ABSTRACT
Tungiasis is a neglected parasitic disease caused by penetration of female Tunga penetrans under the skin, causing important health outcomes in humans. Therefore, the aim of this study was to describe the prevalence of tungiasis in Brazil and in its federative units. In November 2019, an investigation was carried out to find studies published from 1980 onwards in MEDLINE, LILACS, Cochrane, CINAHL, Scopus, Web of Science and Embase databases, and in the gray literature, using descriptors related to the prevalence of tungiasis caused by T. penetrans in Brazil. Of the 542 studies found, only 16 published between 2002 and 2010 met the eligibility criteria to be included in this systematic review. Of the 16 selected publications, 14 addressed the prevalence of tungiasis in communities in the Northeast region of the country, one in the South and one in the Southeast. The general prevalence of the parasitosis in the studies ranged from 1.6% to 54.8%, predominantly in the five to nine age group. Eight studies considered the prevalence by gender, ranging from 2.2% to 62.2% for females and 1.1% to 62.5% for males. This systematic review presents an unprecedented survey of the prevalence of tungiasis, a parasitic disease whose dissemination is facilitated by several factors, occuring mainly in low-income communities. Considering the regionalization of the findings, the scarcity of publications, as well as disease neglect, more studies are required.
Subject(s)
Humans , Parasitic Diseases , Skin , Tunga , TungiasisABSTRACT
Resumen | La tungiasis es una ectoparasitosis endémica en Latinoamérica y está asociada a factores de riesgo como la ruralidad, la pobreza y la convivencia con animales. Popayán, una ciudad al suroccidente de Colombia, fue históricamente afectada por la tungiasis, tanto así que a sus habitantes los apodan "patojos" debido a la forma de caminar de sus habitantes infestados por la pulga. Hoy la enfermedad se creía eliminada. Se presenta el caso de un niño de 12 años procedente del área urbana de Popayán, que consultó por lesiones papulares de bordes circulares, centro negruzco y halo hiperqueratósico en ambos pies, de un mes de evolución. Por los hallazgos clínicos se sospechó tungiasis y se le administró ivermectina. Las lesiones se removieron quirúrgicamente y se enviaron para análisis parasitológico, el cual confirmó la presencia de Tunga penetrans. La evolución del paciente fue satisfactoria. La Secretaría de Salud Municipal de Popayán inspeccionó el domicilio del paciente y encontró perros migrantes del Pacífico colombiano en sus alrededores, algunos con lesiones sospechosas de tungiasis. Se documenta, así, el resurgimiento de esta enfermedad en el área urbana, probablemente debido a la migración de animales desde las zonas rurales. Es importante reconocer la existencia de la pulga en zonas rurales y urbanas, hacer el diagnóstico médico y reportar los casos a los entes de vigilancia. Estas acciones permitirán ofrecer un apropiado manejo y control sanitario de esta ectoparasitosis desatendida en humanos y animales.
Abstract | Tungiasis is an endemic ectoparasitosis in Latin America associated with risk factors such as rurality, poverty, and living with animals. In Popayán, a city in southwest Colombia, the disease was highly prevalent in the past, to such degree that its inhabitants were given the nickname of patojo, a word that describes the way of walking of people infested by the flea. However, it was believed eradicated at present. We present the case of a 12-year-old boy living in the urban area of Popayán, who presented with a one-month history of papular lesions with circular edges, blackish center, and hyperkeratotic halo on both feet. Tungiasis was suspected based on the clinical findings and ivermectin was administered. The lesions were surgically removed and sent for parasitological analysis, which confirmed the presence of Tunga penetrans. The patient evolved satisfactorily. The Secretaría de Salud Municipal de Popayán carried out an inspection of the patient's home where migrant dogs from the Colombian Pacific were found in the surroundings, some with suspicious lesions of tungiasis. We document here the resurgence of this pathology in urban areas, probably secondary to the migration of animals from rural areas. It is important to recognize the existence of the flea in rural and urban areas, make a medical diagnosis, and report cases to the surveillance entities to enable appropriate management and sanitary control of this neglected ectoparasitosis in humans and animals.
