Assessing the impact of tungiasis on children’s quality of life in Kenya

Abstract

Tungiasis is a neglected tropical skin disease caused by the sand flea, Tunga penetrans which penetrates the skin causing considerable pain and itching. In this cross-sectional study we aimed to assess its impact on the quality of life of school children in Kenya. School pupils (198) aged 8-14 years with tungiasis were randomly selected and interviewed using a tungiasis-specific quality of life instrument (TLQI). The caregivers of each infected pupil and 199 randomly selected caregivers of uninfected pupils were interviewed using the proxy KIDscreen52® to assess their child’s general health-related quality of life (HR-QoL). Generalized linear models were used to assess associations between quality-of-life variables, children’s tungiasis status and other covariables. Among infected children, 62.4% had TLQI scores reflecting a moderate to very high impact, with no significant difference between mild and severe cases. Severe cases had a lower proxy-HR-QoL than uninfected pupils (β -21.15, 95% CI -39.63 − -2.68, p=0.025), but this was not significant in multivariable models. For the first time, this study demonstrated for children whose caregivers were depressed, tungiasis had a higher impact on their quality of life (TLQI adjusted β 0.28, 95% CI 0.08−0.49, p=0.006) and had a lower general HR-QoL (adjusted β -40.34, 95%CI -55.91− -24.76, p<0.001). Conversely, if their caregiver showed them affection, tungiasis had a lower impact on their quality of life (TLQI, adjusted β -0.45, 95% CI -0.70− -0.20, p<0.001). Further studies are needed to investigate the interaction of tungiasis with parenting styles, the mental health of children and their caregivers and their effect on children’s well-being.