Prevalence, clinical profile and determinants of tungiasis among schoolchildren in Dschang Health District, Cameroon

Background

Tungiasis, a skin infestation caused by the flea Tunga penetrans, affects resource limited tropical communities of Latin America, the Caribbeans and sub-Saharan Africa. Recently considered by the WHO as a Neglected Tropical Diseases, epidemiological data to inform control strategy is lacking in Cameroon.

Methods

A cross-sectional study targeting schoolchildren from eight primary schools selected by stratified random sampling method was conducted from November 2024 to July 2025 in Dschang Health District, west Cameroon. Data was collected to assess the prevalence of tungiasis infestation, its associated factors, and related morbidity, while observing all necessary ethical requirements.

Results

Some 407 schoolchildren with a median age of 11 (7-16) years, participated in the study of whom 54.8% were males, 84.0% attended government primary schools, and 81.8% cohabited with domestic animals. Fifty-one of the schoolchildren were infested with tungiasis for an overall prevalence of 12.5% (95% CI: 9.5-15.9). Lesions were located mainly on toes (92.2%) hands (31.4%) and heels (27.%%), and morbidity included pains (72.5%), itching (66.7%), sleep disturbance (72.5%, lack of concentration (49.0%), deformation of toes (15.7%) and difficulties in walking (13.7%). Cohabitation with domestic animals (OR=5.15 (95%CI: 1.09-24.29), p=0.039) especially pigs(OR=2.34 (95%CI:1.13-4.82), p=0.022); being a pupil of class 5 (OR=22.11 (95% CI:4.73-103.36), p<001) or class 6 (OR=7.70 (95% CI: 1.97-30.11), p=0.003) were independently associated with tungiasis infestations.

Conclusion

This study reveals a substantial burden of tungiasis among schoolchildren in Dschang and associated with modifiable risk factors involving both the environment and individual behavioral factors. We recommend the implementation of integrated control strategies combining animal reservoir control, hygiene education, and adoption of WHO recommended tungiasis treatment practices. More research is needed to understand the wider spectrum of tungiasis in Cameroon.

Author summary

Tungiasis, commonly known as jigger, is caused by a parasitic flea and mostly affects people living in poor communities of Latin America, the Caribbeans and sub-Saharan Africa. As jiggers have recently been considered a public health problem by the WHO, there is not enough information on the disease in Cameroon.

We therefore carried out a study to assess the burden of the diseases among primary schoolchildren from selected government and private confessional schools in Dschang health district as part of efforts to understand its situation in Cameroon.

Among the 407 schoolchildren surveyed, 51(12.5%) of them were infested with jiggers. Toes, hands and heels were the affected parts of the body, and led to pain, itching, sleep disturbance, lack of concentration, deformation of toes and difficulties in walking among the infested schoolchildren. We found out that the schoolchildren took jiggers for granted and practiced self-extraction of lesions followed by application of some ointments and kerosene as means of treatment. We discovered that jigger infestation was closely associated with cohabitation with animals, especially pigs, and being a pupil of class 5 or 6.

We conclude that jiggers constitute a major problem among schoolchildren in Dschang and is associated with modifiable risk factors. We therefore recommend the limitation of direct cohabitation with animals, hygiene education and the adoption of the WHO recommendations for the treatment of jiggers. We also recommend more research to understand the wider spectrum of tungiasis in Cameroon.