Risk Factors for Tungiasis in Nigeria: Identification of Targets for Effective Intervention

Tungiasis is a parasitic skin disease caused by the sand flea Tunga penetrans. After penetration into the skin, the flea grows and reaches the size of a pea. The disease is a neglected public health problem in endemic areas in Latin America, the Caribbean and Africa, and causes considerable morbidity in the affected communities. We performed a study in a rural community in Nigeria to detect factors associated with tungiasis. People were examined for the presence of sand flea lesions, and a questionnaire was applied. Of the 643 individuals examined, 252 (42.5%) had tungiasis. The most important factors independently associated with the disease were: presence of pigs on the compound (adjusted odds ratio [OR] = 17.98), sand or clay floor inside house (OR = 9.33), and having the common resting place outside the house (OR = 7.14). The regular use of closed footwear (OR = 0.34) and the use of insecticides indoors (OR = 0.2) were protective factors. Our data show that tungiasis in this community is determined to an important extent by some variables that may be a target for interventions

Parasites of importance for human health in Nigerian dogs: high prevalence and limited knowledge of pet owners

Background: Dogs are the most common pet animals worldwide. They may harbour a wide range of parasites with zoonotic potential, thus causing a health risk to humans. In Nigeria, epidemiological knowledge on these parasites is limited.\ud \ud Methods: In a community-based study, we examined 396 dogs in urban and rural areas of Ilorin (Kwara State, Central Nigeria) for ectoparasites and intestinal helminths. In addition, a questionnaire regarding knowledge and practices was applied to pet owners.\ud \ud Results: Nine ectoparasite species belonging to four taxa and six intestinal helminth species were identified: fleas (Ctenocephalides canis, Pulex irritans, Tunga penetrans), mites (Demodex canis, Otodectes sp., Sarcoptes scabiei var. canis), ticks (Rhipicephalus sanguineus, Ixodes sp.), and lice (Trichodectes canis); and Toxocara canis, Ancylostoma sp., Trichuris vulpis, Dipylidium caninum, Taenidae and Strongyloides sp. Overall prevalence of ectoparasites was 60.4% and of intestinal helminths 68.4%. The occurrence of C. canis, R. sanguineus, T. canis, Ancylostoma sp. and T. vulpis was most common (prevalence 14.4% to 41.7%). Prevalence patterns in helminths were age-dependent, with T. canis showing a decreasing prevalence with age of host, and a reverse trend in other parasite species. Knowledge regarding zoonoses was very limited and the diseases not considered a major health problem. Treatment with antiparasitic drugs was more frequent in urban areas.\ud \ud Conclusion: Parasites of importance for human health were highly prevalent in Nigerian dogs. Interventions should include health education provided to dog owners and the establishment of a program focusing on zoonotic diseases

Community knowledge on transmission of malaria and its management practice in Oorelope local government, southwestern region, Nigeria

Malaria control is a major challenge in many endemic countries including Nigeria; implementation of evidenced-based control strategies is therefore needful in the sustainability of malaria control programme. Across-sectional study was designed to investigate perception of two communities in Oyo state using pre-tested structured questionnaire. Of 500 people enrolled for the study, Ninety six percent of respondents reported to have heard of malaria. Though majority reported mosquito as major transmitter of the infection but only 22.6% has adequate knowledge of the correct transmission route. Misconception about the causative agent of malaria is high, only 13.2% mentioned Plasmodium species as the causative agent. The knowledge about the ecology of mosquito was greatly applauded in the study area. Health-seeking behaviors and possession of insecticidal treated bet net were found to be associated with socioeconomic status of individual. In spite of the high knowledge about malaria demonstrated in this study, some misconceptions about transmission and symptom still exist. The need to improve the spreading of information about malaria through rural dispensaries and primary health centers is essential for resounding success to be recorded.Keywords: Malaria, Knowledge, Transmission, Misconception, Causative agent, Treatment, Bed net, Oorelope, Oyo State, Nigeri

Rapid assessment of head lice infestations

[Extract]\ud When financial and human resources are limited, policy makers and health care providers need cost effective and simple indicators for health problems. The so-called rapid assessment method is a way to investigate situations in which some issues are not yet well defined and where sufficient time or resources for long-term assessments are not given. In case of infectious and parasitic diseases,\ud these simple indicators (such as asking a patient if he/she considers being infected, or simple clinical assessments) are commonly used to plan and monitor mass interventions. Additionally, rapid assessment also helps to detect parasitised individuals, and to plan individual treatment. Rapid assessment methods have been developed for a variety of diseases and health conditions, and thus have a great value in resource-poor as well as in high income settings [1-4]. These methods may also be helpful to plan and monitor interventions

