Prevalence of Tungiasis and its associated risk factors among residents of Kipkelion West Sub-county, Kericho County, Kenya

Abstract

Tungiasis is a parasitic skin disease caused by penetration of the female sand flea Tunga penetrans, also called jigger flea, into the epidermis of its host. It is highly prevalent where people live in extreme poverty, occurring in many Latin American and African countries. In Kenya it is endemic in several areas where its prevalence and associated factors have not been intensely studied. The main objective of this study was to determine the prevalence of tungiasis and establish its associated factors among residents of Kipkelion West Sub-county. A cross-sectional study was conducted in Kipkelion West Sub - county; Kericho county, Kenya. A total of 428 randomly selected households were visited. Pretested questionnaires on socio demographic characteristics and risk factors were administered to household heads and household members were examined for the presence of tungiasis. The level of statistical significance was set at Pvalue <0.05. Binary logistic regression was performed to determine the independent factors associated with tungiasis. The prevalence of tungiasis was 30.1 %( 95% CI: 25.5%-34.4%). Risk factors that were associated with occurrence of tungiasis at multivariable analysis included: living in close proximity to domestic animals [AOR=6.58; 95%CI:3.42-12.65; P<0.001], walking barefoot [AOR=9.94; 95% CI: 4.18- 23.61; P<0.001], wearing slippers outdoors,[AOR=6.45; 95% CI: 2.78-14.98; P<0.001], presence of uncollected waste products near residential buildings [AOR=3.73; 95% CI: 2.01-6.91; P<0.001], living in mud houses with cracks on the floors/ walls [AOR=6.92; 95% CI: 3.25-14.70; P<0.001], rearing chicken within the main house [AOR=8; 95% CI: 2.74-23.33; P<0.001], rearing free range chicken [AOR=6.59; 95% CI: 1.37-31.67; P<0.001] and presence of rats in the compound [AOR=2.18; 95% CI: 1.09-4.36; P=0.028]. Despite severe disease being present among the residents of Kipkelion West Sub County, none of those infested sought healthcare .The common practices were removal of fleas using sharp objects and application of products especially petroleum jelly. The presence of tungiasis in the study area is associated to an important extent with a few risk factors which include:- lack of regular use of footwear, living in close proximity xiii to domestic animals, living in houses with cracked walls and floors, rearing chicken within residential houses, living in littered compounds and presence of rats in the compound. An integrated approach addressing these factors needs to be designed and implemented by an interdisciplinary team consisting of the affected, the populace, community leaders, health professionals, non-governmental institutions and policy makers.