Infection with tungiasis through interhost movement of adult female sand fleas, Tunga penetrans

Abstract

Tungiasis is a highly neglected tropical skin disease caused by the parasitic adult female sand flea, Tunga penetrans. More than 80% of tungiasis patients are found in the age group <15 y, in the elderly population and in people with disabilities. Tungiasis is a public health threat in the most marginalized, resource-poor communities of sub-Saharan Africa, South America and the Caribbean.1 Patients struggle to walk, and their sleep is disturbed due to itching and pain. Children avoid going to school and hesitate to play with their friends because walking is painful. Their quality of life is significantly impaired,2 especially when constant re-infection leads to chronic clinical manifestations including desquamation, hyperkeratosis, fissures, ulcers, lymphoedema and loss of nails and deformation of toes.1 Bacterial superinfection is common, exacerbating the inflammation and pain.