National prevalence and risk factors for tungiasis in Kenya
Abstract Background Tungiasis is a highly neglected tropical skin disease caused by the sand flea, Tunga penetrans, the female of which burrows into the skin, causing pain and itching. The disease occurs throughout South America and sub-Saharan Africa but there are few systematic data on national di...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | Infectious Diseases of Poverty |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40249-023-01131-x |
| _version_ | 1797555654662029312 |
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| author | Lynne Elson Christopher Kamau Sammy Koech Christopher Muthama George Gachomba Erastus Sinoti Elwyn Chondo Eliud Mburu Miriam Wakio Jimmy Lore Marta Maia Ifedayo Adetifa Benedict Orindi Phillip Bejon Ulrike Fillinger |
| author_facet | Lynne Elson Christopher Kamau Sammy Koech Christopher Muthama George Gachomba Erastus Sinoti Elwyn Chondo Eliud Mburu Miriam Wakio Jimmy Lore Marta Maia Ifedayo Adetifa Benedict Orindi Phillip Bejon Ulrike Fillinger |
| author_sort | Lynne Elson |
| collection | DOAJ |
| description | Abstract Background Tungiasis is a highly neglected tropical skin disease caused by the sand flea, Tunga penetrans, the female of which burrows into the skin, causing pain and itching. The disease occurs throughout South America and sub-Saharan Africa but there are few systematic data on national disease burdens. The tungiasis research community is keen to develop survey methods to fill this gap. Here we used a school-based, thorough examination method to determine the prevalence and risk factors for tungiasis in Kenya. Methods We conducted the first nationally representative survey of tungiasis, including nine counties covering the major ecological zones of Kenya. A stratified multistage random sampling was used to select 22 primary schools from each of the nine counties and to select up to 114 pupils aged 8 to 14 years in each school. Pupils were examined thoroughly for tungiasis. Two surveys were conducted, the first between May and July 2021 and the second between October 2021 and April 2023 when pupils were also interviewed for risk factors. Mixed effect logistic regression models were used to test associations of independent variables with tungiasis using the school as a random effect. Results The overall prevalence of tungiasis in the first survey was 1.35% [95% confidence interval (CI): 1.15–1.59%], and 0.89% in the second survey. The prevalence ranged from 0.08% (95% CI: 0.01–0.59%) in Taita Taveta county to 3.24% (95% CI: 2.35–4.44%) in Kajiado county. Tungiasis infection was associated with county of residence, male sex [adjusted odds ratio (aOR) = 2.01, 95% CI: 1.52–2.67], and lower age (aOR = 0.81, 95% CI: 0.75–0.88). For the first time we demonstrate an association with attending public schools rather than private schools (aOR = 5.62, 95% CI: 1.20–26.22) and lower socioeconomic status (aOR = 0.10, 95% CI: 0.03–0.33). Using a rapid screening method of the top of feet only, would have missed 62.9% of all cases, 78.9% of mild cases and 20.0% of severe cases. Conclusions Tungiasis is widely but heterogeneously distributed across Kenya. School-based surveys offer an efficient strategy for mapping tungiasis distribution. Graphical Abstract |
| first_indexed | 2024-03-10T16:51:36Z |
| format | Article |
| id | doaj.art-3b041b463cf7483bbcbd72b2563dfaa5 |
| institution | Directory Open Access Journal |
| issn | 2049-9957 |
| language | English |
| last_indexed | 2024-03-10T16:51:36Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Infectious Diseases of Poverty |
