Girma Abayeneh, Abdu Indiris
Department of Biology, College of Natural and Computational Sciences Mekdela Amba University Tulu Awuliya Ethiopia.
Health Sci Rep. 2025 Sep 12;8(9):e71233. doi: 10.1002/hsr2.71233. eCollection 2025 Sep.
Tungiasis, caused by the female sand flea Tunga penetrans, is a neglected tropical disease (NTD) with substantial health and socioeconomic burdens in low- and middle-income countries (LMICs). This systematic review and meta-analysis aimed to estimate the pooled prevalence of tungiasis and identify associated risk factors in Ethiopia's Oromia and Southern Nations, Nationalities, and Peoples' Region (SNNPR).
We systematically searched Scopus, Web of Science, PubMed, Science Direct, and African Journal Online (AJOL) for studies published between October 2015 and September 2024. Study quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist. A random-effects meta-analysis model was employed to account for heterogeneity, quantified using ² statistics. Publication bias was evaluated via funnel plots, and Egger's regression test.
Across eight studies ( = 8502 individuals), the pooled prevalence of tungiasis was 39.0% (95% CI: 28.5-49.6). Subgroup analyses revealed regional disparities, with SNNPR exhibiting a higher prevalence (43.1%; 95% CI: 27.1-58.1) than Oromia (35.0%; 95% CI: 18.8-51.3). Temporal trends indicated a significant increase in prevalence post-2017 compared to earlier years. Low education levels (adjusted odds ratio [AOR]: 2.7, 95% CI: 0.6-4.9), lack of footwear use (AOR: 8.8, 95% CI: 0.1-17.4) and mud/earthen flooring (AOR: 4.9, 95% CI: 2.6-7.2) were significantly associated with tungiasis among selected regions of Ethiopia.
This meta-analysis demonstrates a significant burden of tungiasis in Ethiopia's Oromia and SNNPR regions. Therefore, we recommend implementing integrated interventions that combine: (1) provision of community-based health education programs to improve prevention awareness, (2) distribution of protective footwear to high-risk populations, (3) housing improvements focusing on floor hardening, (4) expanded access to safe treatment modalities, and (5) targeted animal reservoir control measures. Such coordinated efforts, embedded within existing NTD control platforms, could substantially reduce tungiasis transmission while addressing the socioeconomic determinants that perpetuate high infection rates in these endemic regions.
由雌性穿皮潜蚤引起的潜蚤病是一种被忽视的热带疾病（NTD），在低收入和中等收入国家（LMICs）造成了巨大的健康和社会经济负担。本系统评价和荟萃分析旨在估计埃塞俄比亚奥罗米亚州以及南方各族裔人民地区（SNNPR）潜蚤病的合并患病率，并确定相关危险因素。
我们系统检索了Scopus、科学网、PubMed、Science Direct和非洲期刊在线（AJOL），以查找2015年10月至2024年9月期间发表的研究。使用乔安娜·布里格斯研究所（JBI）的批判性评价清单评估研究质量。采用随机效应荟萃分析模型来考虑异质性，异质性用I²统计量进行量化。通过漏斗图和埃格回归检验评估发表偏倚。
在八项研究（n = 8502人）中，潜蚤病的合并患病率为39.0%（95%置信区间：28.5 - 49.6）。亚组分析显示存在地区差异，SNNPR的患病率（43.1%；95%置信区间：27.1 - 58.1）高于奥罗米亚州（35.0%；95%置信区间：18.8 - 51.3）。时间趋势表明，与早年相比，2017年后患病率显著上升。在埃塞俄比亚选定地区，低教育水平（调整优势比[AOR]：2.7，95%置信区间：0.6 - 4.9）、不穿鞋子（AOR：8.8，95%置信区间：0.1 - 17.4）以及泥土地面或土质地面（AOR：4.9，95%置信区间：2.6 - 7.2）与潜蚤病显著相关。
这项荟萃分析表明埃塞俄比亚奥罗米亚州和SNNPR地区潜蚤病负担沉重。因此，我们建议实施综合干预措施，包括：（1）提供基于社区的健康教育项目，以提高预防意识；（2）向高危人群分发防护鞋；（3）以地面硬化为重点改善住房条件；（4）扩大安全治疗方式的可及性；（5）采取针对性的动物宿主控制措施。将这些协调一致的努力纳入现有的被忽视热带病控制平台，可以大幅减少潜蚤病传播，同时解决使这些流行地区感染率居高不下的社会经济决定因素。
