{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T12:33:01Z","timestamp":1777984381923,"version":"3.51.4"},"reference-count":48,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:00:00Z","timestamp":1772496000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:00:00Z","timestamp":1772496000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Wellcome Trust Career Re-Entry Fellowship","award":["213724\/Z\/18\/Z"],"award-info":[{"award-number":["213724\/Z\/18\/Z"]}]},{"name":"Germany Research Foundation","award":["405027164; KR 2245\/7-1"],"award-info":[{"award-number":["405027164; KR 2245\/7-1"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Trop Med Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Tungiasis is a neglected tropical skin disease caused by adult female fleas which burrow into the skin of people and animals, causing considerable pain and itching. The distribution of the disease is heterogeneous, with Napak district, Karamoja sub-region of northeastern Uganda having the highest disease burden recorded globally. We aimed to determine the factors associated with this high prevalence to inform future intervention strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cross-sectional study to identify factors associated with infection of individual children and adults, and a nested case\u2013control study to identify factors for whole households (families). Infected children were identified through mass-screening of children aged 8\u201314\u00a0years between January and March 2022 in 25 villages. Of the 1619 children screened, 210 infected and 358 uninfected children were randomly selected, and their households were enrolled into the study. Observations were made of the homesteads, and structured interviews were conducted with the caregivers. All adults and children in the households were examined. Mixed effect logistic regression analysis was used to identify factors associated with infection of individuals or households.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We found children who lived in high-density settlements (manyattas) had more than three times the odds of being infected than those in more open, low-density settlements (adjusted odds ratio aOR 3.51, 95% CI 1.57\u20137.83,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). To our knowledge, this is the first study to show an association of household infection (at least one case) with having a child with a disability (aOR 5.38, 95% CI 1.92\u201315.03,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001) and a caregiver who did not show affection to their child (aOR 1.79, 95% CI 1.02\u20133.13,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.041). For individual adults, those who reported drinking alcohol had four times the odds of infection than those who did not (aOR 4.74, 95% CI 1.93\u201311.68,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). Frequency of washing feet, soap use and house cleanliness were also associated with household infection.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Control programs should be developed together with the caregivers to enable them to reduce alcohol use, improve their childcare, hygiene and sanitation practices.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s41182-025-00841-2","type":"journal-article","created":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T02:22:32Z","timestamp":1772504552000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Individual and household factors associated with tungiasis in a marginalized population in Karamoja, northeastern Uganda"],"prefix":"10.1186","volume":"54","author":[{"given":"Lynne","family":"Elson","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abneel K.","family":"Matharu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Berrick","family":"Otieno","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hermann","family":"Feldmeier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"Waiswa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amina","family":"Abubakar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00fcrgen","family":"Kr\u00fccken","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrike","family":"Fillinger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francis","family":"Mutebi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,3,3]]},"reference":[{"key":"841_CR1","volume-title":"Ending the neglect to attain the sustainable development goals: a road map for neglected tropical diseases 2021\u20132030","author":"World_Health_Organization","year":"2020","unstructured":"World_Health_Organization. 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Parasitol Res. 2004;94:275\u201382.","journal-title":"Parasitol Res"},{"issue":"7","key":"841_CR47","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1046\/j.1365-3156.2002.00904.x","volume":"7","author":"H Feldmeier","year":"2002","unstructured":"Feldmeier H, Heukelbach J, Eisele M, Sousa AQ, Barbosa LM, Carvalho CB. Bacterial superinfection in human tungiasis. Trop Med Int Health. 2002;7(7):559\u201364. https:\/\/doi.org\/10.1046\/j.1365-3156.2002.00904.x.","journal-title":"Trop Med Int Health"},{"issue":"9","key":"841_CR48","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0005901","volume":"11","author":"RM Nyangacha","year":"2017","unstructured":"Nyangacha RM, Odongo D, Oyieke F, Ochwoto M, Korir R, Ngetich RK, et al. Secondary bacterial infections and antibiotic resistance among tungiasis patients in Western, Kenya. PLoS Negl Trop Dis. 2017;11(9):e0005901. https:\/\/doi.org\/10.1371\/journal.pntd.0005901.","journal-title":"PLoS Negl Trop Dis"}],"container-title":["Tropical Medicine and Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s41182-025-00841-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s41182-025-00841-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s41182-025-00841-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T15:20:18Z","timestamp":1772551218000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s41182-025-00841-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,3]]},"references-count":48,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["841"],"URL":"https:\/\/doi.org\/10.1186\/s41182-025-00841-2","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-7288997\/v1","asserted-by":"object"}]},"ISSN":["1349-4147"],"issn-type":[{"value":"1349-4147","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,3]]},"assertion":[{"value":"4 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 October 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was conducted in accordance with the Helsinki Declaration. Administrative clearance was obtained from Napak District Local Government (CR\/205\/1). Ethical review and clearance for the study was provided by the Vector Control Division-Research and Ethics Committee of the Ministry of Health (Reference VCDREC\/101\/UG-REC-018) and the Ethikkommission of the Charit\u00e9 Berlin (reference number EA2\/100\/16). The study was accredited with the Uganda National Council of Science and Technology (Reference SS 4815). Prior to any interview and foot examinations of household members, informed consent was sought from the household head or their representative. Adults (18\u00a0years and above) provided informed consent for themselves and their younger children. Children aged 12\u201317\u00a0years were also asked to provide informed assent before their examination. All data were collected on PIN protected electronic tablets, stored on password protected RedCap databases on the icipe servers. Data were analyzed after exporting to Excel without the inclusion of personal identifiers. All participants with tungiasis were treated with dimeticone oils (NYDA\n                      \u00ae\n                      PLUS). For those with secondary bacterial infection and other illnesses requiring treatment, a referral was made to the nearest health facility.","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":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"36"}}