Background Tungiasis,a neglected tropical parasitosis,disproportionately afects children.Few empirical studies have reported neurocognitive and mental health outcomes of children with ectoparasitic skin diseases like ...Background Tungiasis,a neglected tropical parasitosis,disproportionately afects children.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 afect cognition and behaviour.This study pioneered the investigation of neurocognitive and mental health outcomes in children with tungiasis.Methods This was a multi-site cross-sectional study including 454 quasi-randomly sampled school-children aged 8-14 from 48 randomly selected schools in two counties in Kenya and a district in Uganda.The participants were stratifed into infected and uninfected based on the presence of tungiasis.The infected were further classifed 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-efects 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.Results When adjusted for covariates,mild infection was associated with lower scores in literacy[adjustedβ(aβ)=−8.9;95%confdence interval(CI)−17.2,−0.6],language(aβ=−1.7;95%CI−3.2,−0.3),cognitive fexibility(aβ=−6.1;95%CI−10.4,−1.7)and working memory(aβ=−0.3;95%CI−0.6,−0.1).Severe infection was associated with lower scores in literacy(aβ=−11.0;95%CI−19.3,−2.8),response inhibition,(aβ=−2.2;95%CI−4.2,−0.2),fne motor control(aβ=−0.7;95%CI−1.1,−0.4)and numeracy(aβ=−3;95%CI−5.5,−0.4).Conclusions This study provides frst evidence that tungiasis is associated with poor neurocognitive functioning in children.Since tungiasis is a chronic disease with frequent reinfections,such negative efects may potentially impair their development and life achievements.展开更多
基金funded by the German Research Foundation(DFG)through the project"Tungiasis in East-Africa-an interdisciplinary approach to understanding the interactions between parasite and host"(project number 405027164KR 2245/7-1)to Jürgen Krücken,Amina Abubakar,Ulrike Fillinger,and Charles Waiswa.
文摘Background Tungiasis,a neglected tropical parasitosis,disproportionately afects children.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 afect cognition and behaviour.This study pioneered the investigation of neurocognitive and mental health outcomes in children with tungiasis.Methods This was a multi-site cross-sectional study including 454 quasi-randomly sampled school-children aged 8-14 from 48 randomly selected schools in two counties in Kenya and a district in Uganda.The participants were stratifed into infected and uninfected based on the presence of tungiasis.The infected were further classifed 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-efects 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.Results When adjusted for covariates,mild infection was associated with lower scores in literacy[adjustedβ(aβ)=−8.9;95%confdence interval(CI)−17.2,−0.6],language(aβ=−1.7;95%CI−3.2,−0.3),cognitive fexibility(aβ=−6.1;95%CI−10.4,−1.7)and working memory(aβ=−0.3;95%CI−0.6,−0.1).Severe infection was associated with lower scores in literacy(aβ=−11.0;95%CI−19.3,−2.8),response inhibition,(aβ=−2.2;95%CI−4.2,−0.2),fne motor control(aβ=−0.7;95%CI−1.1,−0.4)and numeracy(aβ=−3;95%CI−5.5,−0.4).Conclusions This study provides frst evidence that tungiasis is associated with poor neurocognitive functioning in children.Since tungiasis is a chronic disease with frequent reinfections,such negative efects may potentially impair their development and life achievements.