Subject(s)
Tungiasis , Parasites , Colombia , TungaABSTRACT
ABSTRACT Epidermal parasitic skin diseases encompass scabies, pediculosis, cutaneous larva migrans, myiasis, and tungiasis. Tungiasis is probably the most neglected of all Neglected Tropical Diseases (NTD). It occurs in South America, the Caribbean and Sub-Saharan Africa and affects marginalized populations where people live in extreme poverty. In endemic communities the prevalence can be up to 30% in general population and 85% in children. Over time, chronic pathology develops characterized by hyperkeratosis, edema around the nail rim, fissures, ulcers, deformation and loss of nails. This leads to a pattern of disabilities, eventually resulting in impairment of mobility.Dimeticones are a family of silicon oils with a potential to kill parasites located on top or inside the epidermis by a physical mode of action. They are considered the treatment of choice for pediculosis capitis and pediculosis pubis. With regard to tungiasis, the so called rear abdominal cone of the parasites has been identified as a target for treatment with dimeticones. NYDA®, a mixture of two dimeticones with different viscosity, is the only dimeticone product for which data on the mode of action, efficacy and safety with regard to tungiasis exists. The product has been shown highly effective against embedded sand fleas, even in very intense infection with more than 500 parasites situated on top of each other. A randomized controlled trial showed that seven days after a targeted application of NYDA® 97% (95% CI 94-99%) of the embedded sand fleas had lost all signs of viability.Comprehensive toxicological investigations on the dimeticones contained in NYDA® showed that there is practically no risk of embryotoxicity, fetotoxicity, teratogenicity, and other toxicity. The safety of dimeticones was also demonstrated in clinical trials with a total of 106 participants with tungiasis, in which not a single adverse event was observed.
Subject(s)
Animals , Child , Female , Humans , Male , Dimethylpolysiloxanes/therapeutic use , Tungiasis/drug therapy , Neglected Diseases/drug therapy , Skin Diseases, Parasitic/parasitology , Skin Diseases, Parasitic/drug therapy , Clinical Trials as Topic , Neglected Diseases/parasitologyABSTRACT
Abstract: The authors report an unusual case of disseminated tungiasis in a 52-year-old patient living in the city of Campo Grande, state of Mato Grosso do Sul, who had crusted-papular-nodular lesions located in feet, hands, and right thigh. Diagnosis was confirmed by dermoscopy and anatomopathological examination.
Subject(s)
Humans , Male , Middle Aged , Tungiasis/diagnostic imaging , Dermoscopy , Tungiasis/drug therapyABSTRACT
La tungiasis es una ectoparasitosis causada por la penetración en la piel de la pulga hembra Tunga penetrans. Esta enfermedad no es específica del hombre y se distribuye en regiones cálidas y secas alrededor del mundo. Se adquiere por contacto directo con el suelo en donde habitan los parásitos adultos. En zonas endémicas, su alta prevalencia se asocia a pobreza y falta de acceso al sistema de salud. Además es frecuente entre viajeros que visitan regiones endémicas y que regresan a sus lugares de origen. Presentamos un caso típico de tungiasis en un paciente 39 años que había realizado un viaje reciente a zona endémica. (AU)
Tungiasis is an ectoparasitosis caused by penetration into the skin of the female flea Tunga penetrans. This disease is not human-specific and is distributed worldwide in warm, dry regions. It is acquired by direct contact with the soil where the adult parasites live. In endemic areas, its high prevalence is associated with poverty and lack of access to the health system. It is also frequent among travelers visiting endemic regions and returning to their places of origin. We present a typical case of tungiasis in a 39 year old patient who had made a recent trip to an endemic area. (AU)
Subject(s)
Humans , Animals , Male , Female , Child , Adult , Middle Aged , Aged , Tungiasis/diagnosis , Tungiasis/pathology , Argentina/epidemiology , Socioeconomic Factors , Bacterial Infections/complications , Poverty Areas , Risk Factors , Endemic Diseases , DDT/therapeutic use , Tunga/classification , Tungiasis/surgery , Tungiasis/etiology , Tungiasis/parasitology , Tungiasis/prevention & control , Travel-Related Illness , Barriers to Access of Health Services , Health Services Accessibility , Insect Repellents/therapeutic useSubject(s)
Humans , Male , Middle Aged , Tungiasis/diagnosis , Foot Dermatoses/diagnosis , Colombia , Tungiasis/surgery , Foot Dermatoses/surgeryABSTRACT
O objetivo deste artigo é revisar as características clínicas da tungíase. A Tunga penetrans é a menor das pulgas conhecidas, alcançando 1 milímetro de comprimento quando atinge a fase adulta. Os relatos antigos de surtos de tungíase são escassos em relação aos registros epidemiológicos. O diagnóstico da doença é realizado através da história epidemiológica e dos achados clínicos, aliados ao exame direto com visualização do parasita, após abertura da lesão com agulha estéril. A retirada da pulga é o tratamento preconizado, sendo a profilaxia a melhor alternativa para controlar o parasita. Os profissionais de saúde devem atentar para a importância de se orientar as populações de áreas endêmicas em relação à doença, a fim de reduzir o número de casos e de complicações.
