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Tungiasis: a neglected epidermal parasitic skin disease of marginalized populations—a call for global science and policy

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Abstract

Tungiasis (sand flea disease) is an ectoparasitic skin disease caused by the female sand flea/jigger flea (Tunga penetrans). As poverty is the major driving force of the disease, it can be called as a poverty-associated plague. It is one of the emerging neglected diseases in Latin America, Caribbean, sub-Saharan Africa, and India. The aim of the present scrutiny was to assess the public health impact of tungiasis, associated risk factors, and emerging opportunities to prevent and control tungiasis. Searches of PubMed, Google Scholar, and online search engines (Google, AOL, and Yahoo) using keywords “parasitic skin disease,” “tungiasis,” “sand flea,” “ tungiasis-associated risk factors,” “tungiasis prevention and control,” and their synonyms were used as a source of references. Searches were made without time limitations. Of 167 potential articles identified by these criteria, 51 appropriate were selected for review. Tungiasis is widespread in the resource-constrained settings of low-income economies. In the tropics, it is highly prevalent among the impoverished populations, but the associated risk factors are often poorly identified and remain uncontrolled. Though it is a self-limiting disease with considerable morbidity, the parasite may cause subsequent secondary morbidity through life-threatening complications and infections like cellulitis, tetanus, and death. However, the direct and indirect sociocultural, economic, and health impact of tungiasis is often undervalued and misunderstood. A systematic assessment on disease burden is still dearth and deficient. Over the decades, tungiasis has been largely neglected by the scientific community, policy makers, and healthcare stakeholders. In the endemic regions, even tungiasis is not listed for the disease control priorities in the regional, national, and international agenda. The majority of the epidermal parasitic skin diseases particularly tungiasis needs a sustainable global scientific research and control policy. This urges intensive efforts to develop a road map that delivers a clear vision towards zero new infection by designing low-cost prevention and control strategies. Besides, there is an urgency to develop culturally appropriate communication techniques and workable collaboration on a global scale by bringing all the stakeholders of endemic countries.

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Acknowledgments

I would like to thank Mrs. Melita Prakash for her sincere assistance in editing the manuscript. My last but not the least heartfelt thanks goes to my colleagues of our Department of Environmental Health Science, College Public Health and Medicine, Jimma University, Jimma, Ethiopia, for their kind support and cooperation.

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  1. Unit of Medical Entomology and Vector Control, Department of Environmental Health Sciences and Technology, College of Public Health & Medical Sciences, Jimma University, Jimma, Ethiopia

    Kaliyaperumal Karunamoorthi

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Correspondence to Kaliyaperumal Karunamoorthi.

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Karunamoorthi, K. Tungiasis: a neglected epidermal parasitic skin disease of marginalized populations—a call for global science and policy. Parasitol Res 112, 3635–3643 (2013). https://doi.org/10.1007/s00436-013-3551-8

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