Detection of a neglected tropical disease: Case report of Heavy <i>Tunga penetrans</i> lesions on the feet of a thirteen-year-old boy from a community in Lagos, Nigeria

Abstract

Tungiasis is a neglected tropical disease (NTD) arising from an ectoparasitic infection of the skin of its host by the gravid female Tunga species. The prevalence can spike to about 60% in impoverished regions of South America, the Caribbean, and Sub-Saharan Africa. Instances of severe cases are rare. However, according to the consistent pattern of Tunga penetrans distribution, majority of lesions are carried by a few numbers of hosts. Limited research has been conducted in endemic areas of Nigeria, and in Badagry, wherein a prevalence rate of 21.2% was recently documented. In this report, we detail a severe case of Tungiasis in Jegeme, an endemic community within the Badagry Local Government area of Lagos, which was observed during part of an active surveillance conducted from August 2021 to November, 2021. The case involved a 13-year-old boy who reported several lesions containing embedded fleas on his limbs. Extraction and microscopic examination of the wound revealed eggs and adult forms of Tunga flea. This case highlights the persistence of severe tungiasis within this endemic community, underscoring the link between the infection and extreme poverty. Tungiasis is likely to remain endemic in such resource-poor setting where extreme poverty limits access required to prevent infestation. Appropriate response to infestation to reduce morbidity should be implemented. Improved links between locals in endemic populations and healthcare providers, coupled with increased awareness, and implementation of preventive measures is crucial.