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Tungiasis (sand flea disease): a parasitic disease with particular challenges for public health

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Abstract

Tungiasis (sand flea disease) is caused by the penetration of females of Tunga penetrans into the skin of the feet. Within 2 weeks of penetration the burrowed flea increases its volume by a factor of 2,000. This is paralleled by intense inflammation of the surrounding tissue. Acute and chronic inflammation leads to the development of painful and debilitating clinical pathology. This results in impaired physical fitness and mobility. The social implications of tungiasis-associated morbidity are multifold. Children with tungiasis are teased and ridiculed, adults feel ashamed and stigmatized. There is anecdotal evidence that tungiasis negatively affects educational achievements. Impaired mobility and physical fitness will have a negative impact on household economics. Sand flea disease is common in resource-poor communities in South America and in sub-Saharan Africa with prevalence in the general population of up to 60%. In East Africa, it has re-emerged in epidemic dimensions in recent years. Hitherto, no effective drug treatment has been at hand. Traditional treatment, i.e., the manipulation of burrowed sand fleas with blunt and inappropriate instruments may facilitate the transmission of blood-derived pathogens. Prevention is feasible through regular application of a repellent based on coconut oil. Owing to its strong association with poverty, sand flea disease would be an excellent starting point for a community-based fight against rural poverty.

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Acknowledgements

The support of the Director General of Health Services, Uganda Ministry of Health, is highly appreciated.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Institute of Microbiology and Hygiene, Charité Medical School, Campus Benjamin Franklin, Hindenburgdamm 27, 12203, Berlin, Germany

    H. Feldmeier

  2. Department of Medical Microbiology, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, Uganda

    E. Sentongo

  3. The Skaraborg Institute for Research and Development, Skövde, Sweden

    I. Krantz

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  1. H. Feldmeier
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Correspondence to H. Feldmeier.

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Feldmeier, H., Sentongo, E. & Krantz, I. Tungiasis (sand flea disease): a parasitic disease with particular challenges for public health. Eur J Clin Microbiol Infect Dis 32, 19–26 (2013). https://doi.org/10.1007/s10096-012-1725-4

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