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. 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. 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). 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.

中文翻译：

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东蛔虫病儿童的神经认知和心理健康结果：肯尼亚和乌干达农村地区的一项横断面研究

圆蜱病是一种被忽视的热带寄生虫病，对儿童的影响尤为严重。很少有实证研究报告患有体外寄生虫皮肤病（如盾虫病）的儿童的神经认知和心理健康结果。盾虫病的病理生理学表明，它可能会对认知和行为产生不利影响。这项研究开创了对盾虫病儿童神经认知和心理健康结果的调查。这是一项多地点横断面研究，包括来自肯尼亚两个县和乌干达一个地区的 48 所随机选择的学校的 454 名 8-14 岁学童。根据圆线虫病的存在情况，将参与者分为感染者和未感染者。根据感染强度，将感染者进一步分为轻度感染组和重症感染组。使用经过调整、经过验证和标准化的认知和心理健康测量方法（例如乌鸦矩阵和儿童行为检查表）来收集数据。统计测试包括多层次、广义混合效应线性模型，其中家庭联系设置为身份，用于比较未感染和感染儿童的分数，并确定神经认知和行为结果的其他潜在风险因素。当调整协变量时，轻度感染与较低的识字得分相关[调整后的 β(aβ) = − 8.9；95% 置信区间 (CI) − 17.2, − 0.6]、语言 (aβ = − 1.7; 95% CI − 3.2, − 0.3)、认知灵活性 (aβ = − 6.1; 95% CI − 10.4, − 1.7) 和工作记忆（aβ = − 0.3；95% CI − 0.6，− 0.1）。严重感染与读写能力（aβ = − 11.0；95% CI − 19.3，− 2.8）、反应抑制（aβ = − 2.2；95% CI − 4.2，− 0.2）、精细运动控制（aβ = − 0.7；95% CI − 1.1，− 0.4）和计算能力（aβ = − 3；95% CI − 5.5，− 0.4）。这项研究提供了第一个证据，证明盾螺病与儿童神经认知功能不良有关。由于圆线虫病是一种经常再次感染的慢性疾病，这种负面影响可能会损害他们的发育和生活成就。