Article

[Observations of the sand flea (Tunga penetrans) in humans and dogs in French Guiana]

Authors:
To read the full-text of this research, you can request a copy directly from the author.

Abstract

The occurrence of sand fleas (Tunga penetrans) in a reservation in the north of French Guyana is described. The parasite is found on dogs, Europeans and children of the local Indian tribes. Infections in man are supported by a big population of stray dogs as well as by the local cottage construction. Due to the simultaneous efficiency against the larvae of Dermatobia hominis lvermectin is only of limited suitability for the treatment of tungiasis in dogs. In man single parasites can be removed with a splinter forceps. In dogs footbathing with 0.2% Neguvon has shown to be effective. On long term a reduction of the stray dog population is recommended.

No full-text available

Request Full-text Paper PDF

To read the full-text of this research,
you can request a copy directly from the author.

... Concerning drug treatments for animals, which is discussed in this article, this occasionally has been used in animal tungiasis, such as the topical application of the organochlorine lindane (gamma-hexachlorocyclohexane) in pigs [26,27], the topical use of trichlorphone at 0.2% (Neguvon) in infested dogs [28], a 97% oily trichlorphone solution for dogs and cats, and collars impregnated with propoxur (carbamate), and flumethrin (pyrethroid) in dogs [22]. Other topical drugs have also been tested but showed toxic and carcinogenic potential [29,30]. ...
... Currently, a new perspective has emerged in treating tungiasis in dogs, the use of isoxazolines (e.g., fluralaner), which have demonstrated high efficacy [34,35]. Concerning drug treatments for animals, which is discussed in this article, this occasionally has been used in animal tungiasis, such as the topical application of the organochlorine lindane (gamma-hexachlorocyclohexane) in pigs [26,27], the topical use of trichlorphone at 0.2% (Neguvon) in infested dogs [28], a 97% oily trichlorphone solution for dogs and cats, and collars impregnated with propoxur (carbamate), and flumethrin (pyrethroid) in dogs [22]. Other topical drugs have also been tested but showed toxic and carcinogenic potential [29,30]. ...
... In 1989, a case report also described the use of trichlorphone 0.2% (Neguvon) in cases of infected dogs, with reduction in fleas in the animals studied [28]. More recently, in 2008, another study tested a 97% solution of trichlorphone in oil and found it ineffective against T. penetrans in dogs and cats. ...
Article
Full-text available
In tropical and subtropical countries, particularly in disadvantaged communities, tungiasis is a severe public health problem, which is often neglected by the authorities. The sand fleas Tunga penetrans, predominant in endemic areas, and Tunga trimamillata, whose cases in humans are less frequent, are the cause of this zoonosis. Domestic animals are potential reservoirs and disseminators of tungiasis, so controlling their infection would significantly advance the prevention of human cases. This literature review compiles the most recent studies and innovations in treating animal tungiasis. Studies of approaches to the treatment of animal tungiasis, as well as disease control and prevention, are described. Isoxazolines are highlighted as promising drugs to treat animal tungiasis, with high efficacy and pharmacological protection. The positive impacts of this discovery on public health are also discussed, since dogs are an essential risk factor for human tungiasis.
... Sporadic occurrence Tropical Medicine and International Health volume 6 no 4 pp 267±272 april 2001 ã 2001 Blackwell Science Ltd has been reported in parts of Asia and Oceania (Goldsmid 1981;Sane & Satoskar 1985;Mazzini et al. 1988;IbanezBernal & Velasco-Castrejon 1996). In Latin America, it is found in regions spanning Mexico to Northern Argentina and Chile (Faust & Maxwell 1930;Soria & Capri 1953;Grosshans & Pradinaud 1979;Taubman & Spielman 1979;Zalar & Walther 1980;Spielman et al. 1986;Basler et al. 1988;Mazzini et al. 1988;Milgraum & Headington 1988;Rietschel 1989;Chadee et al. 1991a;Ibanez-Bernal & Velasco-Castrejon 1996;Veraldi et al. 1996;Oliver Llull et al. 1997). In Africa, the ectoparasite is found in the whole sub-Saharan region: from Sierra Leone, Ivory Coast, Nigeria and Ethiopia to South Africa; it also occurs in Zanzibar and Madagascar (Hoeppli 1963;Tan-Lim & Pluis 1972;Fuga et al. 1977;P®ster 1977;Ade-Serrano & Ejezie 1981;Baurle & Stroothenke 1981;Ejezie 1981;Goldsmid 1981;Peschlow et al. 1983;Arene 1984;Obengui 1989;Sanusi et al. 1989;Tonge 1989;Fimiani et al. 1990;Pilgrim & Brown 1993;Spradbery et al. 1994;Douglas-Jones et al. 1995;Nte & Eke 1995). ...
... However, thorough studies on the environmental factors enhancing or impairing the propagation of T. penetrans have never been conducted. Adult ¯eas are free-living, but the female ¯ea penetrates into the epidermis of a host: man, dog, cat or pig (Cooper 1967;Verhulst 1976;Rietschel 1989). Various other animals have been found infected: cattle, sheep, goats, horses, rats, mice, chickens, birds, elephants, monkeys and wild mammalians (Hesse 1899;Soria & Capri 1953;Ruthe 1961;Cardoso 1990). ...
... Heukelbach, unpublished observation). Foot bathing of dogs with metrifonate 0.2% and subcutaneous injection of ivermectin (0.2 mg/kg body weight) has been reported to be effective in veterinary medicine (Rietschel 1989). However, similar to the situation in humans, no valid conclusions can be derived from animal therapy studies. ...
