DETERMINANTS OF JIGGER INFESTATION: KNOWLEDGE, ATTITUDE AND PRACTICES AMONG HOUSEHOLD MEMBERS IN KILIFI COUNTY, KENYA

Abstract

Jigger infestation is a zoonotic parasitic infection caused by the jigger flea and is common in resource limited settings. Jigger lesions are susceptible to bacterial super- infections and tend to complicate the infection by triggering a myriad of immunological reactions in the host. Jigger infestation is an important but neglected public health problem. In Kenya Jigger disease afflicts approximately four million people. Prevalence of jigger infection has been on the rise in Kilifi County. The study was undertaken to determine knowledge, attitude and practices of jigger infestation among household members in Kilifi County, Kenya. A cross-sectional descriptive study design was used to recruit the study respondents within Kilifi Health and Demographic Surveillance System (KHDSS). The study utilized a convenience sample consisting of 585 participants both male and female from five sub locations. Data on demographic characteristics, knowledge of jigger infestation, and attitude and treatment practices for Tungiasis was collected. Structured interview schedule and observation checklist was used to collect quantitative data by study enumerators. Descriptive and inferential statistics were analyzed and odds ratios computed at 95% confidence interval to determine variables association. The collected data was double entered on Epi Data database (Version 3.1) and analyzed in R (Version 3.6.1). Among the 585 respondents who had completed questionnaires, 497(85%) were infected with jigger thus, representing a prevalence of participants who had suffered from jigger infestation. Of the 585 participants, majority 365(62%) were females while 220(38%) males. About 278(46%) were married and 262(45%) single. Majority443 (76%) were elderly > 60 years old, while only 63(11%) were less than 10 years. Majority 300(51%) had primary education while 108(18%) had no education. Moreover, 385(66%) were Christians and only 41(7%) were employed. Multivariate analysis showed that age ≥60 years, 10 to 19 years (adjusted odds ratio 2.87 (95%CI 1.36 to 6.06)) and 20 to 59 years (aOR 4.06 (95%CI 1.19 to 13.9)) were associated with higher odds being infested by jiggers. Among the knowledge of jigger infestation factors, only those who agreed witchcraft caused jigger infestation (aOR 1.75 (95%CI 1.34 to 2.29)) was associated with higher odds being infested . xii by jiggers. Among the attitudes towards jigger infestation, only those who agreed people infested by jiggers have specific blood group (aOR 1.88 (95%CI 1.11 to 3.20)) was associated with higher odds being infested by jiggers. Dust was a contributing factor for jigger infestation among household members in the KHDSS study area. Collective efforts should focus on age below 10 years and above sixty 60years. Community dialogues may be employed to understand knowledge on jigger being caused by witchcraft and belief that people with jigger infestation have specific blood grou