections were detected in pigs, dogs, goats and a cat. The prevalences of households with tungiasis ranged from 0% to 71.4% (median 22.2) for animals and from 5 to 71.4% (median 27.8%) for humans. The prevalence of human tungiasis also varied among the population of the villages (median 7%, range 1.3-37.3%). Pig infections had the widest distribution (nine out of 10 villages) and highest prevalence (median 16.2%, range 0-64.1%). Pigs also had a higher number of embedded sand fleas than all other species combined (p < 0.0001). Dog tungiasis occurred in five out of 10 villages with low prevalences (median of 2%, range 0-26.9%). Only two goats and a single cat had tungiasis. Prevalences of animal and human tungiasis correlated at both village (rho = 0.89, p = 0.0005) and household (rho = 0.4, p < 0.0001) levels. The median number of lesions in household animals correlated with the median intensity of infection in children three to eight years of age (rho = 0.47, p < 0.0001). Animal tungiasis increased the odds of occurrence of human cases in households six fold (OR = 6.1, 95% CI 3.3-11.4, p < 0.0001).
  
  
  CONCLUSIONS
  Animal and human tungiasis were closely associated and pigs were identified as the most important animal hosts of T. penetrans. Effective tungiasis control should follow One Health principles and integrate ectoparasites control in animals.
authors.affiliation: School of Veterinary Medicine and Animal Resources, College of Veterinary Medicine, Animal Resources and Bio-security, Makerere University, Kampala, Uganda.
authors.forename: Francis
authors.initials: F
authors.lastname: Mutebi
authors.affiliation: Institute for Parasitology and Tropical Veterinary Medicine, Freie Universität Berlin, Berlin, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Krücken
authors.affiliation: Institute of Microbiology and Hygiene, Charité University Medicine, Berlin, Campus Benjamin Franklin, Berlin, Germany.
authors.forename: Hermann
authors.initials: H
authors.lastname: Feldmeier
authors.affiliation: School of Veterinary Medicine and Animal Resources, College of Veterinary Medicine, Animal Resources and Bio-security, Makerere University, Kampala, Uganda.
authors.forename: Charles
authors.initials: C
authors.lastname: Waiswa
authors.affiliation: Bayer Animal Health, Leverkusen, Germany.
authors.forename: Norbert
authors.initials: N
authors.lastname: Mencke
authors.affiliation: Department of Medical Microbiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Sentongo
authors.affiliation: Institute for Parasitology and Tropical Veterinary Medicine, Freie Universität Berlin, Berlin, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: von Samson-Himmelstjerna
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D002415:Cats; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004197:Disease Reservoirs; D004285:Dogs; D005191:Family Characteristics; D005260:Female; D006041:Goats; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010273:Parasitic Diseases, Animal / Q000453:epidemiology* / Q000469:parasitology; D015995:Prevalence; D012424:Rural Population; D013552:Swine; D058253:Tunga / Q000254:growth & development*; D058285:Tungiasis / Q000453:epidemiology* / Q000469:parasitology / Q000662:veterinary*; D014454:Uganda / Q000453:epidemiology; D055815:Young Adult