02173nas a2200253   4500000000100000008004100001260001200042653002400054653005700078653004000135100001500175700001600190700001300206700001600219700001500235700001200250700001600262245009100278856006600369300000900435490000600444520145500450022001401905       2023                            d  bMDPI AG10aInfectious Diseases10aPublic Health, Environmental and Occupational Health10aGeneral Immunology and Microbiology1 aMcNeilly H1 aThielecke M1 aMutebi F1 aBanalyaki M1 aReichert F1 aWiese S1 aFeldmeier H00aTungiasis Stigma and Control Practices in a Hyperendemic Region in Northeastern Uganda  uhttps://www.mdpi.com/2414-6366/8/4/206/pdf?version=1680251511  a1-140 v83 a<p>Neglected tropical diseases are known to be highly stigmatized conditions. This study investigates tungiasis-related stigma and control practices in the impoverished Napak District in rural northeastern Uganda, where tungiasis is hyperendemic and effective treatment is unavailable. We conducted a questionnaire survey with the main household caretakers (n = 1329) in 17 villages and examined them for tungiasis. The prevalence of tungiasis among our respondents was 61.0%. Questionnaire responses showed that tungiasis was perceived as a potentially serious and debilitating condition and that tungiasis-related stigma and embarrassment were common. Among the respondents, 42.0% expressed judging attitudes, associating tungiasis with laziness, carelessness, and dirtiness, and 36.3% showed compassionate attitudes towards people with tungiasis. Questionnaire responses further indicated that people made an effort to keep their feet and house floors clean (important tungiasis prevention measures), but lack of water was a common problem in the area. The most frequent local treatment practices were hazardous manual extraction of sand fleas with sharp instruments and application of various and sometimes toxic substances. Reliable access to safe and effective treatment and water are therefore key to reducing the need for dangerous treatment attempts and breaking the vicious cycle of tungiasis stigma in this setting marked by poverty.</p>
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