Current status of tungiasis in endemic areas

Medical Review (Med. pregled), 2025, 61(1), 12-15.

V. Velev, R. Tchipeva, T. Valkov

Department of Infectious Diseases, Parasitology and Tropical Medicine, Medical University of Sofia

Abstract. Tungiasis is one of the neglected tropical parasitic skin diseases. It is caused by the infestation of the female sand flea Tunga penetrans in the skin, mainly on the soles of the lower limbs. Very rarely, the infestation is caused by a related flea – Tunga trimamillata. To date, it is a health problem mainly in sub-Saharan Africa, the Caribbean, Latin and South America. It occurs mainly among the poor rural population, being a big problem for children as well. In endemic areas, morbidity can reach over 73%. Early removal of the parasite from the skin is still the most common therapy. Tungiasis is one of the neglected tropical diseases (DNDi) already included in the DNDi Roadmap for 2021-2030 of the World Health Organization and accordingly surveillance of its spread as well as comprehensive prevention measures should be increased. Although being widespread in the described endemic areas, the disease occurs as single imported cases in a number of other countries as well. Its exclusion from major medical studies is probably due to the fact that it is prevalent mainly in poor, underdeveloped areas of the world, and although it causes severe deformities of the lower limbs, it is rarely fatal.

Key words: tungiasis, Tunga penetrans, DNDi

Address for correspondence: Assoc. Prof. Valeri Velev, MD, PhD, e-mail: velev_md@abv.bg