Factors Associated with Tungiasis Infestation among School age Children in Ugenya Sub-County, Siaya County, Kenya
Background: Tungiasis recognized as a neglected parasitic tropical disease by the WHO is caused by female Tunga penetrans (jigger, Flea) which has remained a significant public health problem. It affects resource-poor communities causing various health disabilities. By 2016, about 2.6 million Kenyans were infested out of whom 1.5 million were school going children who developed physical and mental disabilities.
Objective: The study aimed at assessing factors that influence practices towards prevention and control of tungiasis infestation among school children in Ugenya Sub-County, Kenya.
Methodology: A descriptive cross-sectional study design and quantitative data collection method was used between January and March 2018. A total of 385 participants clinically examined for the presence of tungiasis after consenting were enrolled. Male 200 (51%) and female 185(49%) . Using standard methods, macroscopic examination was performed by carefully inspecting the legs, feet, hands and arms of school pupils aged 6 to 14 years. Initially, information meetings were held with County officials in the line ministries, School committees and Community representatives to sensitize on disease prevention, control, and ownership of the process. Community Health Workers (CHWs) getting involved on how to identify classification of tungiasis as performed for them and by field officers. Simple random sampling technique was applied for selection. A pretested semistructured questionnaire had been administered in English/ Vernacular on approximately 10% of the participants. Data was keyed-into Microsoft Excel and analyzed using IBM SPSS version 23.
Results: The overall prevalence was found to be 31.1% which was slightly higher than a previous community-based study that had a prevalence of 25%  indicating higher infestation in schools than in the community. Remarkably, the majority of pupils infested in classes 5 – 6 were 191(49%). Gender of pupils (p<0.005) showed a statistical significance with tungiasis infestation. Infestation of family member at (p<0.005) and action taken when family member was infested (p=0.042) with posted level of significance. A positive relationship between sleeping area in the house (p=0.048) as well as waste disposal (p=0.017) with tungiasis infestation.
Conclusions: Factors including gender, invasion of a family member, action taken upon infestation, sleeping area in the house and waste disposal, significantly predicted tungiasis infestation. Diagnosis of tungiasis having been done by experienced community members and confirmed using ‘Fortaleza classification’. following surgical extraction of the flea, thorough cleansing and covering of the remaining crater with a topical antibiotic cream to prevent secondary infection was guaranteed.  School age children in developing countries bore the greatest health burden from neglected tropical infections including tungiasis.
Recommendations: The key word here is hygiene. Imperative control programs to adopt a more comprehensive approach including School and Community health education to reduce the spread and morbidity from tungiasis is essential. However, sustainable control measures against tungiasis could only be developed if the epidemiological situation is well understood  Oral antibiotics and un-expired
Tetanus prophylaxis should be readily availed within such endemic areas.
Key words: Practice, Tungiasis, Prevention, Control, Ugenya, Infestation