Prevalence and Associated Factors of Human Tungiasis Among Primary School Children in Kamushoko Parish, Bubaare Sub-County, Mbarara District, Uganda

Background: Human Tungiasis is a neglected tropical skin disease caused by the sand flea Tunga penetrans, associated with pain, inflammation, secondary bacterial infections, and significant morbidity. Despite its health impact on school children, it remained understudied in Kamushoko Parish, Bubaare Sub-County, Mbarara District, Uganda. Objectives: To determine the prevalence and identify associated factors of human Tungiasis among primary school children in Kamushoko Parish, Bubaare Sub-County, Mbarara District. Methods: A school-based cross-sectional descriptive study was conducted among 415 primary school children (P1-P7) at Katooma II and Komuyaga Primary Schools in March 2026. A census sampling approach enrolled all eligible pupils. Data were collected through structured face-to-face questionnaires and clinical examination of exposed areas. Tungiasis diagnosis was based on clinical identification of characteristic lesions with microscopic confirmation of extracted specimens. Bivariate and multivariate logistic regression analyses identified independently associated factors. Results: Of 415 children examined, 22 had active Tungiasis lesions, yielding an overall prevalence of 5.3% (95% CI: 3.53%-7.90%). Katooma II Primary School recorded a slightly higher prevalence (6.29%) than Komuyaga Primary School (4.78%), though the difference was not statistically significant (p = 0.499). Male children had higher odds of infection than females (7.1% vs. 3.7%). Children aged 9-10 years had the highest prevalence (7.7%). In the multivariate logistic regression, walking barefoot at school was the only independently significant predictor of infection (aOR = 0.18 for home vs. school; 95% CI: 0.04-0.78, p = 0.022). Conclusion: The prevalence of Tungiasis among primary school children in Kamushoko Parish was 5.3%, confirming ongoing transmission in the community. Walking barefoot at school was the only independent predictor of infection, highlighting the school environment as a critical intervention site. School-based strategies including grounds improvement, routine classroom cleaning, enforcing no-barefoot policies, and health education are recommended.