ArticleBMC public health2023
Developing low-cost house floors to control tungiasis in Kenya - a feasibility study.
Article in BMC public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.
- Prevalence and risk factors for tungiasis in Africa: a systematic review and meta-analysis.BMC infectious diseases · 2025Pooled it
- Better floors, better health: a theory of change for an improved household flooring intervention in rural communities in Kwale and Bungoma counties, Kenya.BMC public health · 2025Trial
- Individual and household factors associated with tungiasis in a marginalized population in Karamoja, northeastern Uganda.Tropical medicine and health · 2026Article
- Integrated action for skin NTDs: Deconstructing transmission, addressing knowledge gaps, and championing one health strategies.Nature communications · 2026Review
- Social, environmental and policy contexts affecting the feasibility and acceptability of improving household flooring for better health in rural Kenya.PLoS neglected tropical diseases · 2026Article
- Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
Abstract
contextTungiasis is a neglected tropical skin disease endemic in resource-poor communities. It is caused by the penetration of the female sand flea, Tunga penetrans, into the skin causing immense pain, itching, difficulty walking, sleeping and concentrating on school or work. Infection is associated with living in a house with unsealed earthen house floors.
methodsThis feasibility study used a community-based co-creation approach to develop and test simple, locally appropriate, and affordable flooring solutions to create a sealed, washable floor for the prevention of tungiasis. Locally used techniques were explored and compared in small slab trials. The floor with best strength and lowest cost was pilot trialed in 12 households with tungiasis cases to assess its durability and costs, feasibility of installation in existing local houses using local masons and explore community perceptions. Disease outcomes were measured to estimate potential impact.
resultsIt was feasible to build the capacity of a community-based organization to conduct research, develop a low-cost floor and conduct a pilot trial. The optimal low-cost floor was stabilized local subsoil with cement at a 1:9 ratio, installed as a 5 cm depth slab. A sealed floor was associated with a lower mean infection intensity among infected children than in control households (aIRR 0.53, 95%CI 0.29-0.97) when adjusted for covariates. The cost of the new floor was US$3/m
conclusionThis study provided promising evidence that retrofitting simple cement-stabilised soil floors with locally available materials is a feasible option for tungiasis control and can be implemented through training of community-based organisations. Disease outcome data is promising and suggests that a definitive trial is warranted. Data generated will inform the design of a fully powered randomized trial combined with behaviour change communications.
trial registrationISRCTN 62801024 (retrospective 07.07.2023).
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Registered trials
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