Tungiasis among five communities in south-western Trinidad, West Indies.

The prevalences of Tunga penetrans Linn. within the five townships of Granville, Fullerton, Icacos, Coromandel and Cedros in south-western Trinidad, West Indies, as determined by physical examination of all inhabitants present during the survey, were 17.0% (38/223 subjects), 15.7% (36/237), 31.4% (102/325), 17.4% (42/242) and 17.9% (50/280), respectively. The rate in Icacos was significantly higher than in the other four sites (P < 0.001). Not only were males more likely to be infected than females in all five study sites (P < 0.0007) but chigoe-flea burdens were also higher in males than in females (P < 0.012), with mean (S.D.) burdens of 5.44 (2.54) fleas/male infected subject and 2.38 (2.00) fleas/female infected subject. Feet were significantly more infected than other areas of the body (P < 0.001). Analysis of variance revealed that the interactions between prevalence of chigoe-flea infection and geographical location (P = 0.0058) and between sex of infected subject and site of infection (P = 0.0109) were highly significant but that between geographical location and sex of infected subject was not significant (P > 0.30). At least seven species of bacteria, with varying sensitivities to antibiotics, were isolated from 16 patients with sepsis associated with their T. penetrans infections: Streptococcus pyogenes, beta-haemolytic Streptococcus (not group A), Klebsiella aerogenes, Enterobacter agglomerans, Staphylococcus aureus, Escherichia coli and a Bacillus species. Closteridium tetani was not isolated.