Intensity and clinical morbidities of tungiasis in an impoverished south-west Nigerian community

Abstract

Sand fleas infestation, Tunga penetrans, remains a neglected tropical disease of public-health concern in many countries. Tungiasis can lead to destruction of the feet causing serious discomfort and deformities. This study aim was to determine the intensity rate and clinical morbidities of tungiasis among the people living in Igbokoda, Ondo State, Nigeria. A community-based cross-sectional survey was conducted among households in three villages in Igbokoda. Hands and feet of selected household members were examined, while fleas on different floor types of houses were sampled by soil collection and extraction by tullgren funnel method. Sand fleas were equally sampled from legs of infested individuals by hand picking. Intensity was determined in terms of number of lesions and fleas in different floor-types. Tungiasis-associated morbidities was assessed using acute and chronic lesions severity scores. The study revealed that moderate infestation was observed in 173 infested individuals and severe infestation in 16 infested individuals. A total of 5293 lesions was observed out of which 3098 were viable. The flea burdens on sampled floors and legs were 127 and 146 fleas respectively occurring mostly in unpaved veranda and rooms (65 and 62 fleas respectively). Tungiasis lesions observed in males were more intense compared to females. Flea lesions and burdens with respect to age stratification and location were significant P < 0.0001. Difficulty in walking, pain upon pressure and deformation of the feet were the most common tungiasis-associated morbidity recorded. Also, tungiasis-associated morbidities, and flea number sampled on legs and on floor of environment were reportedly intense. Therefore, scaling up an appropriate and affordable intervention approach targeted at the fleas would serve as a relief to the scourge of tungiasis in Igbokoda community.