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Neurocognitive and mental health outcomes in children with tungiasis: a cross-sectional study in rural Kenya and Uganda

BACKGROUND: Tungiasis, a neglected tropical parasitosis, disproportionately affects 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 affect...

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Autores principales: Otieno, Berrick, Elson, Lynne, Matharu, Abneel K., Riithi, Naomi, Chongwo, Esther, Katana, Khamis, Nasambu, Carophine, Mutebi, Francis, Feldmeier, Herman, Krücken, Jürgen, Fillinger, Ulrike, Abubakar, Amina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10644620/
https://www.ncbi.nlm.nih.gov/pubmed/37964353
http://dx.doi.org/10.1186/s40249-023-01154-4
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author Otieno, Berrick
Elson, Lynne
Matharu, Abneel K.
Riithi, Naomi
Chongwo, Esther
Katana, Khamis
Nasambu, Carophine
Mutebi, Francis
Feldmeier, Herman
Krücken, Jürgen
Fillinger, Ulrike
Abubakar, Amina
author_facet Otieno, Berrick
Elson, Lynne
Matharu, Abneel K.
Riithi, Naomi
Chongwo, Esther
Katana, Khamis
Nasambu, Carophine
Mutebi, Francis
Feldmeier, Herman
Krücken, Jürgen
Fillinger, Ulrike
Abubakar, Amina
author_sort Otieno, Berrick
collection PubMed
description BACKGROUND: Tungiasis, a neglected tropical parasitosis, disproportionately affects 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 affect 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 stratified into infected and uninfected based on the presence of tungiasis. The infected were further classified 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-effects 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 [adjusted β(aβ) = − 8.9; 95% confidence interval (CI) − 17.2, − 0.6], language (aβ = − 1.7; 95% CI − 3.2, − 0.3), cognitive flexibility (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), fine 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 first evidence that tungiasis is associated with poor neurocognitive functioning in children. Since tungiasis is a chronic disease with frequent reinfections, such negative effects may potentially impair their development and life achievements. GRAPHICAL ABSTRACT: [Image: see text] SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40249-023-01154-4.
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spelling pubmed-106446202023-11-14 Neurocognitive and mental health outcomes in children with tungiasis: a cross-sectional study in rural Kenya and Uganda Otieno, Berrick Elson, Lynne Matharu, Abneel K. Riithi, Naomi Chongwo, Esther Katana, Khamis Nasambu, Carophine Mutebi, Francis Feldmeier, Herman Krücken, Jürgen Fillinger, Ulrike Abubakar, Amina Infect Dis Poverty Research Article BACKGROUND: Tungiasis, a neglected tropical parasitosis, disproportionately affects 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 affect 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 stratified into infected and uninfected based on the presence of tungiasis. The infected were further classified 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-effects 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 [adjusted β(aβ) = − 8.9; 95% confidence interval (CI) − 17.2, − 0.6], language (aβ = − 1.7; 95% CI − 3.2, − 0.3), cognitive flexibility (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), fine 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 first evidence that tungiasis is associated with poor neurocognitive functioning in children. Since tungiasis is a chronic disease with frequent reinfections, such negative effects may potentially impair their development and life achievements. GRAPHICAL ABSTRACT: [Image: see text] SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40249-023-01154-4. BioMed Central 2023-11-14 /pmc/articles/PMC10644620/ /pubmed/37964353 http://dx.doi.org/10.1186/s40249-023-01154-4 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Otieno, Berrick
Elson, Lynne
Matharu, Abneel K.
Riithi, Naomi
Chongwo, Esther
Katana, Khamis
Nasambu, Carophine
Mutebi, Francis
Feldmeier, Herman
Krücken, Jürgen
Fillinger, Ulrike
Abubakar, Amina
Neurocognitive and mental health outcomes in children with tungiasis: a cross-sectional study in rural Kenya and Uganda
title Neurocognitive and mental health outcomes in children with tungiasis: a cross-sectional study in rural Kenya and Uganda
title_full Neurocognitive and mental health outcomes in children with tungiasis: a cross-sectional study in rural Kenya and Uganda
title_fullStr Neurocognitive and mental health outcomes in children with tungiasis: a cross-sectional study in rural Kenya and Uganda
title_full_unstemmed Neurocognitive and mental health outcomes in children with tungiasis: a cross-sectional study in rural Kenya and Uganda
title_short Neurocognitive and mental health outcomes in children with tungiasis: a cross-sectional study in rural Kenya and Uganda
title_sort neurocognitive and mental health outcomes in children with tungiasis: a cross-sectional study in rural kenya and uganda
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10644620/
https://www.ncbi.nlm.nih.gov/pubmed/37964353
http://dx.doi.org/10.1186/s40249-023-01154-4
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