Mutebi Francis, Krücken Jürgen, von Samson-Himmelstjerna Georg, Waiswa Charles, Mencke Norbert, Eneku Wilfred, Andrew Tamale, Feldmeier Hermann
College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, P.O. Box 7062, Kampala, Uganda.
Institute for Parasitology and Tropical Veterinary Medicine, Freie Universität Berlin, 14163 Berlin, Germany.
Acta Trop. 2018 Jan;177:81-88. doi: 10.1016/j.actatropica.2017.10.003. Epub 2017 Oct 7.
Zoonotic tungiasis caused by Tunga penetrans remains a serious public and animal health problem among endemic villages in Uganda and many sub Saharan African countries. Studies on human and animal tungiasis-related knowledge and treatment practices in endemic communities have never been undertaken, a limitation to development of sustainable control measures.
A cross sectional study using semi-structured questionnaires (Supplementary file S1) was conducted among 236 animal rearing households in 10 endemic villages in Bugiri District, South-Eastern Uganda. Focus group discussions and observation checklists were used to validate and clarify the findings.
Most respondents knew the aetiology (89.4%), clinical signs (98%) and the ecology of T. penetrans as well as the major risk factors of human tungiasis (65.2%). In contrast, very few respondents were aware of animal tungiasis. Only 4.8% of those with infected animals on the compound knew that some of their animals were infected and 13.6% of the respondents had ever seen tungiasis-affected animals. Pigs (13.1%, n=31) and dogs (0.85%, n=2) were the only T. penetrans animal hosts known to animal owners. Affected humans were treated by extraction of embedded sand fleas using non-sterile sharp instruments in all households that reported occurrence of human tungiasis at least once (n=227). Also, affected animals were mainly treated by mechanical removal of embedded sand fleas in households that have ever experienced animal tungiasis (four out of 12; 33.3%). In a few instances, plant and animal pesticides (n=3) and other chemicals such as grease, paraffin and wood preservative (n=3) were also used to treat animal tungiasis.
The study revealed a high level of knowledge on human tungiasis but inadequate knowledge on the zoonotic nature of tungiasis. Commonly applied methods for treatment of human and animal tungiasis are a health hazard by themselves. Concerted i.e. One Health-based efforts aiming at promoting appropriate treatment of tungiasis, adequate living conditions and increased awareness on tungiasis in the communities are indicated in order to eliminate tungiasis-associated disease.
由穿皮潜蚤引起的人畜共患潜蚤病在乌干达及许多撒哈拉以南非洲国家的流行村庄中仍然是一个严重的公共卫生和动物健康问题。尚未对流行社区中人与动物潜蚤病相关知识及治疗方法进行研究，这限制了可持续控制措施的制定。
在乌干达东南部布吉里区10个流行村庄的236个动物饲养家庭中，采用半结构化问卷（补充文件S1）进行了一项横断面研究。通过焦点小组讨论和观察清单来验证和澄清研究结果。
大多数受访者了解穿皮潜蚤的病因（89.4%）、临床症状（98%）、生态习性以及人类潜蚤病的主要危险因素（65.2%）。相比之下，很少有受访者知晓动物潜蚤病。在院子里饲养的动物受到感染的受访者中，只有4.8%的人知道他们的一些动物被感染，13.6%的受访者曾见过感染潜蚤病的动物。猪（13.1%，n = 31）和狗（0.85%，n = 2）是动物主人所知的仅有的穿皮潜蚤动物宿主。在所有报告至少发生过一次人类潜蚤病的家庭（n = 227）中，受感染的人通过使用非无菌锐器拔除嵌入的沙蚤进行治疗。此外，在曾经历过动物潜蚤病的家庭（12户中的4户；33.3%）中，受感染的动物主要通过机械方式拔除嵌入的沙蚤进行治疗。在少数情况下，还使用植物和动物杀虫剂（n = 3）以及其他化学品，如油脂、石蜡和木材防腐剂（n = 3）来治疗动物潜蚤病。
该研究表明人们对人类潜蚤病的了解程度较高，但对潜蚤病的人畜共患性质了解不足。常用的治疗人和动物潜蚤病的方法本身就存在健康风险。需要开展协同即基于“同一健康”理念的努力，以促进对潜蚤病的适当治疗、改善生活条件并提高社区对潜蚤病的认识，从而消除与潜蚤病相关的疾病。
