Abstract
BackgroundTungiasis 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.MethodA 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.ResultsPrevalence 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.ConclusionTungiasis 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.
Highlights
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
Factors associated with tungiasis included walking barefoot (AOR: 78.41; 95% confidence interval (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
Summary
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. Tungiasis is an ectoparasitosis, which is caused by infestation with Tunga penetrans, known as a jigger flea or sand flea. It is usually considered as an entomologic nuisance, yet it does not receive much attention from healthcare professionals. The female sand flea is fertilised by a male through a tiny opening of the last abdominal segment, which maintains the parasite in contact with the environment [3]. This opening is used by the parasite to breathe, defecate, and expel eggs to the outside after
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