Tungiasis infection among primary school children in Northeastern Tanzania: prevalence, intensity, clinical aspects and associated factors

Objective: To investigate the prevalence, intensity, clinical aspects and factors associated with tungiasis infection among primary school children in Northeastern Tanzania. Methods: A quantitative school-based cross-sectional study was conducted among 401 primary school children. Participants were assessed through clinical examination to look for embedded Tunga penetrans in their hands, feet, arms and legs. A structured questionnaire was used to enquire about factors associated with tungiasis infection. The data were analysed using descriptive statistics, Chi-squared test and logistic regression, with p<0.05 taken to indicate significance. Results: The overall prevalence of tungiasis infection was 21.2%. Of the 85 tungiasis-infested children, 54 [63.5%, 95% confidence interval (CI) 53.1–74.1] had mild infection, 25 (29.4%, 95% CI 19.0–39.6) had moderate infection, and six (7.1%, 95% CI 1.2–12.9) had heavy infection. A moderate level of knowledge was significantly associated with high odds of tungiasis infection [adjusted odds ratio (AOR) 3.16, 95% CI 1.50–6.67], while not keeping a dog/cat at home was a protective factor (AOR 0.47, 95% CI 0.25–0.89). Conclusions: Moderate prevalence of tungiasis infection was observed among primary school children favoured by factors related to the host, parasitic agent and environment. There is a need for a health education programme in schools encouraging use of appropriate footwear (closed shoes), use of locally accessible repellents (coconut oil), fumigation of households, and washing dogs/cats with insecticides.