Prevalence and risk factors for tungiasis in Africa: a systematic review and meta-analysis

Abstract

Background: Tungiasis, caused by Tunga penetrans, is a neglected tropical disease of major public health concern in sub-Saharan Africa. It is associated with significant health, psychological, and economic consequences. This review aimed to estimate the pooled prevalence of tungiasis in Africa and identify its associated risk factors. Methods: A systematic search was conducted in PubMed, Scopus, Web of Science, ScienceDirect, and African Journal Online. Studies published between June 2007 and December 2023 were included. Data were analyzed using a random-effects model. Heterogeneity was quantified using the I² statistic, and sources of heterogeneity were explored via subgroup analyses and Galbraith plot. Publication bias was evaluated using funnel plots and Egger’s test. Risk factors were summarized as adjusted odds ratios (aOR) with 95% confidence intervals (CI). Results: Thirty-seven studies comprising 29,760 participants from ten African countries were included. The pooled prevalence of tungiasis was 36.23% (95% CI: 30.4–42.1). Male sex (aOR 1.53, 95% CI: 1.05–2.01), living in houses with earthen floors (aOR 4.92, 95% CI: 1.91–7.93), and poor caregiver or family knowledge of tungiasis (aOR 2.33, 95% CI: 1.08–3.58) were significant risk factors. Conclusion: The findings indicate a high-pooled prevalence of tungiasis, highlighting its ongoing status as a common neglected tropical disease in Africa. The identification of male sex, earthen floors, and poor knowledge as significant risk factors provides a clear etiological profile. This evidence points to the necessity of targeted interventions focused on household-level sanitation and public awareness campaigns to effectively prevent and control tungiasis in endemic regions. Protocol registration: This systematic review and meta-analysis protocol is registered in PROSPERO under the registration number CRD42024597922.