Neurocognitive and mental health outcomes in children with tungiasis: a cross-sectional study in rural Kenya and Uganda
Abstract Background Tungiasis, a neglected tropical parasitosis, disproportionately affects children. Few empirical studies have reported neurocognitive and mental health outcomes of children with ectoparasitic skin diseases like tungiasis. Pathophysiology of tungiasis suggests it could detrimentall...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-11-01
|
| Series: | Infectious Diseases of Poverty |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40249-023-01154-4 |
| _version_ | 1827707639793975296 |
|---|---|
| author | Berrick Otieno Lynne Elson Abneel K. Matharu Naomi Riithi Esther Chongwo Khamis Katana Carophine Nasambu Francis Mutebi Herman Feldmeier Jürgen Krücken Ulrike Fillinger Amina Abubakar |
| author_facet | Berrick Otieno Lynne Elson Abneel K. Matharu Naomi Riithi Esther Chongwo Khamis Katana Carophine Nasambu Francis Mutebi Herman Feldmeier Jürgen Krücken Ulrike Fillinger Amina Abubakar |
| author_sort | Berrick Otieno |
| collection | DOAJ |
| description | Abstract Background Tungiasis, a neglected tropical parasitosis, disproportionately affects children. Few empirical studies have reported neurocognitive and mental health outcomes of children with ectoparasitic skin diseases like tungiasis. Pathophysiology of tungiasis suggests it could detrimentally affect cognition and behaviour. This study pioneered the investigation of neurocognitive and mental health outcomes in children with tungiasis. Methods This was a multi-site cross-sectional study including 454 quasi-randomly sampled school-children aged 8–14 from 48 randomly selected schools in two counties in Kenya and a district in Uganda. The participants were stratified into infected and uninfected based on the presence of tungiasis. The infected were further classified into mild and severe infection groups based on the intensity of the infection. Adapted, validated, and standardized measures of cognition and mental health such as Raven Matrices and Child Behaviour Checklist were used to collect data. Statistical tests including a multilevel, generalized mixed-effects linear models with family link set to identity were used to compare the scores of uninfected and infected children and to identify other potential risk factors for neurocognitive and behavioural outcomes. Results When adjusted for covariates, mild infection was associated with lower scores in literacy [adjusted β(aβ) = − 8.9; 95% confidence interval (CI) − 17.2, − 0.6], language (aβ = − 1.7; 95% CI − 3.2, − 0.3), cognitive flexibility (aβ = − 6.1; 95% CI − 10.4, − 1.7) and working memory (aβ = − 0.3; 95% CI − 0.6, − 0.1). Severe infection was associated with lower scores in literacy (aβ = − 11.0; 95% CI − 19.3, − 2.8), response inhibition, (aβ = − 2.2; 95% CI − 4.2, − 0.2), fine motor control (aβ = − 0.7; 95% CI − 1.1, − 0.4) and numeracy (aβ = − 3; 95% CI − 5.5, − 0.4). Conclusions This study provides first evidence that tungiasis is associated with poor neurocognitive functioning in children. Since tungiasis is a chronic disease with frequent reinfections, such negative effects may potentially impair their development and life achievements. Graphical abstract |
| first_indexed | 2024-03-10T16:51:23Z |
| format | Article |
| id | doaj.art-03be3673397f463cb61903ba17dc6445 |
| institution | Directory Open Access Journal |
| issn | 2049-9957 |
| language | English |
| last_indexed | 2024-03-10T16:51:23Z |
| publishDate | 2023-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Infectious Diseases of Poverty |
| spelling | doaj.art-03be3673397f463cb61903ba17dc64452023-11-20T11:17:39ZengBMCInfectious Diseases of Poverty2049-99572023-11-0112111610.1186/s40249-023-01154-4Neurocognitive and mental health outcomes in children with tungiasis: a cross-sectional study in rural Kenya and UgandaBerrick Otieno0Lynne Elson1Abneel K. Matharu2Naomi Riithi3Esther Chongwo4Khamis Katana5Carophine Nasambu6Francis Mutebi7Herman Feldmeier8Jürgen Krücken9Ulrike Fillinger10Amina Abubakar11Kenya Medical Research Institute (KEMRI)-Wellcome Trust Programme, Hospital RoadKenya Medical Research Institute (KEMRI)-Wellcome Trust Programme, Hospital RoadInternational Centre of Insect Physiology and Ecology (ICIE), Human Health ThemeInternational Centre of Insect Physiology and Ecology (ICIE), Human Health ThemeInstitute for Human Development, Aga Khan UniversityKenya Medical Research Institute (KEMRI)-Wellcome Trust Programme, Hospital RoadKenya Medical Research Institute (KEMRI)-Wellcome Trust Programme, Hospital RoadSchool of Veterinary Medicine and Animal Resources, College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere UniversityCharité University MedicineInstitute for Parasitology and Tropical Veterinary Medicine, Freie Universität BerlinInternational Centre of Insect Physiology and Ecology (ICIE), Human Health ThemeKenya Medical Research Institute (KEMRI)-Wellcome Trust Programme, Hospital RoadAbstract Background Tungiasis, a neglected tropical parasitosis, disproportionately affects