Impact of socio-environmental determinants and hygiene practices in tungiasis transmission in a vulnerable rural community

BackgroundTungiasis is a neglected tropical disease (NTD) caused by the penetration of adult female Tunga fleas into the skin of humans and animals. The disease disproportionately affects individuals in tropical and subtropical regions, particularly in sub-Saharan Africa, South America and Caribbean, where poverty, inadequate sanitation and limited healthcare services facilitate transmission, especially among vulnerable populations. ObjectiveTo evaluate the association between socio-environmental factors and personal hygiene practices with tungiasis prevalence among residents of rural communities in the periphery of Badagry, Lagos State, Nigeria, across the rainy and dry seasons from September 2021 - April 2022. MethodsA cross-sectional survey was conducted, targeting at least 423 participants per sampling season. Following ethical approval and informed consent, semi-structured questionnaires were administered to collect demographic, socioeconomic, environmental and hygiene-related data. Physical examinations, performed by a qualified medical practitioner, identified tungiasis cases based on previously validated criteria. Descriptive statistics were used to summarize the data, while the Chi-square test assessed associations between infection status and categorical variables. A multivariate generalized linear model was used to identify key predictors of tungiasis infection. ResultsOverall tungiasis prevalence of 5.3% (54/1020) among study participants. While infection rates were slightly higher in males (27/410; 6.6%), the difference was not statistically significant. Most infected participants (96.3%) had lower education levels and exhibited unsatisfactory hygiene practices. The Chi-square test identified residing in a household with an earthen floor as the strongest variable correlated with tungiasis [{chi}2= 63.2, p = <0.001]. However, the final model, revealed seasonality -rainy season (OR: 4.80 [2.33-10.82], p = <0.001), frequent rat sightings (OR: 3.04 [1.40-7.29], p = 0.008) and sleeping on a mattress placed directly on the floor (OR: 2.60 [1.18-6.28], p = 0.024) as the most significant determinants of tungiasis infection. ConclusionsOur findings highlight the complex interplay between socioeconomic status, environmental characteristics, hygiene practices and seasonal variations in shaping tungiasis prevalence within a vulnerable rural community. Key predictors of infection, that is, seasonality, frequent rat sightings and poor sleeping conditions, underscore the need for targeted interventions to prioritize improving personal and household hygiene, implementing sustainable rodent control measures and raising community awareness about tungiasis prevention. These measures will not only help reduce tungiasis prevalence but also mitigate the burden of other zoonotic diseases that thrive under similar socio-environmental conditions.