Reduction of tungiasis prevalence, intensity, and morbidity during a two-year long community-based tungiasis control project in a hyperendemic region in Karamoja, Uganda.

Tungiasis is a widespread and debilitating zoonotic Neglected Tropical Disease (NTD). Manual extraction of the sand fleas with non-sterile sharp instruments is the most common but unsafe treatment method in affected communities. Topical application of a dimeticone oil formula (NYDA) has previously b...

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Main Authors: Hannah McNeilly, Francis Mutebi, Felix Reichert, Marlene Thielecke, Mike L Banalyaki, George M Mukone, Rebecca Arono, Hermann Feldmeier
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-06-01
Series:PLoS Neglected Tropical Diseases
Online Access:https://doi.org/10.1371/journal.pntd.0013149
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author Hannah McNeilly
Francis Mutebi
Felix Reichert
Marlene Thielecke
Mike L Banalyaki
George M Mukone
Rebecca Arono
Hermann Feldmeier
author_facet Hannah McNeilly
Francis Mutebi
Felix Reichert
Marlene Thielecke
Mike L Banalyaki
George M Mukone
Rebecca Arono
Hermann Feldmeier
author_sort Hannah McNeilly
collection DOAJ
description Tungiasis is a widespread and debilitating zoonotic Neglected Tropical Disease (NTD). Manual extraction of the sand fleas with non-sterile sharp instruments is the most common but unsafe treatment method in affected communities. Topical application of a dimeticone oil formula (NYDA) has previously been shown to be a safe and effective method of killing embedded sand fleas. The objective of this study was to evaluate a two-year long humanitarian One Health tungiasis control project in 17 villages in Napak district, Karamoja region, Northeastern Uganda. The community-based intervention included quarterly systematic tungiasis detection and treatment with the dimeticone oil formula in residents and domestic animals in combination with community health promotion. In each of the eight quarterly tungiasis diagnosis and treatment rounds, between 3,674 and 5,155 residents were examined (coverage 73.6-89.9%). Overall, 12,540 tungiasis cases among residents were diagnosed and treated and 16 community dialogue meetings were held. Tungiasis prevalence among residents decreased from 62.8% to 5.7% in the two-year study period. While at baseline tungiasis was most prevalent in children and the elderly, at the end elderly women were the single most affected group. The prevalence of tungiasis-related walking difficulties in the community decreased from 11.5% to 0.5%, and pain and itching were greatly reduced. The number of animals present in the villages was low (between 79 and 414 per treatment round) and the prevalence of tungiasis in animals dropped from 14.2% to 0% throughout the two-year project. This implementation study shows that regular community-based treatment of tungiasis cases among humans and animals with dimeticone oil formula, combined with community engagement and health promotion, can reduce tungiasis prevalence and morbidity to very low levels within two years, even in a hyperendemic area where people live in extreme poverty.
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spelling doaj-art-1b99295bda3a42d6ac54e5c72e0523ea2025-08-20T02:36:16ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352025-06-01196e001314910.1371/journal.pntd.0013149Reduction of tungiasis prevalence, intensity, and morbidity during a two-year long community-based tungiasis control project in a hyperendemic region in Karamoja, Uganda.Hannah McNeillyFrancis MutebiFelix ReichertMarlene ThieleckeMike L BanalyakiGeorge M MukoneRebecca AronoHermann FeldmeierTungiasis is a widespread and debilitating zoonotic Neglected Tropical Disease (NTD). Manual extraction of the sand fleas with non-sterile sharp instruments is the most common but unsafe treatment method in affected communities. Topical application of a dimeticone oil formula (NYDA) has previously been shown to be a safe and effective method of killing embedded sand fleas. The objective of this study was to evaluate a two-year long humanitarian One Health tungiasis control project in 17 villages in Napak district, Karamoja region, Northeastern Uganda. The community-based intervention included quarterly systematic tungiasis detection and treatment with the dimeticone oil formula in residents and domestic animals in combination with community health promotion. In each of the eight quarterly tungiasis diagnosis and treatment rounds, between 3,674 and 5,155 residents were examined (coverage 73.6-89.9%). Overall, 12,540 tungiasis cases among residents were diagnosed and treated and 16 community dialogue meetings were held. Tungiasis prevalence among residents decreased from 62.8% to 5.7% in the two-year study period. While at baseline tungiasis was most prevalent in children and the elderly, at the end elderly women were the single most affected group. The prevalence of tungiasis-related walking difficulties in the community decreased from 11.5% to 0.5%, and pain and itching were greatly reduced. The number of animals present in the villages was low (between 79 and 414 per treatment round) and the prevalence of tungiasis in animals dropped from 14.2% to 0% throughout the two-year project. This implementation study shows that regular community-based treatment of tungiasis cases among humans and animals with dimeticone oil formula, combined with community engagement and health promotion, can reduce tungiasis prevalence and morbidity to very low levels within two years, even in a hyperendemic area where people live in extreme poverty.https://doi.org/10.1371/journal.pntd.0013149
spellingShingle Hannah McNeilly
Francis Mutebi
Felix Reichert
Marlene Thielecke
Mike L Banalyaki
George M Mukone
Rebecca Arono
Hermann Feldmeier
Reduction of tungiasis prevalence, intensity, and morbidity during a two-year long community-based tungiasis control project in a hyperendemic region in Karamoja, Uganda.
PLoS Neglected Tropical Diseases
title Reduction of tungiasis prevalence, intensity, and morbidity during a two-year long community-based tungiasis control project in a hyperendemic region in Karamoja, Uganda.
title_full Reduction of tungiasis prevalence, intensity, and morbidity during a two-year long community-based tungiasis control project in a hyperendemic region in Karamoja, Uganda.
title_fullStr Reduction of tungiasis prevalence, intensity, and morbidity during a two-year long community-based tungiasis control project in a hyperendemic region in Karamoja, Uganda.
title_full_unstemmed Reduction of tungiasis prevalence, intensity, and morbidity during a two-year long community-based tungiasis control project in a hyperendemic region in Karamoja, Uganda.
title_short Reduction of tungiasis prevalence, intensity, and morbidity during a two-year long community-based tungiasis control project in a hyperendemic region in Karamoja, Uganda.
title_sort reduction of tungiasis prevalence intensity and morbidity during a two year long community based tungiasis control project in a hyperendemic region in karamoja uganda
url https://doi.org/10.1371/journal.pntd.0013149
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