The purpose of this article is to review the clinical features of tungiasis. Tunga penetrans is the smallest known flea, reaching a millimeter in length when fully grown. The earliest accounts of outbreaks of tungiasis are scarce in relation to epidemiological records. The diagnosis is made by history and clinical epidemiological findings, coupled with the direct examination with visualization of the parasite after opening the wound with a sterile needle. The removal of the flea is the recommended treatment, and prophylaxis the best way to control the parasite. Healthcare professionals should be aware as to the importance of educating the public in endemic areas for the disease in order to reduce the number of cases and complications.
Subject(s)
Humans , Tungiasis/diagnosis , Tungiasis/drug therapy , Thiabendazole/administration & dosage , Disinfection , Mercury/administration & dosageABSTRACT
Tungiasis is a cutaneous ectoparasitosis caused by the sand flea Tunga penetrans whose higher prevalence occurs in South America, the Caribbean and Sub-Saharan Africa. It is clinically characterized by a papular lesion, either single or multiple, with a whitish halo and a brown-black central core, most of them localized on the feet. The lesions can be painful and itchy with the most common complication being bacterial superinfection of the skin. We report three cases of Chilean patients who presented skin lesions suggestive of tungiasis on their return from areas of high prevalence of the disease. The diagnosis is made by the clinical features of lesions in a patient from an endemic zone. Standard treatment consists of surgical extraction of the flea followed by application of a topical antibiotic and a tetanus prophylaxis. Prevention of the infestation is essential and includes the use of closed footwear and repellents.
La tungiasis es una ectoparasitosis cutánea causada por la pulga Tunga penetrans, prevalente en Sudamérica, el Caribe y África Subsahariana. Clínicamente se caracteriza por la formación de pápulas, únicas o múltiples, con un halo blanquecino translúcido y una región central pardo-negruzca, frecuentemente localizadas en los pies. Las lesiones pueden cursar con prurito o dolor leve, siendo la sobreinfección bacteriana la complicación más frecuente. Se comunican tres casos clínicos de chilenos que viajaron a zonas de alta prevalencia de tungiasis y que a su regreso presentaron lesiones dérmicas sugerentes de la enfermedad. El diagnóstico se realizó en base a las características clínicas de las lesiones en un paciente proveniente de zonas endémicas. El tratamiento de elección es la extracción quirúrgica de la pulga seguido del uso de antimicrobianos tópicos y la vacunación antitetánica. La prevención es esencial con el uso de calzado cerrado y repelentes.
Subject(s)
Adult , Female , Humans , Male , Young Adult , Tungiasis/diagnosis , Chile , Travel , Tungiasis/surgeryABSTRACT
The female flea Tunga penetrans is responsible for a cutaneous parasitosis known as Tungiasis. We report the clinical case of a 12 year-old Caucasian boy who sought treatment in a dermatological private office due to a painful lesion in the plantar area and whose dermoscopic examination, without skin contact, allowed the visualization of parasite's movement inside the skin. The diagnosis of tungiasis is clinical, but it can be aided by in vivo and ex vivo dermoscopic examination of the lesion.
A fêmea da pulga Tunga penetrans é responsável pela dermatose ectoparasitária denominada Tungíase. Relatamos o caso clínico de um adolescente branco de 12 anos de idade, o qual procurou atendimento em consultório dermatológico devido à lesão dolorosa na planta e cujo exame dermatoscópico sem contato com a pele permitiu visualizar o movimento do parasita dentro da pele. O diagnóstico da tungíase é clínico, porém pode ser auxiliado pelo exame dermatoscópico in vivo e ex vivo da lesão.
Subject(s)
Animals , Child , Female , Humans , Male , Foot Diseases/pathology , Tungiasis/pathology , Dermoscopy , Tunga/anatomy & histologySubject(s)
Humans , Male , Adult , Staphylococcal Skin Infections/diagnosis , Skin Diseases, Parasitic , Tungiasis/diagnosis , Tungiasis/therapyABSTRACT
A tungíase é uma infestação zooantropofílica causada pela Tunga penetrans. É endêmica na América Latina e no Caribe. Ocorre, principalmente, em comunidades carentes e sem saneamento básico e em indivíduos que visitam áreas contaminadas. O local mais comum de penetração do ectoparasita é a região periungueal dos pés. Os autores mostram a ocorrência de uma forma disseminada num habitante da zona rural.
Tungiasis is a zoophilic and anthropophilic infestation caused by Tunga penetrans. It is endemic in Latin America and in the Caribbean. It occurs mainly in impoverished communities that have no access to basic sanitation and in individuals that visit contaminated areas. The most common penetration site of this ectoparasite is the periungueal region of the feet. The authors present its disseminated form occurring in a patient inhabiting a rural area.
