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1.
PLoS Negl Trop Dis ; 18(5): e0011800, 2024 May.
Article in English | MEDLINE | ID: mdl-38776337

ABSTRACT

Tungiasis is a highly neglected tropical skin disease caused by the sand flea, Tunga penetrans. The flea burrows into the skin inducing a strong inflammatory response, leading to pain and mobility restrictions with potential impacts on quality of life. Few countries implement control efforts and there are few data on the impact of the disease to support policy decisions. We conducted a survey to determine the impact of tungiasis among primary school children across nine counties of Kenya. A total of 10,600 pupils aged 8 to 14 years were randomly selected from 97 primary schools and examined for tungiasis. For 81 cases and 578 randomly selected controls, anthropometric measurements were made, and school attendance and exam scores were collected from school records. Of those with tungiasis, 73 were interviewed regarding their quality of life using a tungiasis-specific instrument. Mixed effect ordered logistic and linear models were used to assess associations between disease status and impact variables. Compared to uninfected pupils, those with tungiasis had lower weight-for-age z-scores (adjusted ß -0.41, 95% CI: -0.75-0.06, p = 0.020), missed more days of school the previous term (adjusted Incidence Rate Ratio: 1.49, 95% CI: 1.01-2.21, p = 0.046) and were less likely to receive a high score in mathematics (aOR 0.18, 95% CI: 0.08-0.40, p<0.001) and other subjects. Pupils with severe disease (clinical score >10) were four times more likely to experience severe pain than those with mild disease (OR 3.96, 95% CI: 1.35-11.64, p = 0.012) and a higher impact on their quality of life than those with mild disease (aOR 3.57, 95% CI: 1.17-10.8, p = 0.025) when adjusted for covariates. This study has demonstrated tungiasis has a considerable impact on children's lives and academic achievement. This indicates the need for integrated disease management for school-aged children to protect their physical and cognitive development and their future prospects.


Subject(s)
Absenteeism , Nutritional Status , Quality of Life , Tungiasis , Humans , Child , Male , Tungiasis/epidemiology , Adolescent , Female , Kenya/epidemiology , Tunga/physiology , Schools , Animals , Academic Performance/statistics & numerical data
2.
Heliyon ; 9(11): e22381, 2023 Nov.
Article in English | MEDLINE | ID: mdl-38027715

ABSTRACT

Consumption of poultry meat, eggs, and other animal-sourced commodities has dramatically risen by almost 86 %, with the demand of indigenous chicken products almost doubling over the past few decades. In Kenya, poultry farmers prefer indigenous chicken (IC) due to their resilience to harsh climatic conditions, high feed conversion rates, delicious end products, ability to scavenge and potential to reduce greenhouse gas emissions among other factors. Despite the high demand for poultry and its products, the gap between demand and production remains high. Poultry farmers try to keep pace with the demand by integrating the recommended improved IC breeds into their production system. Although there exists some understanding on the determinants of the farmers to adopt improved IC, still there is scanty information on how socio-psychological factors influence the intention to adoption improved IC among the farmers in Kenya. Thus, this study sought to investigate the determinants of intention to adopt improved IC while specially focusing on the role of socio-psychological factors. A total of 374 IC farmers in Machakos county were selected using a multistage sampling technique. Partial Least Square - Structural Equation Modelling (PLS-SEM) was employed to analyze the data. Results from descriptive statistics showed that approximately 90 % of IC farmers in the study area were aware of the improved indigenous chicken breeds. However, the adoption of the improved IC was below average (44.9 %). The path analysis results revealed that Subjective Norm (SN) was the main determinant of farmer's intention to adopt improved IC breeds, followed by Attitude (ATT) and Perceived Behavioral Control (PBC). The study recommends more emphasis to be given to psycho-social issues through well designed public and private interventions that will promote adoption of improved breeds among IC farmers.

3.
Infect Dis Poverty ; 12(1): 85, 2023 Sep 18.
Article in English | MEDLINE | ID: mdl-37723532

ABSTRACT

BACKGROUND: Tungiasis is a highly neglected tropical skin disease caused by the sand flea, Tunga penetrans, the female of which burrows into the skin, causing pain and itching. The disease occurs throughout South America and sub-Saharan Africa but there are few systematic data on national disease burdens. The tungiasis research community is keen to develop survey methods to fill this gap. Here we used a school-based, thorough examination method to determine the prevalence and risk factors for tungiasis in Kenya. METHODS: We conducted the first nationally representative survey of tungiasis, including nine counties covering the major ecological zones of Kenya. A stratified multistage random sampling was used to select 22 primary schools from each of the nine counties and to select up to 114 pupils aged 8 to 14 years in each school. Pupils were examined thoroughly for tungiasis. Two surveys were conducted, the first between May and July 2021 and the second between October 2021 and April 2023 when pupils were also interviewed for risk factors. Mixed effect logistic regression models were used to test associations of independent variables with tungiasis using the school as a random effect. RESULTS: The overall prevalence of tungiasis in the first survey was 1.35% [95% confidence interval (CI): 1.15-1.59%], and 0.89% in the second survey. The prevalence ranged from 0.08% (95% CI: 0.01-0.59%) in Taita Taveta county to 3.24% (95% CI: 2.35-4.44%) in Kajiado county. Tungiasis infection was associated with county of residence, male sex [adjusted odds ratio (aOR) = 2.01, 95% CI: 1.52-2.67], and lower age (aOR = 0.81, 95% CI: 0.75-0.88). For the first time we demonstrate an association with attending public schools rather than private schools (aOR = 5.62, 95% CI: 1.20-26.22) and lower socioeconomic status (aOR = 0.10, 95% CI: 0.03-0.33). Using a rapid screening method of the top of feet only, would have missed 62.9% of all cases, 78.9% of mild cases and 20.0% of severe cases. CONCLUSIONS: Tungiasis is widely but heterogeneously distributed across Kenya. School-based surveys offer an efficient strategy for mapping tungiasis distribution.


Subject(s)
Tungiasis , Female , Male , Humans , Tungiasis/epidemiology , Kenya/epidemiology , Prevalence , Risk Factors , Surveys and Questionnaires
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