At Kreavet, we are committed to advancing evidence-based approaches to improve One Health. After recent work on the impact of parasitic diseases in companion animals and zoonotic roundworm infections, we are proud to announce a new study that provides the first quantitative estimate of the global burden of tungiasis, a neglected tropical disease that continues to affect vulnerable communities across Africa and Latin America. The study was conducted in collaboration with a research consortium led by prof. Georg von Samson-Himmelstjerna (Freie Universität Berlin) and recently published in BMC Global and Public Health.
What is tungiasis?
Tungiasis is a parasitic skin disease caused by sand fleas of the genus Tunga, primarily Tunga penetrans. The female flea burrows into the skin, most commonly on the feet, where it causes inflammation, pain and severe itching. Repeated or heavy infestations can lead to difficulty walking, chronic lesions, sleep disturbance, secondary infections and reduced quality of life. The disease is particularly associated with communities facing poverty, inadequate housing and limited access to sanitation and healthcare. It is a One Health disease since both humans and animals (like dogs, rodents, pigs, sheep and goats) are affected.
Despite being included in the World Health Organization's Neglected Tropical Diseases (NTD) Roadmap since 2021, tungiasis remains one of the least studied NTDs, and until now its overall health burden had never been formally estimated.
Measuring the impact of an overlooked disease
Our consortium, bringing together researchers from Europe, Africa and South America estimated the burden of tungiasis using disability-adjusted life years (DALYs), a standard metric used in public health to quantify years of healthy life lost due to disease and disability.
Using published prevalence data, demographic information and disease severity estimates from endemic countries, we estimated that tungiasis is responsible for approximately 380,000 DALYs lost each year, increasing to more than 575,000 DALYs when associated complications and comorbidities are included. Most of this burden was concentrated in sub-Saharan Africa, although substantial impacts were also identified in parts of Latin America, particularly Brazil.
How does tungiasis compare with other neglected tropical diseases?
Our study suggests that the estimated burden of tungiasis is comparable to, or greater than, several other neglected tropical diseases that receive considerably more attention in research and public health programmes, for instance fascioliasis, toxocariasis, cystic echinococcosis. When adjusted for population size, the burden of tungiasis in endemic countries is higher than estimates reported for soil-transmitted helminths and schistosomiasis. These findings suggest that the impact of tungiasis has historically been under-recognised within global health discussions.
Why does this matter?
Disease burden estimates play an important role in guiding public health priorities, research funding and the development of control programmes. Many neglected tropical diseases have benefited from coordinated international initiatives only after their health and economic impacts became more clearly quantified.
The current calculations remain initial, with important uncertainties around the estimates, due to the limited availability of national surveillance data in many endemic countries. Nevertheless, we believe our work is an important step towards understanding the true scale of the problem and identifying key knowledge gaps that require further investigation. These include the need for additional prevalence studies, improved surveillance systems and disease-specific disability assessments.
A call for greater attention
The facts that tungiasis may be far more impactful than being considered today, that it affects the world's most vulnerable communities and is largely preventable and treatable support increased efforts in surveillance, research and control. By improving our understanding of its burden, we can better inform future efforts aimed at reducing its impact on affected communities worldwide.
Moreover, as a zoonotic disease involving human, animal and environmental factors, tungiasis also highlights the importance of a One Health perspective. Strengthening collaboration between public health, veterinary and environmental sectors may help improve understanding of disease transmission and the development of effective control strategies.
Reference
Antonopoulos A., Elson L., Krücken J., Thielecke M., Mutebi F., Yapi R.B., Fillinger U., Feldmeier H., Nyangacha R., Kuispond N.-R.S., Laken E.K., Carlos R.S.A., Charlier J., von Samson-Himmelstjerna G. Estimation of the global burden of tungiasis in endemic countries using a disability adjusted life-years modelling approach. BMC Glob. Public Health 4, 85 (2026). https://doi.org/10.1186/s44263-026-00318-2
