Determinants and management of tungiasis (Tunga penetrans): In Trans-Nzoia County, Kenya

Abstract

Introduction: Tunga Penetrans is a flea (chigoe) that causes infestation known as jiggers. It affects approximately 3 million Kenyans in the Central, Eastern, and Western parts of Kenya. Jigger victims are stigmatized, children‟s education is negatively impacted and individuals‟ productivity is compromised. Objectives: The objective of the study was to assess the determinants of Tungiasis infestation, assess the community‟s knowledge and management approaches, and assess the housing conditions of inhabitants in Trans Nzoia County. The study was carried out in rural areas of Trans Nzoia County believed to have a high prevalence of Tungiasis infestation. Methods: A cross-sectional study design involving 167 households in Trans Nzoa County, and data obtained via multi stage-sampling procedures. Interviewer-administered questionnaires focused group discussions and observation checklists were used to collect data. R-statistical software was used to manage and analyze data. Frequency tables, bar graphs, and pie charts were used to summarize the presentation of data. Chi-square tests and Odds Ratios were used to assess risk factors associated with Tungiasis infestation. A logistic regression model was also fitted to determine predictors of Tungiasis infestation in the area while controlling for confounders. Results; Prevalence of Tungiasis was found to be high at 82.3%. Among the residents, Removal of jiggers using thorns was the most common crude method of management though with a risk of transmission of blood-derived pathogens, 85.4 %. Only 11.6 % of the cases would visit government clinics while 55.5 % burnt vegetation around their compound in an attempt to manage Tungiasis infestation. Other forms of management executed by residents include the application of paraffin, Vaseline, and hydrogen peroxide on the affected area to kill or block the breathing of the jigger species. No traditional herb was reported to be used to manage Tungiasis, nor is the use of dung to smear the floor of houses useful in the reduction of jigger infestation. The study found out that 95% of the respondents occupied semi-permanent houses, 81.7% of which had an earthen floor. Knowledge on causes of Tungiasis was low and 57.3 % of the households had no form of alternative host. While family size, education level, and family ownership were found to be significantly associated factors, education remained the only significant predictor for Tungiasis infestation. Conclusion: The prevalence of jigger infestation in Trans Nzoia County was found to be high in this study. The socio-economic factors associated with tungiasis especially poverty was a determinant factor in transmission of the disease. Majority of the respondents had poor knowledge on the causes of Tungiasis disease and the most common way of management was to remove the jiggers fleas and the eggs. Community intervention strategies were inefficient in lowering the prevalence and could cause potential risks of transmitting blood-borne pathogens. Recommendations: The study recommends the need to empower households on causes and preventive measures to reduce the prevalence of tungiasis.