Article
Full-text available
Tungiasis is caused by the flea Tunga penetrans. Growing urbanization, improved housing and use of appropriate footwear presumably have led to an overall reduction of the occurrence of this ectoparasitosis within the last decades. However, it is still highly prevalent where people live in extreme poverty, occurring in many Latin American and African countries. Although the infection has long been known, data on the ectoparasite's biology and the epidemiology of the disease are scant. Methods for treatment, prevention and control have never been evaluated in a scientific manner. Tungiasis remains an important public health problem for the very poor, a problem neglected by those who are affected, by the medical profession and by the scientific community.
... Early reports of tungiasis treatment in animals indicate that topical applications of organochlorine pesticides such as lindane (gamma-hexachlorocyclohexane) (Cooper 1967(Cooper , 1976 and 0.2% trichlorphone were tungicidal in pigs and dogs (Rietschel 1989). In contrast, an oily solution of 97% trichlorphone was reported to be non-effective against embedded sand fleas in dogs (Pilger et al. 2010). ...
Article
Full-text available
Tunga penetrans, Tunga trimamillata and Tunga hexalobulata are the three species of sand fleas which cause tungiasis in domestic animals. Tunga penetrans and T. trimamillata are zoonotic in the tropical and sub-tropical endemic communities of Latin America and Africa. Tungiasis in animals frequently occurs alongside human tungiasis. Currently, most of the attention given to tungiasis is focusing on the human disease, and animal tungiasis is extremely neglected despite its public health and animal health significance. This review highlights recent findings concerning the clinical implications and treatment options but also summarises the occurrence, major features, public health and economic significance of tungiasis in domestic animals. Pigs, dogs, cats and domestic ruminants have been reported to harbour high intensities of sand fleas in endemic communities. High infection intensities cause significant animal morbidity which is often exacerbated by excoriations and secondary bacterial infections which are potentially fatal. In addition to the potential economic losses accruing from tungiasis-related morbidity, infected domestic animals contribute to transmission and persistence of sand fleas and eventually also to severe human disease. Although control of animal tungiasis is possible by adoption of proper husbandry practices, affected communities may not afford the resources required to implement them. Also, there are no widely acceptable and affordable insecticides for treatment of tungiasis in animals. Extension services aiming at increasing awareness on tungiasis and its control should be intensified. Also, available commercial insecticides should be evaluated for therapeutic and prophylactic properties against animal tungiasis.
... The author claimed that lindane was effective but no data was presented to support the statement [51,52]. Topical applications of an oily solution of Trichlorphone 0.2% (Neguvon) applied on embedded sand fleas in dog foot pads was also reported to be tungicidal [53]. Again, no convincing data was provided. ...
Article
Full-text available
Background In endemic communities, zoonotic tungiasis, a severe skin disease caused by penetrating female sand fleas, is a public health hazard causing significant human and animal morbidity. No validated drugs are currently available for treatment of animal tungiasis. Due to the reservoir in domestic animals, integrated management of human and animal tungiasis is required to avert its negative effects. Methods and principal findings A topical aerosol containing chlorfenvinphos 4.8%, dichlorphos 0.75% and gentian violet 0.145% licensed to treat tick infestations, myiasis and wound sepsis in animals in the study area, was tested for its potential tungicidal effects in a randomized controlled field trial against pig tungiasis in rural Uganda. Animals with at least one embedded flea were randomized in a treatment (n = 29) and a control (n = 26) group. One week after treatment, 58.6% of the treated pigs did not show any viable flea lesion whereas all control pigs had at least one viable lesion. After treatment the number of viable lesions (treated median = 0, overall range = 0–18 vs. control median = 11.5, range = 1–180) and the severity score for estimating acute pathology in pig tungiasis (treated median = 1, range = 0–3.5 vs. control median = 7, range = 0–25) were significantly lower in treated than in control pigs (p < 0.001). In the treatment group the median number of viable flea lesions decreased from 8.5 to 0 (p < 0.001). Similarly, the median acute severity score dropped from 6 to 1 (p < 0.001). Every pig in the treatment group showed a decrease in the number of viable fleas and tungiasis-associated acute morbidity while medians for both increased in the control group. Conclusions The study demonstrates that a topical treatment based on chlorfenvinphos, dichlorphos and gentian violet is highly effective against pig tungiasis. Due to its simplicity, the new approach can be used for the treatment of individual animals as well as in mass campaigns.
