Tungiasis: Biology, Life Cycle, Epidemiology, Diagnosis, Prevention, and Treatment

Rhoda Nwalozie *

Department of Medical Laboratory Science, Faculty of Science, Rivers State University, Port Harcourt, Nigeria.

Chinonye Oluchi Ezenwaka

Department of Biology, Faculty of Science, Federal University Otuoke, Bayelsa State, Nigeria.

*Author to whom correspondence should be addressed.


Abstract

Tungiasis, caused by the female sand flea Tunga penetrans, is a neglected tropical disease that affects impoverished communities in tropical and subtropical regions. This comprehensive review discusses the biology, life cycle, epidemiology, clinical presentation, diagnosis, prevention, and treatment of tungiasis. Tungiasis exhibits a patchy distribution, with higher prevalence rates reported in rural areas and areas with poor sanitation. Risk factors include poverty, inadequate housing conditions, and lack of access to proper footwear. The disease primarily affects vulnerable populations such as children and the elderly, leading to a significant socioeconomic burden. Clinical presentation of tungiasis involves characteristic lesions with embedded fleas, often leading to secondary infections, abscesses and ulcerations. Diagnosis is based on clinical examination and visualization of the flea within the skin lesion. Treatment involves the physical removal of embedded fleas, management of associated complications, wound care, and prevention of secondary infections. Prevention and control strategies are crucial in reducing the disease burden. Personal and environmental hygiene, including regular washing of feet and maintaining clean living environments, play a vital role in prevention. Community education and health promotion campaigns raise awareness and promote behavior change. Vector control measures and integrated approaches combining multiple strategies are effective in reducing tungiasis prevalence. Although progress has been made in understanding and managing tungiasis, challenges persist. Further research is needed to improve diagnostic techniques, enhance treatment options, and address the long-term consequences of the disease. Community engagement, interdisciplinary collaborations, and sustainable interventions are essential in controlling tungiasis and improving the health and well-being of affected populations. By implementing comprehensive prevention and control strategies, raising awareness, and addressing the socioeconomic impact of tungiasis, we can strive towards reducing the burden of this neglected tropical disease and improving the lives of individuals and communities affected by tungiasis.

Keywords: Tungiasis, Tunga penetrans, epidemiology, clinical presentation, diagnosis, prevention, treatment


How to Cite

Nwalozie , Rhoda, and Chinonye Oluchi Ezenwaka. 2023. “Tungiasis: Biology, Life Cycle, Epidemiology, Diagnosis, Prevention, and Treatment”. South Asian Journal of Parasitology 6 (2):83-93. https://www.journalsajp.com/index.php/SAJP/article/view/155.

Downloads

Download data is not yet available.

References

Muehlen M, Feldmeier H. Epidemiology in Tungiasis: A global problem with common solutions. South African Journal of Science. 2003;99(11-12):573-578.

Utzinger J, Raso G, Brooker S, de Savigny D, Tanner M. Orphans of a Neglected Disease: A literature review on the neglected tropical disease schistosomiasis in sub-saharan Africa. African Health Sciences. 2009;9(1):1–18.

Heukelbach J, Ugbomoiko US. Feldmeier H. Ectoparasitic Diseases: An overview and research trends. Annals of Tropical Medicine and Parasitology. 2008;102(3):67-74.

Feldmeier H. Heukelbach J. Epidermal Parasitic Skin Diseases: A Neglected Category of Poverty-associated Plagues. Bulletin of the World Health Organization. 2010;88(5):359-364.

Santos SL. Heukelbach J. Tungiasis. In Neglected Tropical Diseases - Middle East and North Africa. Springer. 2013:295-308.

Feldmeier H, Heukelbach J. Tungiasis—An Ancient Disease Revisited. Travel Medicine and Infectious Disease. 2009;7(3):166-172.

Herrero AP, Vinícius MB. Teixeira LFM. A Comprehensive Review of the Tungiasis Cycle, Its Epidemiology, Risk Factors, and Myths. Brazilian Journal of Infectious Diseases. 2013;17(5):937-944.

Maia C, Heukelbach J. Atlas of Tungiasis: Epidemiology, Diagnosis and Treatment. Springer; 2014

Ugbomoiko US, Ariza L, Ofoezie IE. The Epidemiology, Socioeconomic Impacts, and Control of Tungiasis in Nigeria: A Systematic Review. PLoS Neglected Tropical Diseases. 2007;1(3):87.

Finkelstein JL. Mena I. Sand Fleas (Tungiasis) in Sub-Saharan Africa: A Disease Overlooked. International Journal of Infectious Diseases. 2007;11(2):129-133.

Gyorkos TW, Maheu-Giroux M, Blouin B, Casapia M. Impact of health education on soil-transmitted helminth infections in schoolchildren of the peruvian amazon: A Cluster-Randomized Controlled Trial. PLoS Neglected Tropical Diseases. 2012;6(11):1943.

Ugbomoiko US, Ofoezie IE, Heukelbach J. Tungiasis: High Prevalence, Intensity of Infestation and Associated Factors in a Rural Community in Lagos State, Nigeria. International Journal of Dermatology. 2008;47(5):434-443.

World Health Organization (WHO) Tungiasis - Fact Sheet; 2021.

Available:https://www.who.int/news-room/fact-sheets/detail/tungiasis.

Tomczyk S, Deribe K, Brooker SJ, Clark H, Rafique K, Knopp S, Utzinger J. Davey G. Association between footwear use and neglected tropical diseases: A systematic review and meta-analysis. PLoS Neglected Tropical Diseases. 2014;8(11):3285.

Heukelbach J, Feldmeier H. Tungiasis: A persistent health problem in resource-poor communities. Trends in Parasitology. 2012;28(8):313-317.

Nair PA. Vora RV. Parasitic Infections. In A. B. Chhabra, & S. R. George (Eds.), Dermatology: An Illustrated Colour Text. Elsevier. 2019;7:189-193.

Marschalkó M, Zalaudek I. Nonmelanocytic Dermatoscopy. In A. A. Marghoob, A. M. Blum RP. Braun (Ed.), Dermatological Atlas of Black Skin. Adis. 2017:15-26.

Krücken J, Schröder R, Schäfer I. von Samson-Himmelstjerna G. Molecular Diagnosis of Tungiasis. The New England Journal of Medicine. 2012;366(23):33.

Chadee DD. Fisher M. The significance of community participation in the control of Tunga penetrans infestation. Acta Tropica. 2010;113(3):217-220.

Muehlen M, Heukelbach J, Wilcke T, Winter B, Mehlhorn H, Feldmeier H. Investigations on the biology, epidemiology, pathology and control of Tunga penetrans in Brazil: III. Cytokine levels in the skin lesions of infected laboratory BALB/c mice. Parasitology Research. 2003;91(6):491-496.