TUNGIASIS: A NEGLECTED TROPICAL DISEASE

ABSTRACT

Tungiasis is an ecto-parasitic disease of humans and animals caused by the burrowing of gravid female fleas of the genus ‘Tunga’. Of the known species of Tunga fleas, Tunga penetrans and Tunga trimamillata are parasites of humans besides other warm blooded mammals, most of which are peri-domestic. The host of the others is limited to a few genera of wild mammals. The burrowed female flea rapidly expands its body size, causing immense itching, inflammation, pain and debilitation. By nature, tungiasis is self-limiting but in endemic settings, re-infection usually occurs leading to an increasing parasite load. Although very much ignored, severe tungiasis occurs in settings where patients do not have access to health care and are stricken in a web of pre-existing illness, poverty and neglect and if not treated, severe tungiasis may end in a fatal disease course through secondary bacteria infection. The consequences of tungiasis are debilitating, eventually leading to chronic morbidity with impaired mobility and quality of life. Diagnosis of the disease is usually by clinical inspection and laboratory examination, often with microscope. The disease is treated by extracting embedded fleas with sterile needles or curets and administration of bacteria prophylaxis incase of a secondary bacteria infection. The current lack of good treatment methods means that infested individuals attempt to remove the fleas themselves with non-sterile instruments and in the process, causes more damage. Control efforts focus on prevention although there are little data available to serve as a guide. Although not officially included in the World Health Organization’s list of neglected tropical diseases (NTDs), the disease bears all the hallmark of an NTD to merit apprehension from the health sector. This seminar reviews tungiasis, a disease considered a neglected tropical disease.