Tungiasis in Western Kenya: Knowledge, Perceptions, and Practices of Household Heads – A Crossectional Study

Abstract

Background: According to reports of AHADT Kenya, tungiasis afflicts four million Kenyans with 10 million more at risk of severe infestation. Anecdotal reports suggest that lack of knowledge and retrogressive beliefs and practices of household heads, them being the key decision makers in rural homes, might be barriers to the control of tungiasis.
 Objective: To assess the knowledge, perceptions, and practices of household heads regarding tungiasis in Kenya
 Methodology: A crossectional study was done in Otwenya Location, Maseno Division, Kenya. Seventy-eight (78) homes were visited and all their household members checked for the presence of tungiasis. Structured pretested questionnaires were used to collect the socio demographic data of household heads and the knowledge, perceptions, and practices around tungiasis evaluated. Data analysis was done using version 21 of the Statistical Package for Social Scientists (SPSS) software. A modified technique by Memon et al. was used to compute the knowledge and attitude scores. Fisher’s exact test with Cochran Mantel Haenszel statistics was used for data analyses at 95% CI.
 Results: Our data was collected in Urudi Rata (39.7%), Mbeka (35.6%), and Mariwa (24.4%) villages. Most houses had iron sheer roofs (93.6%) and floors plastered with dung or cement (60.3%). Household heads were mainly female (71.8%) with primary level education (67.9%). Tungiasis was found in 39.7% of households. Earth floors (OR=11.1, P<0.01) and overcrowding (OR=3.4, p=0.04) were risk factors for tungiasis. Most respondents (75.7%) had a moderate knowledge of tungiasis with it being lowest among heads with no formal education (OR=35.56 (1.7 to 732.6), p=0.02). The knowledge of tungiasis did not influence its occurrence in homes. (p=0.49). Most respondents (82.1%) had poor perceptions of tungiasis, which did not vary by the age, education, and gender of household. However, odds of infestation was over 4.9 times higher in homes where household head had negative perception of tungiasis (OR=4.9 p=0.03). The extraction of fleas (91.1%) was the commonest treatment option.
 Conclusion: Tungiasis is a common ectoparasitosis in rural Kenya with a prevalence of 19.5%. Household heads are knowledge about tungiasis. However, retrogressive beliefs, negligence, and stigma are barriers for its control.