Knowledge, attitude and practices on jigger infestation among household members aged 18 to 60 years: case study of a rural location in Kenya

Abstract

Jigger flea, also known as sand flea, Chigoe or Tunga penetrans is an ecto-parasite which causes Tungiasis parasitic condition of humans and animals. The flea affects many impoverished populations living in sub- Saharan Africa, the Caribbean and South America. Hundreds of millions of people are at risk of infection in more than 70 nations, mostly in developing countries. The importance of Tunga infestation is localization in the foot causing serious difficulty in walking, reducing the infected person’s ability to work normally. In endemic areas, prevalence ranges from 15-40% [1]. Jigger transmission from one person to another is not possible but it occurs through the insanitary environment. The jigger flea causes debility in resource-poor communities of developing countries. The flea survives best in sandy and dusty environments. Poverty and powerlessness or inability to do anything about it is the greatest cause of ill health among communities. Tungiasis occurs in resource poor countries in the Caribbean, South America and Africa. In some communities, the prevalence may be as high as 50% in the general population [2]. Tungiasis is usually considered an entomologic nuisance and does not receive much attention and therefore remains an important public health problem for the poor. It is a problem neglected by those affected, the medical profession and the scientific community [3]. Household status determines the health conditions of the occupants and home hygiene is important in order to control pests and provide pleasant atmosphere to the household members [4]. Jigger menace has also led to school dropout and it is estimate that over 2 million people in Kenya need assistance in relation to jigger menace [5]. The risk of secondary Supplement article 2 Pan African Medical Journal. 2012;13(Supp 1):7 | Bernard Kimani et al. infection is high. Tetanus is a common secondary infection that has reported associations with death [6]. Determinants of health include healthy human activities (practices, knowledge and attitude) as well as environmental determinants that create conditions which impact on the epidemiological pattern of these diseases and conditions. These determinants also increase susceptibility to environmental factors leading to more breeding sites for the vectors and increase the risk of jigger transmission [7]. If health workers are to deal effectively with ill community health, they need to understand their practices, ignorance, poverty and attitudes. They need to understand their behaviour and the surrounding environment in which people live [6]. Published information on knowledge, attitude and practices as well as jigger situation is scanty and fragmented in Kenya despite having a well focused National Health policies and reform agenda; consequently, there has not been a breakthrough in improving the situation of households entrapped in vicious cycle of poverty and ill health. This study therefore sought to elucidate the status of knowledge, attitude and practices on jigger infestation in a rural Kenyan setting