Assessment, Quantification and Documentation of Factors Abetting Jigger Infestation in Kandara Sub-county, Kenya

Abstract

Jigger infestation or Tungiasis, is an ectoparasitosis caused by penetration of female Tunga penetrans into the skin of a susceptible animal or human and the consequent hypertrophy of the parasite. It is a disease associated with resource poor communities where ignorance and unhygienic practices are intricately intertwined. Tungiasis is accompanied by debilitating morbidities which cause an enormous public health burden among the communities afflicted. The objective of this study was to assess the risk factors associated with tungiasis among the residents of Kandara Sub-County in Muranga County where the disease has become a perennial health problem. The factors assessed were domestic animals, housing conditions, personal hygiene and the disease management knowledge among the residents. This was a 50:50 unmatched case-control study that involved 776 individuals. Structured questionnaires were administered among the heads of the households to which the participants belonged, to gather information concerning the risk factors. Univariate regression analysis was conducted between case and control variables. Factors depicting significant differences were further analyzed in a multivariate regression to establish those that stood out independently in aiding infestation. The results of this study depicted that, when compared with the control, there was very poor knowledge among the infested participants on how tungiasis is spread, prevented and treated (P< 0.001 in each variable). Fifty six percent of the jigger infested individuals did not bathe daily with soap. Fifty two percent of the infested participants who did not bathe at all were mentally handicapped. Jigger infested participants were also 4.2 times more likely to live in houses with un-cemented floors in comparison to the control. Most of the jigger infested house floors were cracked and dusty (53.2%). The jigger infested participants were 9.6 times more likely to keep dogs, which they mainly allowed to loiter in their home compounds. Seventy percent of the jigger infested participants shared their houses with chicken. The results of this survey demonstrated a high relationship between tungiasis and all the assessed risk factors in Kandara Sub- County. This calls for concerted efforts by the government and all relevant stake holders like WHO and humanitarian organizations in conducting robust anti-jigger campaigns in the area and especially educating the residents on the role played by these factors in aggravating tungiasis. These findings can be instrumental in efficacious interventional measures in the management and prevention of jigger infestation in the region.