Animal and human tungiasis-related knowledge and treatment practices among animal keeping households in Bugiri District, South-Eastern Uganda

Mutebi, Francis; Krücken, Jürgen; Samson‐Himmelstjerna, Georg von; Waiswa, Charles; Mencke, Norbert; Eneku, Wilfred; Tamale, Andrew; Feldmeier, Hermann

doi:10.1016/j.actatropica.2017.10.003

Cited by 18 publications

(22 citation statements)

References 26 publications

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“…The high rate of manipulation of embedded sand fleas suggests an attempt to eliminate or minimise the morbidity attributable to tungiasis despite the pain that is associated with the manipulation of lesions and the risk of secondary bacterial infections. Due to the inaccessibility of effective alternative treatments for tungiasis in many endemic communities, the mechanical extraction of sand fleas remains the most widely used method [ 59 , 72 ]. Apart from pain, the practice of mechanically removing embedded sand fleas from the body has many limitations.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, little data are available on the epidemiology of tungiasis, and an effective control strategy has not been developed. To date, the most widely applied tungiasis treatment method in endemic communities is the extraction of sand fleas with non-sterilised sharp instruments [ 59 ]. This method is very painful, destroys normal tissues and poses a risk of secondary bacterial infections, including tetanus [ 53 ].…”

Section: Introductionmentioning

confidence: 99%

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Prevalence and Infection Intensity of Human and Animal Tungiasis in Napak District, Karamoja, Northeastern Uganda

et al. 2023

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Tungiasis is an important but highly neglected cause of morbidity in resource-poor communities in Latin America and sub-Saharan Africa. Data upon which implementation of control measures can be based are scarce. Before piloting an integrated tungiasis control program in three parishes of Napak district, Uganda, a cross-sectional survey involving the systematic examination of humans and domestic mammals was implemented to establish the occurrence patterns of tungiasis. The study population was 5482 residents, of which 4035 (73.6%) participated in the study. The prevalence of tungiasis in humans was 62.8% (95% CI: 61.3–64.3%), with slightly more males than females affected (p = 0.01). Age-specific prevalence and intensity of human tungiasis followed an S-curve pattern, with children of 5–14 years and the elderly (≥60 years) being the most affected. Half of all lesions (50%) had been manipulated by sharp objects. The prevalence of tungiasis in animals was lower (14.2%, 95% CI: 10.9–18.0) than that of humans (p < 0.001). Animal tungiasis occurred in decreasing order of frequency in pigs (80%), dogs (24%), goats (16.3%), cats (8.1%) and sheep (4.9%). In conclusion, human tungiasis was highly prevalent but animal infections were comparatively few in the study area. Nevertheless, effective control measures should be based on One Health principles.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevalence and Infection Intensity of Human and Animal Tungiasis in Napak District, Karamoja, Northeastern Uganda

et al. 2023

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“…The economic base for 53% of the local people is subsistence-oriented farming [29], with some villagers engaging in small-scale business such as operating small roadside shops. The Busoga region has 42.0% of the population living in poverty and is known to suffer from famine [29], malnutrition, very high infant mortality rates, and rampant jigger epidemics [30, 31]. Literacy levels are low, with 56.1% and 43.8% of male and female heads of households being literate.…”

Section: Methodsmentioning

confidence: 99%

Understanding the context of delays in seeking appropriate care for children with symptoms of severe malaria in Uganda

