title: Tungiasis-associated morbidity in pigs and dogs in endemic villages of Uganda.
abstract: BACKGROUND
  Tunga penetrans (Insecta, Siphonaptera, Tungidae) causes severe morbidity among heavily infected humans and animals in Latin America and sub-Saharan Africa. The clinical pathology of tungiasis in animals has never been studied systematically.
  
  
  METHODS
  This was a cross-sectional study conducted between January to March 2015, aimed at describing tungiasis-associated clinical pathology in 121 and 20 T. penetrans-infected pigs and dogs, living in nine and five endemic rural villages respectively located in Bugiri District, Busoga, Uganda.
  
  
  RESULTS
  The parasite load of infected animals ranged from one to 246 (median 8) and one to eight (median 2) in pigs and dogs, respectively. In pigs 99.3% and in dogs 100% of the lesions were located on feet. In pigs, hind legs were significantly more affected than front legs (90.9% vs. 57.9%; p = 0.002) and also had more lesions than the front legs (median 5 vs. 1; p = 0.0001). However, in dogs localization of lesions between front and hind legs never differed significantly (front, 50% vs. hind, 65%; p = 0.51) and so were the number of lesions (median front = 0.5 vs. median hind = 2; p = 0.7). Acute and chronic clinical pathology coexisted. The most common disease manifestations in pigs were hoof wall erosions (68.6%), tissue necrosis of hoof wall and skin (66.1), pain at infection sites (47.9%), hoof deformity (45.5%), fissures (44.6%) and edema (44.6%). In dogs, tungiasis mainly presented with pain at attachment site (80%), ulcers (55%), necrosis (30%) as well as hyperemia and edema (both 15%). One pig had lost dew claws while two had loose detaching claws. Despite a lower number of sand fleas, a higher proportion of infected dogs (20%) than pigs (5.8%) exhibited functional limb use difficulties (p = 0.05).
  
  
  CONCLUSIONS
  The pattern of clinical manifestations in pigs and dogs were very similar to those reported from affected humans and rats. The important morbidity associated with animal tungiasis makes the disease a serious veterinary health problem in sub-Saharan Africa warranting treatment and control for optimal animal production.
authors.affiliation: School of Veterinary Medicine and Animal Resources, College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, P.O. box 7062, Kampala, Uganda. francmutebi10@gmail.com.
authors.forename: Francis
authors.initials: F
authors.lastname: Mutebi
authors.affiliation: Institute for Parasitology and Tropical Veterinary Medicine, Freie Universität Berlin, 14163, Berlin, Germany. Juergen.Kruecken@fu-berlin.de.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Krücken
authors.affiliation: Institute of Microbiology and Hygiene, Charité University Medicine, Berlin Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany. Feldmeier.FUBerlin@t-online.de.
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 Biosecurity, Makerere University, P.O. box 7062, Kampala, Uganda. hhsltd@yahoo.com.
authors.forename: Charles
authors.initials: C
authors.lastname: Waiswa
authors.affiliation: Bayer Animal Health, 51368, Leverkusen, Germany. norbert.mencke@bayer.com.
authors.forename: Norbert
authors.initials: N
authors.lastname: Mencke
authors.affiliation: Institute for Parasitology and Tropical Veterinary Medicine, Freie Universität Berlin, 14163, Berlin, Germany. gvsamson@fu-berlin.de.
authors.forename: Georg
authors.initials: G
authors.lastname: von Samson-Himmelstjerna
mesh_terms: D000818:Animals; D003430:Cross-Sectional Studies; D004283:Dog Diseases / Q000453:epidemiology / Q000473:pathology*; D004285:Dogs; D019353:Endemic Diseases / Q000662:veterinary*; D005260:Female; D006801:Humans; D008297:Male; D009017:Morbidity; D012424:Rural Population; D013552:Swine; D013553:Swine Diseases / Q000453:epidemiology / Q000473:pathology*; D058253:Tunga / Q000502:physiology*; D058285:Tungiasis / Q000453:epidemiology / Q000473:pathology / Q000662:veterinary*; D014454:Uganda / Q000453:epidemiology
references.citation: Vet Rec. 1967 Mar 18;80(11):365-6
references.pmid: 4166051
references.citation: J Am Anim Hosp Assoc. 2010 Jul-Aug;46(4):285-96
references.pmid: 20610704
references.citation: Vet Dermatol. 2009 Aug;20(4):300-3
references.pmid: 19659542
references.citation: Int J Dermatol. 2007 May;46(5):475-81
references.pmid: 17472674
references.citation: Parasitol Res. 2003 Jun;90(2):87-99
references.pmid: 12756541
references.citation: Med J Aust. 1994 Jul 18;161(2):173
references.pmid: 8028549
references.citation: CMAJ. 2011 Jan 11;183(1):E33-4
references.pmid: 21115678
references.citation: Parasite. 2004 Mar;11(1):51-7
references.pmid: 15071827
references.citation: Med Vet Entomol. 2004 Dec;18(4):329-35
references.pmid: 15641998
references.citation: Vet Rec. 1976 May 8;98(19):384
references.pmid: 936443
references.citation: J Public Health Afr. 2011 Sep 05;2(2):e21
references.pmid: 28299062
references.citation: Parasitol Res. 2004 Oct;94(4):275-282
references.pmid: 15368123
references.citation: Am J Trop Med Hyg. 2002 Aug;67(2):214-6
references.pmid: 12389950
references.citation: Parasitol Res. 2007 Jan;100(2):413-21
references.pmid: 17058108
references.citation: Parasitol Res. 2007 Dec;102(1):1-13
references.pmid: 17851690
references.citation: Trop Med Int Health. 2002 Jul;7(7):559-64
references.pmid: 12100437
references.citation: Eur J Clin Microbiol Infect Dis. 2013 Jan;32(1):19-26
references.pmid: 22941398
references.citation: Parasitol Res. 2003 Aug;90(6):449-55
references.pmid: 12768415
references.citation: Parasitol Res. 2005 Oct;97 Suppl 1:S113-S119
references.pmid: 16228267
references.citation: PLoS Negl Trop Dis. 2015 Oct 16;9(10):e0004126
references.pmid: 26473360
references.citation: PLoS Negl Trop Dis. 2014 Oct 30;8(10):e3133
references.pmid: 25356978
references.citation: Trop Doct. 2008 Oct;38(4):226-7
references.pmid: 18820191
references.citation: Trop Med Int Health. 2001 Apr;6(4):267-72
references.pmid: 11348517
references.citation: Am J Trop Med Hyg. 2012 Jul;87(1):125-7
references.pmid: 22764302
references.citation: Vet Rec. 1976 Jun 5;98(23):472
references.pmid: 936467
references.citation: Med Clin North Am. 2013 Jul;97(4):697-720, xi
references.pmid: 23809721
references.citation: Parasitol Res. 2008 Apr;102(5):875-80
references.pmid: 18172688
references.citation: Med Vet Entomol. 2009 Sep;23(3):172-86
references.pmid: 19712148
references.citation: Trans R Soc Trop Med Hyg. 2012 Apr;106(4):259-63
references.pmid: 22305586