Hyuga Ayako, Larson Peter S, Ndemwa Morris, Muuo Sheru W, Changoma Mwatasa, Karama Mohamed, Goto Kensuke, Kaneko Satoshi
Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, Nagasaki-shi 852-8523, Nagasaki, Japan.
Department of Eco-Epidemiology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki-shi 852-8523, Nagasaki, Japan.
Trop Med Infect Dis. 2021 Dec 23;7(1):2. doi: 10.3390/tropicalmed7010002.
Tungiasis is a cutaneous parasitosis caused by an embedded female sand flea. The distribution of cases can be spatially heterogeneous even in areas with similar risk profiles. This study assesses household and remotely sensed environmental factors that contribute to the geographic distribution of tungiasis cases in a rural area along the Southern Kenyan Coast. Data on household tungiasis case status, demographic and socioeconomic information, and geographic locations were recorded during regular survey activities of the Health and Demographic Surveillance System, mainly during 2011. Data were joined with other spatial data sources using latitude/longitude coordinates. Generalized additive models were used to predict and visualize spatial risks for tungiasis. The household-level prevalence of tungiasis was 3.4% (272/7925). There was a 1.1% (461/41,135) prevalence of infection among all participants. A significant spatial variability was observed in the unadjusted model (-value < 0.001). The number of children per household, earthen floor, organic roof, elevation, aluminum content in the soil, and distance to the nearest animal reserve attenuated the odds ratios and partially explained the spatial variation of tungiasis. Spatial heterogeneity in tungiasis risk remained even after a factor adjustment. This suggests that there are possible unmeasured factors associated with the complex ecology of sand fleas that may contribute to the disease's uneven distribution.
潜蚤病是由雌性沙蚤寄生引起的一种皮肤寄生虫病。即使在风险状况相似的地区，病例分布在空间上也可能存在异质性。本研究评估了肯尼亚南部沿海农村地区家庭和遥感环境因素对潜蚤病病例地理分布的影响。家庭潜蚤病病例状况、人口和社会经济信息以及地理位置数据在健康与人口监测系统的定期调查活动中记录，主要是在2011年期间。数据通过经纬度坐标与其他空间数据源合并。使用广义相加模型预测和可视化潜蚤病的空间风险。潜蚤病的家庭层面患病率为3.4%（272/7925）。所有参与者的感染患病率为1.1%（461/41135）。在未调整模型中观察到显著的空间变异性（P值<0.001）。每户儿童数量、泥土地面、有机屋顶、海拔、土壤铝含量以及到最近动物保护区的距离降低了优势比，并部分解释了潜蚤病的空间变异。即使在因素调整后，潜蚤病风险的空间异质性仍然存在。这表明可能存在与沙蚤复杂生态相关的未测量因素，可能导致该病分布不均。
