Tungiasis: high prevalence, parasite load, and morbidity in a rural community in Lagos State, Nigeria

Authors

  • Uade Samuel Ugbomoiko BSc MSc PhD,

    1. From the Department of Zoology, University of Ilorin, Ilorin, Nigeria, Department of Zoology, University of Nigeria, Nsukka, Nigeria, Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza, Brazil, and School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, Qld, Australia
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  • Ifeanyi Emmanuel Ofoezie BSc MSc PhD,

    1. From the Department of Zoology, University of Ilorin, Ilorin, Nigeria, Department of Zoology, University of Nigeria, Nsukka, Nigeria, Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza, Brazil, and School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, Qld, Australia
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  • Jorg Heukelbach MD PhD

    1. From the Department of Zoology, University of Ilorin, Ilorin, Nigeria, Department of Zoology, University of Nigeria, Nsukka, Nigeria, Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza, Brazil, and School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, Qld, Australia
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Jorg Heukelbach, MD, PhD Departamento de Saúde Comunitária Faculdade de Medicina Universidade Federal do Ceará Rua Prof Costa Mendes 1608, 5. andar Fortaleza, CE 60430-140 Brazil E-mail: heukelbach@web.de

Abstract

Background  Tungiasis is common in resource-poor populations throughout Latin America, the Caribbean, and sub-Saharan Africa, but epidemiologic data from Africa on this ectoparasitosis are scarce.

Methods  A cross-sectional study was carried out in a representative sample of a rural community in Lagos State, 54 km west of Lagos (Nigeria). In the dry season, 142 households of the community were randomly selected and visited. Family members were examined for the presence of tungiasis. The localization, number, and stage of penetrated fleas, as well as the associated morbidity, were documented.

Results  Five hundred and fifty-seven individuals were examined, 299 (53.7%) males and 258 (46.3%) females. In total, 252 (45.2%; 95% confidence interval, 41.1–49.5) were infested with Tunga penetrans. The prevalence was highest between the ages of 5 and 14 years, decreased in adults, and increased again in the elderly. There was no statistically significant difference between the prevalence in males and females (47.2% vs. 43.0%; P = 0.3). Almost 95% of lesions were localized on the feet. Ten per cent of individuals presented with sand fleas on the hands and elbows. The median parasite load was six (interquartile range, 3–16). Individuals aged 60 years or over had significantly more lesions (median of 41 lesions; P < 0.01). About one-third of the study participants found it difficult to walk; in 10% of cases, fissures were present. Superinfection was common.

Conclusions  The prevalence of tungiasis and the parasite load were high, and the severity of the disease was considerable. The prevalence and parasite burden showed a characteristic distribution. In western Nigeria, tungiasis needs to be regarded as an important public health problem.

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