Abstract
BackgroundAnimal tungiasis is believed to increase the prevalence and parasite burden in humans. Animal reservoirs of Tunga penetrans differ among endemic areas and their role in the epidemiology of tungiasis had never been investigated in Uganda.Methods and FindingsTo identify the major animal reservoirs of Tunga penetrans and their relative importance in the transmission of tungiasis in Uganda, a cross sectional study was conducted in animal rearing households in 10 endemic villages in Bugiri District. T. penetrans infections were detected in pigs, dogs, goats and a cat. The prevalences of households with tungiasis ranged from 0% to 71.4% (median 22.2) for animals and from 5 to 71.4% (median 27.8%) for humans. The prevalence of human tungiasis also varied among the population of the villages (median 7%, range 1.3–37.3%). Pig infections had the widest distribution (nine out of 10 villages) and highest prevalence (median 16.2%, range 0–64.1%). Pigs also had a higher number of embedded sand fleas than all other species combined (p<0.0001). Dog tungiasis occurred in five out of 10 villages with low prevalences (median of 2%, range 0–26.9%). Only two goats and a single cat had tungiasis. Prevalences of animal and human tungiasis correlated at both village (rho = 0.89, p = 0.0005) and household (rho = 0.4, p<0.0001) levels. The median number of lesions in household animals correlated with the median intensity of infection in children three to eight years of age (rho = 0.47, p<0.0001). Animal tungiasis increased the odds of occurrence of human cases in households six fold (OR = 6.1, 95% CI 3.3–11.4, p<0.0001).ConclusionAnimal and human tungiasis were closely associated and pigs were identified as the most important animal hosts of T. penetrans. Effective tungiasis control should follow One Health principles and integrate ectoparasites control in animals.
Highlights
Tungiasis is an ectoparasitosis that accrues from the penetration of female sand fleas into the skin
Animal reservoirs of Tunga penetrans differ among endemic areas and their role in the epidemiology of tungiasis had never been investigated in Uganda
While T. penetrans occurs in all endemic areas, T. trimamillata has only been reported in a few countries in South America [3,4]
Summary
Tungiasis is an ectoparasitosis that accrues from the penetration of female sand fleas into the skin. Tunga penetrans [1] and Tunga trimamillata [2] are the only species known to cause tungiasis in both humans and animals. While T. penetrans occurs in all endemic areas, T. trimamillata has only been reported in a few countries in South America [3,4]. In Uganda, human tungiasis occurs in all regions but the prevalence appears to be high in the Busoga sub-region, South Eastern, and Karamoja in North Eastern, Uganda [8]. These regions are among the poorest in the country. Animal reservoirs of Tunga penetrans differ among endemic areas and their role in the epidemiology of tungiasis had never been investigated in Uganda.
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