Factors associated with tungiasis among primary school children: a cross-sectional study in a rural district in Rwanda

Abstract

Background Tungiasis is a relatively frequent ectoparasitosis in low-income settings, yet its morbidity and social impact are still not well understood due to the scarcity of information. In Rwanda, data on the magnitude and conditions leading to the tungiasis is rare. This study sought to determine the prevalence and factors associated with tungiasis among primary school children in Rwandan setting. Method A descriptive cross-sectional study utilising systematic random sampling method was adopted to select 384 children from three primary schools. From July to October 2018, data were collected on socio-demographic characteristics of children, parents, and households. Logistic regression was applied to analyse socio-demographic factors associated with tungiasis with a level of significance set at P -value< 0.05. Results Prevalence of tungiasis among three primary schools was 23%. Factors associated with tungiasis included walking barefoot (AOR: 78.41; 95% CI: 17.91–343.10), irregular wearing of shoes (AOR: 24.73; 95% CI: 6.27–97.41), having dirty feet (AOR: 12.69; 95% CI: 4.93–32.64), wearing dirty clothes (AOR: 12.69; 95% CI: 4.18–38.50), and living in a house with earthen plastered floor (AOR: 28.79; 95% CI: 7.11–116.57). Children infected with tungiasis attended class less frequently (AOR: 19.16, 95%CI: 7.20–50.97) and scored lower (AOR: 110.85, 95%CI: 43.08–285.20) than those non-infected. The low school attendance and poor performance could be partly explained by difficulty of walking, lack of concentration during school activities, and isolation or discrimination from classmates. Conclusion Tungiasis was a public health challenge among school going children in a rural Rwandan setting. This study revealed that children affected with tungiasis had poor hygiene, inadequate housing environments and consequently poor school attendance and performance. Improving socio-economic conditions of households with special emphasis on hygiene of family members and housing conditions, would contribute to preventing tungiasis. Electronic supplementary material The online version of this article (10.1186/s12889-019-7481-y) contains supplementary material, which is available to authorized users.

Risk factors for scabies, tungiasis, and tinea infections among schoolchildren in southern Ethiopia: A cross-sectional Bayesian multilevel model

“…Similar to previous reports from Ethiopia [ 19 ] and Rwanda [ 15 ], we observed no differences in tungiasis rates among boys and girls. Our bivariate frequentist model identified boys as slightly more at risk (p = 0.103), perhaps due to behavioral factors related to hygiene.…”

“…We could not confirm these findings as our study did not include adolescents older than 14 years or older age groups. Previous reports indicate that poor hygiene, including low frequency of washing with soap [ 79 ], is associated with increased tungiasis rates [ 15 , 80 ]. We similarly found that children who did not wash with soap every week were more likely to be affected by tungiasis.…”

“…Foot hygiene and appropriate footwear provide important protection [ 88 ] against tinea [ 89 , 90 ] and tungiasis [ 86 , 91 ]. Walking barefoot is a known risk factor for tungiasis [ 15 , 19 ]. In this study, walking barefoot was not associated with skin problems in either the Bayesian or frequentist model.…”

“…It causes erythema, edema tenderness, itching, and pain in acute phase; and shining skin, desquamation, nail and toes deformity or loss of nails may occur in the chronic phase [13]. It have also socio-economic impact that includes difficulty walking or gripping, sleep disturbances, stigma, and all of which affects quality of life, school absenteeism, and dropout rates [13][14][15][16]. Bacterial superinfection is almost constant.…”

Sustainable control of tungiasis in rural Nigeria: a case for One Health

“…On the African continent, the disease is widespread, and a recent study suggested that 44 countries in sub-Saharan Africa provide suitable environmental characteristics for the occurrence of tungiasis [2] . Historical reports evidenced an extremely high burden of tungiasis throughout the African continent many years ago [3] , and recent studies show that numerable communities still suffer from severe infestations today, with a particularly high burden in schoolchildren [1,[4][5][6][7] . In Nigeria, several historical and recent studies reported extremely high prevalences and demonstrated evidence that tungiasis is a major public health problem in the country [3,5,[8][9][10][11][12] .…”