Aim: To describe the impact and sustainability of an evidence-based intervention against tungiasis in a severely affected community in Lagos State, Nigeria. Methods:We performed an intervention targeted at the control of tungiasis, and a cross-sectional follow-up study after one year. After 14 years, the community was revisited, and a rapid assessment was performed. Risk factors identified before the intervention included sandy floors inside houses, irregular use of footwear, and free-roaming pigs on the compound. In collaboration with community members and traditional leaders, the floors of the primary school and houses without concreted floor were sealed with concrete, free-roaming pigs were banned/confined to pigpens, and regular use of footwear and environmental hygiene, particularly consisting of cleaning the compound and streets from waste, were encouraged. We examined the participants for the presence of tungiasis on legs, feet, hands, and arms. Signs and symptoms were documented. Results:In the baseline survey before intervention, 557 participants were included in the follow-up study after one year, 540 participants were included. The prevalence of tungiasis decreased from 45.2% to 21.3%, and the total number of lesions from 3,111 to 617 (both P < 0.0001). Severe symptoms and pathology (e.g., difficulty walking, deformation of toenails, loss of toenails, and bacterial superinfection) were reduced from high to negligible levels. After 14 years, there was no case with vital tungiasis lesions. Conclusion:Long-term control of tungiasis is possible in heavily affected communities by considering an evidencebased One Health approach. Urbanization may have contributed to elimination of tungiasis after 14 years.

Aim: We aimed to measure the degree to which onchocercal skin disease (OSD) impairs quality of life (QoL) in endemic resource-poor communities in the Ushongo, Kwande, and Katsina-ale local government areas of Benue State, Nigeria. Methods: We evaluated the skin characteristics and QoL of 307 children and adults with OSD using a modified dermatological life quality index (mDLQI). Assessment of OSD was conducted and scored using mDLQI from 0 (no effects) to 18 (large effects). Thereafter, structured questionnaires were applied to assess the knowledge, attitudes, and predictors of moderate and severe OSD patients. Results: In total, 235/307 (76.5%) participants presented onchocercal nodules; chronic papular dermatitis was found in 68 (22.1%). A total of 288 (93.8%) had two or more OSD-associated symptoms. The median mDLQI score was 0 [interquartile range (IQR): 0-0] in children and 5 in adults (IQR: 2-8). A higher mDLQI median score was observed in farmers. There was a statistically significant difference between children and adults (P < 0.001). The most frequently reported impairments were social exclusion, embarrassment/shame, and restriction from work/leisure activities. In logistic regression analysis, there was a significant association with increasing age (adjusted odds ratio (AOR) = 1.44; 95%CI: 1.21-1.71; P < 0.001) and visual impairment (AOR = 1.78; 95%CI: 1.02-3.10; P = 0.040) with severe mDLQI. Papular rash was an independent protective factor (AOR = 0.50; 95%CI: 0.27-0.93; P = 0.030). Conclusion: Onchocerciasis-related morbidity has a profound measurable impact on the individual QoL, affecting the overall socioeconomic well-being of the affected community, if left untreated. Therefore, strict supervision and follow-up of home-based mass treatment with ivermectin are vital for successful control of the disease and to reduce the burden on affected communities.