children. Few empirical studies have reported neurocognitive and mental health outcomes of children with ectoparasitic skin diseases like tungiasis. Pathophysiology of tungiasis suggests it could detrimentally affect cognition and behaviour. This study pioneered the investigation of neurocognitive and mental health outcomes in children with tungiasis. Methods This was a multi-site cross-sectional study including 454 quasi-randomly sampled school-children aged 8–14 from 48 randomly selected schools in two counties in Kenya and a district in Uganda. The participants were stratified into infected and uninfected based on the presence of tungiasis. The infected were further classified into mild and severe infection groups based on the intensity of the infection. Adapted, validated, and standardized measures of cognition and mental health such as Raven Matrices and Child Behaviour Checklist were used to collect data. Statistical tests including a multilevel, generalized mixed-effects linear models with family link set to identity were used to compare the scores of uninfected and infected children and to identify other potential risk factors for neurocognitive and behavioural outcomes. Results When adjusted for covariates, mild infection was associated with lower scores in literacy [adjusted β(aβ) = − 8.9; 95% confidence interval (CI) − 17.2, − 0.6], language (aβ = − 1.7; 95% CI − 3.2, − 0.3), cognitive flexibility (aβ = − 6.1; 95% CI − 10.4, − 1.7) and working memory (aβ = − 0.3; 95% CI − 0.6, − 0.1). Severe infection was associated with lower scores in literacy (aβ = − 11.0; 95% CI − 19.3, − 2.8), response inhibition, (aβ = − 2.2; 95% CI − 4.2, − 0.2), fine motor control (aβ = − 0.7; 95% CI − 1.1, − 0.4) and numeracy (aβ = − 3; 95% CI − 5.5, − 0.4). Conclusions This study provides first evidence that tungiasis is associated with poor neurocognitive functioning in children. Since tungiasis is a chronic disease with frequent reinfections, such negative effects may potentially impair their development and life achievements. Graphical abstracthttps://doi.org/10.1186/s40249-023-01154-4TungiasisTunga penetransNeglected tropical diseaseNeurocognitionMental healthSchool-aged children |
| spellingShingle | Berrick Otieno Lynne Elson Abneel K. Matharu Naomi Riithi Esther Chongwo Khamis Katana Carophine Nasambu Francis Mutebi Herman Feldmeier Jürgen Krücken Ulrike Fillinger Amina Abubakar Neurocognitive and mental health outcomes in children with tungiasis: a cross-sectional study in rural Kenya and Uganda Infectious Diseases of Poverty Tungiasis Tunga penetrans Neglected tropical disease Neurocognition Mental health School-aged children |
| title | Neurocognitive and mental health outcomes in children with tungiasis: a cross-sectional study in rural Kenya and Uganda |
| title_full | Neurocognitive and mental health outcomes in children with tungiasis: a cross-sectional study in rural Kenya and Uganda |
| title_fullStr | Neurocognitive and mental health outcomes in children with tungiasis: a cross-sectional study in rural Kenya and Uganda |
| title_full_unstemmed | Neurocognitive and mental health outcomes in children with tungiasis: a cross-sectional study in rural Kenya and Uganda |
| title_short | Neurocognitive and mental health outcomes in children with tungiasis: a cross-sectional study in rural Kenya and Uganda |
| title_sort | neurocognitive and mental health outcomes in children with tungiasis a cross sectional study in rural kenya and uganda |
| topic | Tungiasis Tunga penetrans Neglected tropical disease Neurocognition Mental health School-aged children |
| url | https://doi.org/10.1186/s40249-023-01154-4 |
| work_keys_str_mv | AT berrickotieno neurocognitiveandmentalhealthoutcomesinchildrenwithtungiasisacrosssectionalstudyinruralkenyaanduganda AT lynneelson neurocognitiveandmentalhealthoutcomesinchildrenwithtungiasisacrosssectionalstudyinruralkenyaanduganda AT abneelkmatharu neurocognitiveandmentalhealthoutcomesinchildrenwithtungiasisacrosssectionalstudyinruralkenyaanduganda AT naomiriithi neurocognitiveandmentalhealthoutcomesinchildrenwithtungiasisacrosssectionalstudyinruralkenyaanduganda AT estherchongwo neurocognitiveandmentalhealthoutcomesinchildrenwithtungiasisacrosssectionalstudyinruralkenyaanduganda AT khamiskatana neurocognitiveandmentalhealthoutcomesinchildrenwithtungiasisacrosssectionalstudyinruralkenyaanduganda AT carophinenasambu neurocognitiveandmentalhealthoutcomesinchildrenwithtungiasisacrosssectionalstudyinruralkenyaanduganda AT francismutebi neurocognitiveandmentalhealthoutcomesinchildrenwithtungiasisacrosssectionalstudyinruralkenyaanduganda AT hermanfeldmeier neurocognitiveandmentalhealthoutcomesinchildrenwithtungiasisacrosssectionalstudyinruralkenyaanduganda AT jurgenkrucken neurocognitiveandmentalhealthoutcomesinchildrenwithtungiasisacrosssectionalstudyinruralkenyaanduganda AT ulrikefillinger neurocognitiveandmentalhealthoutcomesinchildrenwithtungiasisacrosssectionalstudyinruralkenyaanduganda AT aminaabubakar neurocognitiveandmentalhealthoutcomesinchildrenwithtungiasisacrosssectionalstudyinruralkenyaanduganda |