Prevalence and Risk Factors Associated with Tungiasis among School-Aged Children in the City of Port Gentil, Ogooué-Maritime Province, Gabon in Central Africa

Abstract

Background: Tungiasis is a skin infestation caused by the female sand flea called Tunga penetrans. Associated with a significant morbidity, this ectoparasite is present in all tropical regions, such as Gabon. Unfortunately, in this country, no study has ever been undertaken on this disease. However, in both urban and rural areas of this country, it causes disfigurement and mutilation of the feet or hands in infested persons, and is sometimes responsible for the school dropout of many children. It is in this context that this timely and relevant research was conducted to assess the prevalence and risk factors associated with Tungiasis in school-aged children in the city of Port Gentil, Ogooué-Maritime province, Gabon in Central Africa. Materials and Methods: This prospective and cross-sectional study took place from May 22 to August 18, 2022, in two popular and underprivileged neighborhoods of the city of Port Gentil. It consisted of a physical diagnosis of the participants, and with the help of a questionnaire submitted to their parents/guardians, numerous data were collected. Entered into an Excel 2016 spreadsheet, the data were exported to the R software in its R Commander interface, for two types of analyses. A univariate and a multivariate analysis, using logistic regression, first on socio-demographic characteristics and then on habitual and environmental behavioral characteristics, was performed and the variables in this analysis reported odds ratios and their 95% confidence intervals. The results were statistically significant at p Tunga penetrans infestation was found in 242 children, indicating an overall prevalence of 37.99% (95% CI [0.34 - 0.41]). Univariate and multivariate analyses, using logistic regression, first according to socio-demographic characteristics and then according to risk factors indicated that, the age groups of 5 to 9 years (Adjusted Odds Ratio = 9.27; 95% CI: [6.66 - 12. 91]) and 10 - 14 years (Adjusted Odds Ratio = 0.16; 95% CI: [0.10 - 0.25]), Eshira ethnicity (Adjusted Odds Ratio = 7.46; 95% CI: [2.97 - 18.76]), child’s primary education level (Adjusted Odds Ratio = 0.008; 95% CI: [0.006 - 0.011]), Father’s/Guardian’s education level (Adjusted Odds Ratio = 0.22; 95% CI: [0.13 - 0.35]), homemaker status (Adjusted Odds Ratio = 4.89; 95% CI: [3.51 - 6. 79]) and risk factors such as: promiscuity with dogs, cats or other animals around the house (Adjusted Odds Ratio = 38.30; 95% CI: [22.13 - 66.26]), wearing shoes a few times (Adjusted Odds Ratio = 0.02; 95% CI [0.01 - 0.03]), walking sometimes barefoot, on land or sand (Adjusted Odds Ratio = 0.28; 95% CI: [0.18 - 0.42]), having other sources of water consumed than the tap (Adjusted Odds Ratio = 0.25; 95% CI: [0.16 - 037]), living in a dwelling with soil or sand (Adjusted Odds Ratio = 6.8; 95% CI: [4.58 - 10.09]), having average housing conditions (Adjusted Odds Ratio = 46.8; 95% CI [24.29 - 90.16]), and the number of people living in the family that was greater than or equal to 6 (Adjusted Odds Ratio = 0.1; 95% CI [0.07 - 0.13]), were significantly associated with the prevalence of Tungiasis. Conclusion: The results of this study will inform control programs and water and sanitation interventions for the Tunga penetrans epidemic in Port Gentil, Gabon.