| spelling | doaj.art-3b041b463cf7483bbcbd72b2563dfaa52023-11-20T11:17:31ZengBMCInfectious Diseases of Poverty2049-99572023-09-0112111210.1186/s40249-023-01131-xNational prevalence and risk factors for tungiasis in KenyaLynne Elson0Christopher Kamau1Sammy Koech2Christopher Muthama3George Gachomba4Erastus Sinoti5Elwyn Chondo6Eliud Mburu7Miriam Wakio8Jimmy Lore9Marta Maia10Ifedayo Adetifa11Benedict Orindi12Phillip Bejon13Ulrike Fillinger14Kenya Medical Research Institute-Wellcome Trust Research ProgrammeDepartment of HealthDepartment of HealthDepartment of HealthDepartment of HealthDepartment of HealthDepartment of HealthDepartment of HealthDepartment of HealthDepartment of HealthKenya Medical Research Institute-Wellcome Trust Research ProgrammeKenya Medical Research Institute-Wellcome Trust Research ProgrammeKenya Medical Research Institute-Wellcome Trust Research ProgrammeKenya Medical Research Institute-Wellcome Trust Research ProgrammeInternational Centre for Insect Physiology and Ecology (Icipe)Abstract Background Tungiasis is a highly neglected tropical skin disease caused by the sand flea, Tunga penetrans, the female of which burrows into the skin, causing pain and itching. The disease occurs throughout South America and sub-Saharan Africa but there are few systematic data on national disease burdens. The tungiasis research community is keen to develop survey methods to fill this gap. Here we used a school-based, thorough examination method to determine the prevalence and risk factors for tungiasis in Kenya. Methods We conducted the first nationally representative survey of tungiasis, including nine counties covering the major ecological zones of Kenya. A stratified multistage random sampling was used to select 22 primary schools from each of the nine counties and to select up to 114 pupils aged 8 to 14 years in each school. Pupils were examined thoroughly for tungiasis. Two surveys were conducted, the first between May and July 2021 and the second between October 2021 and April 2023 when pupils were also interviewed for risk factors. Mixed effect logistic regression models were used to test associations of independent variables with tungiasis using the school as a random effect. Results The overall prevalence of tungiasis in the first survey was 1.35% [95% confidence interval (CI): 1.15–1.59%], and 0.89% in the second survey. The prevalence ranged from 0.08% (95% CI: 0.01–0.59%) in Taita Taveta county to 3.24% (95% CI: 2.35–4.44%) in Kajiado county. Tungiasis infection was associated with county of residence, male sex [adjusted odds ratio (aOR) = 2.01, 95% CI: 1.52–2.67], and lower age (aOR = 0.81, 95% CI: 0.75–0.88). For the first time we demonstrate an association with attending public schools rather than private schools (aOR = 5.62, 95% CI: 1.20–26.22) and lower socioeconomic status (aOR = 0.10, 95% CI: 0.03–0.33). Using a rapid screening method of the top of feet only, would have missed 62.9% of all cases, 78.9% of mild cases and 20.0% of severe cases. Conclusions Tungiasis is widely but heterogeneously distributed across Kenya. School-based surveys offer an efficient strategy for mapping tungiasis distribution. Graphical Abstracthttps://doi.org/10.1186/s40249-023-01131-xTungiasisNeglected tropical diseasesPrevalenceDisease burdenKenya |
| spellingShingle | Lynne Elson Christopher Kamau Sammy Koech Christopher Muthama George Gachomba Erastus Sinoti Elwyn Chondo Eliud Mburu Miriam Wakio Jimmy Lore Marta Maia Ifedayo Adetifa Benedict Orindi Phillip Bejon Ulrike Fillinger National prevalence and risk factors for tungiasis in Kenya Infectious Diseases of Poverty Tungiasis Neglected tropical diseases Prevalence Disease burden Kenya |
| title | National prevalence and risk factors for tungiasis in Kenya |
| title_full | National prevalence and risk factors for tungiasis in Kenya |
| title_fullStr | National prevalence and risk factors for tungiasis in Kenya |
| title_full_unstemmed | National prevalence and risk factors for tungiasis in Kenya |
| title_short | National prevalence and risk factors for tungiasis in Kenya |
| title_sort | national prevalence and risk factors for tungiasis in kenya |
| topic | Tungiasis Neglected tropical diseases Prevalence Disease burden Kenya |
| url | https://doi.org/10.1186/s40249-023-01131-x |
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