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Few empirical studies have reported neurocognitive and mental health outcomes of children with ectoparasitic skin diseases like tungiasis. Pathophysiology of tungiasis suggests it could detrimentally affect cognition and behaviour. This study pioneered the investigation of neurocognitive and mental health outcomes in children with tungiasis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This was a multi-site cross-sectional study including 454 quasi-randomly sampled school-children aged 8\u201314 from 48 randomly selected schools in two counties in Kenya and a district in Uganda. The participants were stratified into infected and uninfected based on the presence of tungiasis. The infected were further classified into mild and severe infection groups based on the intensity of the infection. Adapted, validated, and standardized measures of cognition and mental health such as Raven Matrices and Child Behaviour Checklist were used to collect data. Statistical tests including a multilevel, generalized mixed-effects linear models with family link set to identity were used to compare the scores of uninfected and infected children and to identify other potential risk factors for neurocognitive and behavioural outcomes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>When adjusted for covariates, mild infection was associated with lower scores in literacy [adjusted <jats:italic>\u03b2<\/jats:italic>(<jats:italic>a\u03b2<\/jats:italic>)\u2009=\u2009\u2212\u00a08.9; 95% confidence interval (<jats:italic>CI<\/jats:italic>) \u2212\u00a017.2, \u2212\u00a00.6], language (<jats:italic>a\u03b2<\/jats:italic>\u2009=\u2009\u2212\u00a01.7; <jats:italic>95% CI<\/jats:italic> \u2212\u00a03.2, \u2212\u00a00.3), cognitive flexibility (<jats:italic>a\u03b2<\/jats:italic>\u2009=\u2009\u2212\u00a06.1; <jats:italic>95% CI\u00a0<\/jats:italic>\u2212\u00a010.4, \u2212\u00a01.7) and working memory (<jats:italic>a\u03b2<\/jats:italic>\u2009=\u2009\u2212\u00a00.3; <jats:italic>95% CI <\/jats:italic>\u2212\u00a00.6, \u2212\u00a00.1). Severe infection was associated with lower scores in literacy (<jats:italic>a\u03b2<\/jats:italic>\u2009=\u2009\u2212\u00a011.0; <jats:italic>95% CI<\/jats:italic> \u2212\u00a019.3, \u2212\u00a02.8), response inhibition, (<jats:italic>a\u03b2<\/jats:italic>\u2009=\u2009\u2212\u00a02.2; <jats:italic>95% CI<\/jats:italic> \u2212\u00a04.2, \u2212\u00a00.2), fine motor control (<jats:italic>a\u03b2<\/jats:italic>\u2009=\u00a0\u2212\u00a00.7; <jats:italic>95% CI<\/jats:italic> \u2212\u00a01.1, \u2212\u00a00.4) and numeracy (<jats:italic>a\u03b2<\/jats:italic>\u2009=\u2009\u2212\u00a03; <jats:italic>95% CI<\/jats:italic> \u2212\u00a05.5, \u2212\u00a00.4).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This study provides first evidence that tungiasis is associated with poor neurocognitive functioning in children. Since tungiasis is a chronic disease with frequent reinfections, such negative effects may potentially impair their development and life achievements.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Graphical abstract<\/jats:title>\n                \n              <\/jats:sec>","DOI":"10.1186\/s40249-023-01154-4","type":"journal-article","created":{"date-parts":[[2023,11,14]],"date-time":"2023-11-14T12:02:10Z","timestamp":1699963330000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Neurocognitive and mental health outcomes in children with tungiasis: a cross-sectional study in rural Kenya and Uganda"],"prefix":"10.1186","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5017-1671","authenticated-orcid":false,"given":"Berrick","family":"Otieno","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynne","family":"Elson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abneel K.","family":"Matharu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi","family":"Riithi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Chongwo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khamis","family":"Katana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carophine","family":"Nasambu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis","family":"Mutebi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herman","family":"Feldmeier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Kr\u00fccken","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"Fillinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amina","family":"Abubakar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,11,14]]},"reference":[{"key":"1154_CR1","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1046\/j.1365-3156.2001.00716.x","volume":"6","author":"J Heukelbach","year":"2001","unstructured":"Heukelbach J, Oliveira F, Hesse G, Feldmeier H. 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Informed assent and consent were obtained from the children and their caregivers. All assessments and interviews were conducted in empty classrooms. Participants with serious health concerns were to be excluded from the field study and referred to appropriate healthcare services according to country guidelines. In the event of such an exclusion, they would be invited to participate at a later date. Fortunately, no participants presented with serious health concerns during data collection.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"All authors declare no competing interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"100"}}