Tungiasis--a neglected disease with many challenges for global public health.

Abstract

Tungiasis (sand flea disease) is a parasitic skin disease with origins in South America. It was introduced into sub-Saharan Africa in the 19th century [1]–[3]. Sand flea disease is a zoonosis caused by the penetration of female sand fleas into the skin. In humans, tungiasis predominantly affects marginalized populations. Children and elderly people are especially susceptible to severe disease. Sand flea disease is the most frequent parasitic infection in many resource-poor communities. In animals like dogs, pigs, or ruminants, the infection has severe consequences with, for example, reduced milk production when the skin of the udder is affected. Despite the substantial disease burden caused by embedded sand fleas, tungiasis is basically neglected by health care providers, policy makers, the scientific community, the pharmaceutical industry, and funding institutions [4]. Although not included in WHO's list of neglected tropical diseases (NTDs), tungiasis bears all the hallmarks of an NTD to merit apprehension from the public health sector [5]–[7]. It occurs in resource-poor communities, causing considerable morbidity and loss of quality of life. Systematic data on disease occurrence are not available.