Developing low-cost house floors to control tungiasis in Kenya - a feasibility study.

Floors Housing NTD Prevention Tunga penetrans Tungiasis

Journal

BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562

Informations de publication

Date de publication:
12 Dec 2023
Historique:
received: 21 07 2023
accepted: 06 12 2023
medline: 13 12 2023
pubmed: 13 12 2023
entrez: 13 12 2023
Statut: epublish

Résumé

Tungiasis is a neglected tropical skin disease endemic in resource-poor communities. It is caused by the penetration of the female sand flea, Tunga penetrans, into the skin causing immense pain, itching, difficulty walking, sleeping and concentrating on school or work. Infection is associated with living in a house with unsealed earthen house floors. This feasibility study used a community-based co-creation approach to develop and test simple, locally appropriate, and affordable flooring solutions to create a sealed, washable floor for the prevention of tungiasis. Locally used techniques were explored and compared in small slab trials. The floor with best strength and lowest cost was pilot trialed in 12 households with tungiasis cases to assess its durability and costs, feasibility of installation in existing local houses using local masons and explore community perceptions. Disease outcomes were measured to estimate potential impact. It was feasible to build the capacity of a community-based organization to conduct research, develop a low-cost floor and conduct a pilot trial. The optimal low-cost floor was stabilized local subsoil with cement at a 1:9 ratio, installed as a 5 cm depth slab. A sealed floor was associated with a lower mean infection intensity among infected children than in control households (aIRR 0.53, 95%CI 0.29-0.97) when adjusted for covariates. The cost of the new floor was US$3/m This study provided promising evidence that retrofitting simple cement-stabilised soil floors with locally available materials is a feasible option for tungiasis control and can be implemented through training of community-based organisations. Disease outcome data is promising and suggests that a definitive trial is warranted. Data generated will inform the design of a fully powered randomized trial combined with behaviour change communications. ISRCTN 62801024 (retrospective 07.07.2023).

Identifiants

pubmed: 38087242
doi: 10.1186/s12889-023-17427-4
pii: 10.1186/s12889-023-17427-4
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

2483

Informations de copyright

© 2023. The Author(s).

Références

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Auteurs

Lynne Elson (L)

KEMRI-Wellcome Trust, Kilifi, Kenya.
Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
Dabaso Tujengane CBO, Watamu, Kenya.

Shadrack Mwadai Nyawa (SM)

Dabaso Tujengane CBO, Watamu, Kenya.

Abneel Matharu (A)

Human Health Theme, International Centre for Insect Physiology and Ecology, Nairobi, Kenya.

Ulrike Fillinger (U)

Human Health Theme, International Centre for Insect Physiology and Ecology, Nairobi, Kenya. ufillinger@gmail.com.

Classifications MeSH