et al. 2019

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Introduction A large proportion of children with uncomplicated malaria receive appropriate treatment late, contributing to progression of illness to severe disease. We explored contexts of caregiver delays in seeking appropriate care for children with severe malaria. Methods This qualitative study was conducted at the Children’s Ward of Jinja Hospital, where children with severe malaria were hospitalized. A total of 22in-depth interviews were conducted with caregivers of children hospitalized with severe malaria. Issues explored were formulated based on the Partners for Applied Social Sciences (PASS) model, focusing on facilitators and barriersto caregivers’promptseeking and accessing ofappropriate care. The data were coded deductively using ATLAS.ti (version 7.5). Codes were then grouped into families based on emerging themes. Results Caregivers’ rating of initial symptoms as mild illness lead to delays in response. Use of home initiated interventions with presumably ineffective herbs or medicines was common, leading to further delay. When care was sought outside the home, drug shops were preferred over public health facilities for reasons of convenience. Drug shops often provided sub-optimal care, and thus contributed to delays in access to appropriate care. Public facilities were often a last resort when illness was perceived to be progressing to severe disease. Further delays occurred at health facilities due to inadequate referral systems. Conclusion Communities living in endemic areas need to be sensitized about the significance of fever, even if mild, as an indicator of malaria. Additionally, amidst ongoing efforts at bringing antimalarial treatment services closer to communities, the value of drug shops as providers ofrationalantimalarialtreatment needs to be reviewed.

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“…concerning the long-term prevention of T. penetrans infestation in the treated dogs, the use of Bravecto chewable tablets in a comprehensive One Health based investigation aiming to provide proof-of-principle for the elimination of clinical tungiasis is now urgently needed. Since it has been repeatedly shown in the past that also other animal hosts such as swine or cats may also be involved in the T. penetrans epidemiology [17,29,42], these animals would require to be included according to the prevailing conditions in such efforts as well. Since human tungiasis is often found in the most under-resourced communities, any application of Bravecto chewable tablets appears only realistic if the product would be donated either by public health authorities and/or philanthropic donors.…”

Section: Plos Neglected Tropical Diseasesmentioning

confidence: 99%

Efficacy of oral fluralaner (Bravecto) against Tunga penetrans in dogs: A negative control, randomized field study in an endemic community in Brazil

et al. 2022

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The sand flea Tunga penetrans is one of the zoonotic agents of tungiasis, a parasitic skin disease of humans and animals. The dog is one of its main reservoirs. This negatively controlled, randomized, double-masked clinical trial evaluated the therapeutic and residual efficacy of fluralaner for treatment of dogs naturally infested with T. penetrans. Sixty-two dogs from an endemically affected community in Brazil were randomly assigned to either receive oral fluralaner (Bravecto chewable tablets) at a dose of 25 to 56 mg fluralaner/kg body weight, or no treatment (31 dogs per group). Dogs were clinically examined using a severity score for acute canine tungiasis (SCADT), parasitological examinations as defined by the Fortaleza classification, and pictures of lesions on days 0 (inclusion and treatment), 7 ± 2, 14 ± 2, 21 ± 2, 28 ± 2, 60 ± 7, 90 ± 7, 120 ± 7 and 150 ± 7. The percentage of parasite-free dogs after treatment was >90% between days 14 and 90 post-treatment with 100% efficacy on study days 21, 28 and 60. Sand flea counts on fluralaner treated dogs were significantly lower (p<0.025) than control dogs on all counts from day 7 to 120. The number of live sand fleas on treated dogs was reduced by > 90% on day 7, > 95% on days 14 and 90, and 100% from day 21 to 60, and with a significant difference between groups from day 7 to 120. From day 7 to day 120, mean SCADT scores were significantly reduced in treated dogs with a mean of 0.10 compared to 1.54 on day 120 in untreated dogs. Therefore, a single oral fluralaner administration is effective for treating and achieving long lasting (> 12 weeks) prevention for tungiasis in dogs.

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Animal and human tungiasis-related knowledge and treatment practices among animal keeping households in Bugiri District, South-Eastern Uganda

Cited by 18 publications

References 26 publications

Prevalence and Infection Intensity of Human and Animal Tungiasis in Napak District, Karamoja, Northeastern Uganda

Prevalence and Infection Intensity of Human and Animal Tungiasis in Napak District, Karamoja, Northeastern Uganda

Understanding the context of delays in seeking appropriate care for children with symptoms of severe malaria in Uganda

Efficacy of oral fluralaner (Bravecto) against Tunga penetrans in dogs: A negative control, randomized field study in an endemic community in Brazil

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