Subject(s)
Adult , Humans , Male , Foot Dermatoses/diagnosis , Tungiasis/diagnosis , Foot Dermatoses/therapy , Tungiasis/therapyABSTRACT
We report a 54-year-old male that, after working in a rural zone of Rio de Janeiro, Brazil, presented with an itching cutaneous lesion in the wrist with a black small central zone. The patient extracted from the lesion a on of 0.5 mm diameter. The pathological study of the insect recognized its body segments. The epidemiological background and the characteristics of the lesion led to the diagnosis of tungiasis.
Subject(s)
Animals , Humans , Male , Middle Aged , Siphonaptera , Travel , Tungiasis/parasitology , Brazil , ChileABSTRACT
La tungiasis es una parasitosis cutánea originaria de América causada por Tunga penetrans. Se caracteriza por lesiones papulares, negruzcas, únicas o múltiples, que suelen afectar los pies, principalmente en las zonas subungueales y periungueales. El diagnóstico de tungiasis se realiza por las características clínicas de las lesiones en un paciente proveniente de zonas endémicas. El tratamiento de elección es la extracción quirúrgica de la pulga y la aplicación de antibióticos tópicos. Presentamos un caso de tungiasis en una paciente de 10 años de edad con múltiples lesiones en ambos pies, que fue tratada satisfactoriamente con ivermectina y extracción quirúrgica.
Tungiasis, is a cutaneous parasitosis, native of America caused by Tunga penetrans. Infestations usually presents with black papular lesions, either single or multiple, most of them localized on the feet, mainly in the subungual and periungual areas. Diagnosis of tungiasis is based on the characteristic aspect of the lesions in a patient coming from an endemic area. Surgical removal of the fea and application of a topical antibiotic is the standard treatment. We describe a case of a 10-years-old girl, with multiple lesions localized on feet, who was succesfully treated with ivermectin and surgical removal of lesions.
Subject(s)
Child , Female , Humans , Tungiasis , Tungiasis/diagnosis , Tungiasis/drug therapyABSTRACT
Introdução: Existe pouco conhecimento sistemático sobre a epidemiologia da tungíase em aéreas endêmicas. São necessários métodos de avaliação rápida para delimitar áreas em risco e possibilitar a implementação e avaliação do impacto de intervenções. Objetivo: Desenvolver e avaliar um método epidemiológico rápido para estimar a prevalência geral e a gravidade da tungíase em comunidades endêmicas com diferentes característica demográficas, sócio-culturais e ambientais. Material e Métodos: Análise de dez estudos transversais realizados em cinco comunidades, três do Brasil (dados secundários) e duas da Nigéria (dados primário), no período de 2001-2008. A tungíase foi diagnosticada clinicamente a partir da presença de lesões de Tunga penetrans na epiderme dos indivíduos. Para elaborar o método rápido, seis localizações topográficas dos pés foram selecionadas como potenciais indicadores de infestação em nível comunitário. Foram deitas regressões lineares, calculados coeficientes de determinação (R²) e os valores p. Critérios operacionais como rapidez e facilidade do exame também foram utilizados para a escolha do método mais adequado. Resultados: Ao todo, nos dez estudos transversais foram incluídos 7.121 indivíduos. As prevalências da tungíase variaram entre 21% e 54%. Nas duas comunidades nigerianas a prevalência geral da tungíase nas 302 pessoas examinadas foi de 47% (intervalo de confiança 95%; 41% - 53%)...
Subject(s)
Humans , Epidemiology , Tunga , TungiasisABSTRACT
Tungiasis is an ectoparasitic disease that is caused by the penetration of Tunga penetrans into the epidermis of the host. Tungiasis is indigenous to South Americaand the Caribbean regions, but it has spread to Latin America, India, and sub-Saharan Africa. The area of soft skin such as the soles, toes, webs and subungual regions are the favored sites for sand flea embedding. As the flea enlarges within epidermis a pruritic, painful white or erythematous papulonodule develops. A black central punctum is characteristic. A 32-year-old woman presented with a small black crust on the right sole after traveling to an endemic area(Congo). Histopathologic examination revealed the internal organs of the arthropod embedded intothe epidermis, which allowed a definitive diagnosis of tungiasis. Although tungiasis is common in endemic areas, there has been no report of tungiasis in the Korean literature. We report herein an interesting case of tungiasis in a patient after traveling to Congo.
Subject(s)
Adult , Female , Humans , Africa South of the Sahara , Arthropods , Caribbean Region , Congo , Epidermis , India , Latin America , Siphonaptera , Skin , Toes , Tunga , TungiasisABSTRACT
We present a ten years' old patient immune competent, with multiple lesions of tungiasis in both feet, that consult when she returned of her vacations in Paraguay. We make a brief description of the topic.
Se presenta una paciente de 10 años de edad inmunocompetente con lesiones múltiples de tungiasis en ambos pies, que consulta al regreso de sus vacaciones en Paraguay. Se efectúa una breve revisión del tema.