The Effectiveness of Topical Dimethicone Together with a One Health Approach for the Control of Tungiasis in the Sanumás Communities, Yanomami Territory, Amazon Rainforest: A Real-World Study.

BACKGROUND: The success of tungiasis treatment is highly dependent on adequate environmental control. METHODS: This is a real-world observational cohort study designed to monitor the effectiveness of topical dimethicone together with a One Health approach for the control of tungiasis in the Sanumás communities, Amazon rainforest, Brazil. We followed up on 562 indigenous people and 81 domestic dogs for 1.5 years in a 3-month interval. A new molecular method for large-scale soil evaluation was also tested. The control of tungiasis was independently conducted by the Brazilian Ministry of Health and comprised topical dimethicone application (NYDA®) for humans, single-dose oral afoxolaner for dogs, and in-house soil fumigation with fipronil. The main outcome was the occurrence of tungiasis after the use of topical dimethicone together with the One Health approach. RESULTS: A total of 49 of the 562 indigenous people had active tungiasis at enrollment (8.72%). Only three cases of tungiasis resulted in active lesions after the use of topical dimethicone together with the One Health approach, with two cases of recurrence. From the 6-month follow-up and after, soil infestation was not detected. CONCLUSIONS: We conclude that the use of NYDA® together with animal and environmental interventions are effective measures for the control of tungiasis.

Tungiasis in the Sanumás Amerindians in the Amazon Rainforest, Brazil: Prevalence, Intensity and Morbidity.

BACKGROUND: Tungiasis is a disease associated with extreme poverty. We aimed to evaluate the prevalence of tungiasis in six different settlements of the Sanumás indigenous community in a remote area in the Auaris region, Yanomami territory, Brazil. METHODS: We conducted an observational study to detect clinical and epidemiological factors associated with tungiasis using a cross-sectional strategy and multivariate logistic regression. Soil analysis was performed by visual and microscopic methods. RESULTS: We examined 555 persons, 45 of whom had active tungiasis; 18 cases were classified as mild, 16 as moderate and 11 as severe. The disease was significantly more prevalent in children than in adults (odds ratio (OR) 15.77; 95% confidence interval (CI) = 5.34-67.91; p < 0.001). Soil infestation was significantly related to the occurrence of human tungiasis (OR = 12.29; 95% CI = 3.75-45.88). The sex and GPS location of the houses were not related to the occurrence of tungiasis. CONCLUSIONS: We conclude that tungiasis is an important problem in the Sanumás community, especially for children. We suggest that interruption of the off-host transmission cycle, together with regular treatment [human and animal interventions], must be prioritized to achieve control of tungiasis in indigenous populations.

[Health and indigenous peoples in Brazil: the challenge of professional training and continuing education of workers in intercultural contexts]. / Saúde e povos indígenas no Brasil: o desafio da formação e educação permanente de trabalhadores para atuação em contextos interculturais.

This article discusses training and continuing medical education for indigenous health workers and health professionals in indigenous health under the guidelines of the Brazilian National Healthcare Policy for Indigenous Peoples, which is currently behind schedule and incomplete as part of the official government agenda. Based on inter-sector proposals for health training by the Ministries of Health and Education, the article highlights the case of indigenous healthcare, emphasizing that government initiatives in this area still need to incorporate the concept of continuing education, a powerful tool for fostering intercultural dialogue and orienting health practices.

A medicalização de conflitos: entre o paternalismo e a participação / Healt care of conflicts: between the protection and participation (the case of Yanomami)

Este trabalho procura abordar do ponto de vista histórico a utilização e a crítica dos sistemas oficiais de saúde num contexto intercultural, baseando-se na consulta bibliográfica e na prática da assistência à saúde entre os yanomami, em circunstâncias diversas, entre 1985 e 1994 (AU)

A medicalizaçäo de conflitos: entre o paternalismo e a participaçäo (o caso dos Yanomami) / Health care of conflicts: between the protection and participation (the case of Yanomami)

Este trabalho procura abordar do ponto de vista histórico a utilizaçäo e a crítica dos sistemas oficiais de saúde num contexto intercultural, baseando-se na consulta bibliográfica e na prática da assistência à saúde entre os Yanomami, em circunstâncias diversas, entre 1985 e 1994