Tunga penetrans (Jiggers) infestation is a disease that affects a high number of individuals in Kenya but has for a long time been neglected. Its impact on communities is generally underestimated, often leading to subtle debilitating sickness that is accompanied by extreme stigma and may have a highly negative impact on the economy and well-being of communities. The prevalence of jiggers often follows a characteristic pattern with a maximum prevalence in children and elderly people. Cohesu has a keen interest in school health, particularly in neglected parasitic infections that are often overlooked in mainstream health programs.
Cohesu has identified Tunga as one of the diseases that need immediate attention among school-going children in certain areas of Western Kenya and the Lake Victoria region, and granular mapping of the disease is a first step towards the ability to use resources effectively by knowing exactly where to target efforts. We launched the exercise in 10 schools and found the prevalence to stand at 6.8%, ranging from 1.6% to 12.2%. The results of this exercise show a gender bias, with boys harboring more infections than girls. The highest prevalence in the ten schools was in children aged 8-13 years old.
Community Based Treatment
Cohesu has found that in order to achieve the best results, it's important to follow up with affected children in their homes and spray their homes to prevent re-infection. To help with this effort, a number of community health workers have been trained and given the capacity to follow up with the children for treatment. While this approach has been successful, it's also labor-intensive.
To address the lack of capacity to follow up with every child at their home, Cohesu has set up drop-in centers in Sabatia and Maseno. At these centers, community members who are infected can drop in and receive treatment. This approach has been very successful in overcoming stigma, especially in Sabatia where the clinic is held on most days. The Maseno clinic, which is held on Saturdays under a tree, is limited by the lack of a physical facility, treatment supplies, and volunteer personnel to run them on a more regular basis.
Due to the popularity of these community clinics, Cohesu is seeking partnerships to put up a physical facility in Maseno and deploy community health workers and treatment supplies to meet the demand.
The Maseno drop-in center
The center which treats jigger-infested individuals, is currently held under a tree at a volunteer's house. Cohesu would like to improve the facility by providing an improved shed that would be more hygienic and prevent individuals from reinfecting each other. The proposed shed would have a cemented floor that is easy to clean, a roof to protect individuals from the weather, and a water tank to provide water for washing the feet of those under treatment.
TIGFIX
Cohesu tries its best to dispel myths about jiggers and holds community trainings to encourage people to seek treatment. We always try to partner with local administration to participate in Chief's barazas and educate affected households on hygiene and the need to smear houses with cow dung to avoid cracks on the floors and walls.
Cohesu has successfully used Jigfix schools in the western Kenya and has conducted trials, which found it to be safe, effective, and quick. Each bottle of Jigfix can treat three individuals, and the time it takes to cure depends on the severity of infection and frequency of treatment. Cohesu encourages victims to wear shoes, fumigate their homes, educate their families, and treat their animals. They also urge healing victims to check their feet daily for fresh burrowing jiggers and hope that county governments can prioritize the jigger problem and incorporate spraying of insecticides in affected areas.