دورية أكاديمية
أعرض في EDS

Characterization of tungiasis infection and morbidity using thermography in Kenya revealed higher disease burden during COVID-19 school closures.

التفاصيل البيبلوغرافية
العنوان: Characterization of tungiasis infection and morbidity using thermography in Kenya revealed higher disease burden during COVID-19 school closures.
المؤلفون: Elson L; KEMRI-Wellcome Trust Research Programme, Hospital Road, Kilifi, Kenya. lelson@kemri-wellcome.org.; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK. lelson@kemri-wellcome.org., Matharu AK; International Centre of Insect Physiology and Ecology, Human Health Theme, Nairobi, Kenya., Riithi N; International Centre of Insect Physiology and Ecology, Human Health Theme, Nairobi, Kenya., Ouma P; International Centre of Insect Physiology and Ecology, Human Health Theme, Nairobi, Kenya., Mutebi F; College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala, Uganda., Feldmeier H; Institute of Microbiology, Infectious Diseases and Immunology, Charité University Medicine, Berlin, Germany., Krücken J; Institute for Parasitology and Tropical Veterinary Medicine, Freie Universität Berlin, Berlin, Germany., Fillinger U; International Centre of Insect Physiology and Ecology, Human Health Theme, Nairobi, Kenya.
المصدر: Infectious diseases of poverty [Infect Dis Poverty] 2023 Mar 21; Vol. 12 (1), pp. 24. Date of Electronic Publication: 2023 Mar 21.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 101606645 Publication Model: Electronic Cited Medium: Internet ISSN: 2049-9957 (Electronic) Linking ISSN: 20499957 NLM ISO Abbreviation: Infect Dis Poverty Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, 2012-
مواضيع طبية MeSH: Tungiasis*/diagnosis , Tungiasis*/epidemiology , COVID-19*/diagnosis , COVID-19*/epidemiology, Male ; Animals ; Humans ; Female ; Child ; Adolescent ; Kenya/epidemiology ; Thermography ; Pandemics ; Prevalence ; Cost of Illness ; Tunga ; Inflammation/epidemiology ; Schools
مستخلص: Background: Tungiasis is a neglected tropical skin disease caused by the sand flea Tunga penetrans. Female fleas penetrate the skin, particularly at the feet, and cause severe inflammation. This study aimed to characterize disease burden in two highly affected regions in Kenya, to test the use of thermography to detect tungiasis-associated inflammation and to create a new two-level classification of disease severity suitable for mapping, targeting, and monitoring interventions.
Methods: From February 2020 to April 2021, 3532 pupils age 8-14 years were quasi-randomly selected in 35 public primary schools and examined for tungiasis and associated symptoms. Of the infected pupils, 266 were quasi-randomly selected and their households visited, where an additional 1138 family members were examined. Inflammation was assessed using infra-red thermography. A Clinical score was created combining the number of locations on the feet with acute and chronic symptoms and infra-red hotspots.
Results: The overall prevalence of tungiasis among all the school pupils who were randomly selected during survey rounds 1 and 3 was 9.3% [95% confidence interval (CI): 8.4-10.3]. Based on mixed effects logistic models, the odds of infection with tungiasis among school pupils was three times higher in Kwale (coastal Kenya) than in Siaya [western Kenya; adjusted odds ratio (aOR) = 0.36, 95% CI: 0.18-0.74]; three times higher in males than in females (aOR = 3.0, 95% CI: 2.32-3.91) and three times lower among pupils sleeping in a house with a concrete floor (aOR = 0.32, 95% CI: 0.24-0.44). The odds of finding an infected person among the household population during surveys before the COVID-19 pandemic was a third (aOR = 0.32, 95% CI: 0.19-0.53) of that when schools were closed due to COVID-19 restrictions and approximately half (aOR = 0.44, 95% CI: 0.29-0.68) in surveys done after school re-opening (round 3). Infection intensity was positively correlated with inflammation as measured by thermography (Spearman's rho = 0.68, P < 0.001) and with the clinical score (rho = 0.86, P < 0.001). Based on the two-level classification, severe cases were associated with a threefold higher level of pain (OR = 2.99, 95% CI: 2.02-4.43) and itching (OR = 3.31, 95% CI: 2.24-4.89) than mild cases.
Conclusions: Thermography was a valuable addition for assessing morbidity and the proposed two-level classification of disease severity clearly separated patients with mild and severe impacts. The burden of tungiasis was considerably higher in households surveyed during COVID-19 restrictions suggesting underlying risks are found in the home environment more than in school.
(© 2023. The Author(s).)
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معلومات مُعتمدة: United Kingdom WT_ Wellcome Trust; 213724/Z/18/Z United Kingdom WT_ Wellcome Trust
فهرسة مساهمة: Keywords: COVID-19; Child; Kenya; Morbidity; Neglected tropical diseases; Thermography; Tungiasis
تواريخ الأحداث: Date Created: 20230321 Date Completed: 20230322 Latest Revision: 20240506
رمز التحديث: 20240506
مُعرف محوري في PubMed: PMC10027580
DOI: 10.1186/s40249-023-01080-5
PMID: 36941724
قاعدة البيانات: MEDLINE
الوصف
تدمد:2049-9957
DOI:10.1186/s40249-023-01080-5