Tungiasis: A neglected health problem in rural cameroon

Background: The jigger flea (Tunga penetrans) is a parasitic insect that causes debility in resource-poor communities of the developing world. The flea originates from South America, but it has spread across the Caribbean, Sub-Saharan Africa and parts of South Asia. Virulence, known as tungiasis, results from infestation by the fertilised female flea, which embeds into the epidermis (usually of the feet), feeds on lymph and swells as the eggs grow. The mature eggs are extruded onto the ground, where the larvae feed, pupate and metamorphose into the adult flea. / Aim & Objectives: To ascertain the prevalence and impact of Tunga penetrans in a rural population of Northwest Cameroon, in relation to a series of associated risk factors. / Method/Study Design: In July and August 2008, a survey was carried out across a representative sample of compounds within nine villages in the Ndu sub-division of North-west Cameroon. The residents were questioned in relation to suggested risk factors, as well as local treatments and folklore. Their hands and feet were examined for the presence of tungiasis, and the number and locality of lesions were recorded. Results/Findings: 1,151 individuals were examined, including 567 males (49%) and 584 females (51%). Of these, 53% were children (0-14 years), and 10% were elderly (60+ years). In total, 610 individuals (53%) were infested with Tunga penetrans. Prevalence was higher in males (59%) than in females (47%) (p=0.004). Prevalence was highest in children, decreased in adults and increased again in the elderly. Illiterate people were more likely to suffer (59%) than those who were literate (50%) (p=0.05). The mean parasite intensity was 5.1, and the median parasite intensity was 2 (interquartile range, 2-5). Of those surveyed, 769 (67%) had experienced the flea within the previous month, and 21% of the study sample did not consider jigger flea infestation to be a disease. / Conclusion: The prevalence and impact of tungiasis in rural areas of North-west Cameroon are high, causing suffering and disability to a large proportion of the population. The disease remains an important health problem to the impoverished, and needs to be addressed by health officials, the medical community, educationalists and sufferers themselves.