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

Abstract

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.

Factors associated with tungiasis among school-age children in Kwale County, rural Kenya

“…Besides socio-economic factors, male gender, age <15 y and older age groups, a sandy floor inside the house, no regular use of footwear and the presence of animals on the compound are associated with a higher prevalence and more severe morbidity. 6 …”

“…3 Overall, the disease is usually not perceived as an important condition, not by the populations affected or by decision makers and health personnel, and there are often no district or countrywide control programs. 6 …”

Occurrence of Tungiasis in Ceará State, Northeast Brazil: Results of a Rapid Assessment Method

“…Similarly, it can also be assumed that severe tungiasis was considerably underreported in our study, as severe disease may go unnoticed by many health care providers: most heavily affected patients are often living in remote settings in the hinterland, hide themselves as a result of embarrassment and bullying, and do not have easy access to health care [23]. Tungiasis is usually not perceived as an important condition, neither by the populations affected nor by decision makers or health personnel, as well are often no district or countrywide control programs [16].…”

Detection of a neglected tropical disease: Case report of Heavy <i>Tunga penetrans</i> lesions on the feet of a thirteen-year-old boy from a community in Lagos, Nigeria

“…The current epidemiological status within the African continent remains uncertain. In Nigeria, few studies have been done in endemic communities of Lagos State with prevalence ranging between 21.3% to 45.2% by some researchers (Ade-Serrano and Ejezie, 1981; Ugbomoiko et al, 2007;Otubanjo et al, 2016;Heukelbach et al, 2021).…”