Sustainable control of tungiasis in rural Nigeria: a case for One Health

Aim: To describe the impact and sustainability of an evidence-based intervention against tungiasis in a severely affected community in Lagos State, Nigeria.Methods: We performed an intervention targeted at the control of tungiasis, and a cross-sectional follow-up study after one year. After 14 years, the community was revisited, and a rapid assessment was performed. Risk factors identified before the intervention included sandy floors inside houses, irregular use of footwear, and free-roaming pigs on the compound. In collaboration with community members and traditional leaders, the floors of the primary school and houses without concreted floor were sealed with concrete, free-roaming pigs were banned/confined to pigpens, and regular use of footwear and environmental hygiene, particularly consisting of cleaning the compound and streets from waste, were encouraged. We examined the participants for the presence of tungiasis on legs, feet, hands, and arms. Signs and symptoms were documented.Results: In the baseline survey before intervention, 557 participants were included in the follow-up study after one year, 540 participants were included. The prevalence of tungiasis decreased from 45.2% to 21.3%, and the total number of lesions from 3,111 to 617 (both P < 0.0001). Severe symptoms and pathology (e.g., difficulty walking, deformation of toenails, loss of toenails, and bacterial superinfection) were reduced from high to negligible levels. After 14 years, there was no case with vital tungiasis lesions.Conclusion: Long-term control of tungiasis is possible in heavily affected communities by considering an evidence-based One Health approach. Urbanization may have contributed to elimination of tungiasis after 14 years

Scabies in Resource-Poor Communities in Nasarawa State, Nigeria: Epidemiology, Clinical Features and Factors Associated with Infestation

Epidemiology and clinical features of scabies remain largely unknown in Nigeria’s rural communities. To fill this gap, we performed a cross-sectional study in three rural communities in north central Nigeria. A total of 500 individuals were included and examined for scabies infestation; a questionnaire was applied to collect socio-demographic and behavioral data. Scabies was diagnosed in 325 (65.0%) participants. Excoriations (68.6%), vesicles (61.8%), and papules (58.8%) were common skin lesions. Itching was the most common symptom (77.5%); 64% complained of sleep disturbances. Lymphadenopathy was identified in 48.3%. Lesions were most commonly encountered on the abdomen (35.5%), inguinal area (19.1%), and interdigital spaces (14.2%). Poverty-related variables, such as illiteracy (OR: 7.15; 95% CI: 3.71–13.95), low household income (7.25; 1.19–88.59), absence of a solid floor inside house (12.17; 2.83–52.34), and overcrowding (1.98; 1.08–2.81) were significantly associated with infestation. Individual behavior, such as sharing of beds/pillows (2.11; 1.42–3.14) and sharing of clothes (2.51; 1.57–3.99), was also highly significantly associated with scabies. Regular bathing habits (0.37; 0.24–0.56) and regular use of bathing soap (0.36; 0.21–0.53) were protective factors. Scabies is extremely common in the communities under study and is associated with considerable morbidity. The disease is intrinsically linked with extreme poverty

A simple approach improving the performance of urine reagent strips for rapid diagnosis of urinary schistosomiasis in Nigerian schoolchildren

In Nigeria, schistosomiasis, caused predominantly by the species Schistosoma haematobium, is highly endemic in resource-poor communities. We performed a school-based survey in two rural communities in Osun State (Southwestern Nigeria) and assessed macrohaematuria, microhaematuria and proteinuria as indirect indicators for the presence of disease. Urine samples were inspected macroscopically for haematuria and screened for microhaematuria and proteinuria using urine reagent strips. The microscopic examination of schistosome eggs was used as the gold standard for diagnosis. In total, 447 schoolchildren were included in this study and had a 51% prevalence of urinary schistosomiasis. The sensitivity of microhaematuria (68%) and proteinuria (53%) for infection with S. haematobium was relatively low. In patients with a heavy infection (>500 eggs/10 mL), the sensitivity of microhaematuria was high (95%). When the presence of macrohaematuria and the concomitant presence of microhaematuria and proteinuria were combined, it revealed a sensitivity of 63%, a specificity of 93% and a positive predictive value of 91%. Macrohaematuria also showed high specificity (96%) and a positive predictive value of 92%, while sensitivity was < 50%. These data show that combining urine reagent strip tests (presence of proteinuria and microhaematuria) and information on macrohaematuria increased the accuracy of the rapid diagnosis of urinary schistosomiasis in an endemic rural West African setting. This simple approach can be used to increase the quality of monitoring of schistosomiasis in schoolchildren