Risk Factors for Tungiasis in Nigeria Identification of Targets for Effective Intervention 英文参考文献.docVIP

RiskFactorsforTungiasisinNigeria:Identificationof TargetsforEffectiveIntervention UadeSamuelUgbomoiko1,LianaAriza2,IfeanyiEmmanuelOfoezie3,Jo¨rgHeukelbach2,4* 1Department of Zoology, University of Ilorin, Ilorin, Nigeria, 2Department of Community Health, School of Medicine, Federal University of Ceara′, Fortaleza, Brazil, 3Department of Zoology, University of Nigeria, Nsukka, Nigeria, 4School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville,Australia Abstract Background:Theparasiticskindiseasetungiasis(causedbythefleaTungapenetrans)affectsresource-poorcommunitiesin LatinAmerica,theCaribbeanandsub-SaharanAfrica.Prevalencesinendemicareasarehigh,andseverepathologyoccurs commonly.However,riskfactorsforinfestationhaveneverbeenassessedinAfrica. MethodsandFindings:Across-sectionalstudywasconductedinErekiti,aruralcommunityinLagosState(Nigeria),where tungiasisisendemic.Individualswereexaminedclinicallyforthepresenceoftungiasis,andaquestionnairewasapplied. Datafrom643individuals(86.6%ofthetargetpopulation)wereanalyzed;252(42.5%)wereinfestedwithT.penetrans .In the multivariate logistic regression analysis, presence of pigs on the compounds (adjusted odds ratio=17.98; 95% confidenceinterval:5.55–58.23),sandorclayfloorinsidehouses(9.33;5.06–17.19),andhavingthecommonrestingplace outsidethehouse(7.14;4.0–14.29)werethemostimportantriskfactorsidentified.Theregularuseofclosedfootwear(0.34; 0.18–0.62) and the use of insecticides indoors (0.2; 0.05–0.83) were protective against infestation. The population attributablefractionsassociatedwithtungiasiswere:sandorclayfloorinsidethehouse(73.7%),restingusuallyoutsidethe house(65.5%),noregularuseofclosedfootwear(51.1%),andpigsonthecompound(37.9%). Conclusion:ThepresenceoftungiasisinErekitiisdeterminedtoanimportantextentbyalimitednumberofmodifiable variables. Effective and sustainable intervention measures addressing these factors need to be implemented in this and otherWestAfricancommunities