... Presenta una amplia gama de hospederos selváticos, domésticos y mascotas. Se la ha detectado infestando monos, ratas, ratones, cerdos, vacas, caballos, mulas, ovejas, cabras, perros, gatos, aves de corral y al hombre [18][19][20][21][22] . Suele adquirirse la pulga al caminar descalzo en la tierra arenosa en regiones endémicas de la enfermedad. ...
Article
Full-text available
La tungiasis es una ectoparasitosis cutánea producida por la hembra de la pulga de arena Tunga penetrans, cuya mayor prevalencia ocurre en África Sub-sahariana, Sudamérica y el Caribe. Comunicamos el caso de un chileno de 23 años que viajó a Brasil y que a su regreso presentó lesiones dérmicas sugerentes de tungiasis. El diagnóstico fue confirmado por una biopsia identificando el artrópodo y un huevo en una de las lesiones. Se revisa la historia natural, las co-morbilidades asociadas y alternativas de tratamiento.
... The zoonosis is widespread in resourcepoor urban and rural communities in sub-Saharan Africa, the Carribean region, and South America. 1 Tunga penetrans infests a broad range of sylvatic, domestic, and pet animals, such as monkeys, cows, pigs, goats, cats, and dogs. [2][3][4][5][6][7] In addition, at least in northeastern Brazil, Rattus rattus has been frequently found to be infested. 3 Because of the zoonotic characteristics of this ectoparasitosis, it is difficult to establish the role various animal reservoirs have on human infestation. ...
Article
Full-text available
Tungiasis is a zoonotic ectoparasitosis that causes considerable morbidity in affected populations. The type of microenvironment that facilitates infestation of hosts by Tunga penetrans has not been investigated. In this study, we exposed 30 laboratory-raised Wistar rats, a suitable model for the infestation, at six different places characterized by different microenvironments in a hyperendemic fishing village in northeastern Brazil. During a period of two weeks, the animals were monitored and the number of embedded fleas was documented. The number of lesions varied considerably according to the microenvironment and was highest in a cage placed at the far end of a compound of a household affected by tungiasis. No penetration was observed inside houses. Results indicate that in this endemic area transmission of T. penetrans seems to occur mainly outdoors.
... In the Xavante village and in the Yanomami malocas, T. penetrans life stages were recovered from several resting places of dogs. In these settings, dogs probably act as important 'reservoir' hosts ( Rieschel, 1989;Heukelbach et al., 2003). In an epidemiological study in north-eastern Brazil, between 30.9% and 67.1% of the dogs in impoverished rural and urban communities were found infested with T. penetrans, some of the animals harbouring more than 100 embedded fleas each ( Heukelbach et al., 2003). ...
Article
Full-text available
To explore the local transmission dynamics of Tunga penetrans in brazil, 134 soil samples from various environments were collected in three different endemic regions of the country and checked for the presence of the flea's larvae, pupae and adults. the samples, which came from an urban slum in the north-east, a village of xavante indians in the central-west and a community of yanomami indians living in traditional longhouses (malocas) in the north, were categorized as indoor, outdoor or indoor-outdoor (the latter representing samples collected in the malocas). The proportion of samples found positive for T. penetrans was lowest in the slum (9.3%) and highest in the Yanomami village (32.0%; P=0.01). Soil samples collected below bedsteads or hammocks or from the indoor resting places of dogs were significantly more likely to be positive than the indoor samples collected at other sites (65.0% v. 35.0%; P=0.02). There was no evidence indicating that the presence of T. penetrans in a soil sample was markedly affected by soil temperature, air temperature or air humidity. As no life stages of T. penetrans were found in any outdoor sample, it seems likely that, in resource-poor settings in Brazil, most transmission of T. penetrans occurs indoors. Control measures against the off-host life stages of T. penetrans should therefore be targeted at particular indoor micro-environments.
... The so-called chigoe-or jigger-flea, Tunga penetrans (Linne´1758; syn. Sarcopsylla, Dermatophilis, Rhynchop-rion), is a fascinating example of an arthropod which, having started from an ectoparasitic life-style, has adapted to a peculiar type of endoparasitism for the reproductive phase of its life cycle, which takes place in various domestic, peridomestic and wild animals and in humans (Cooper 1967;Rietschel 1989;Vaz and Rocha 1946). Once the female flea penetrates into the epidermis of its host, a complex sequence of structural and morphological changes is initiated. ...
Article
Full-text available
Tungiasis is an important health problem in poor communities in Brazil and is associated with severe morbidity, particularly in children. The causative agent, the female flea Tunga penetrans, burrows into the skin of its host, where it develops, produces eggs and eventually dies. From the beginning of the penetration to the elimination of the carcass of the ectoparasite by skin repair mechanisms, the whole process takes 4-6 weeks. The present study is based on specimens from 86 patients, for some of whom the exact time of penetration was known. Lesions were photographed, described in detail and biopsied. Biopsies were examined histologically and by means of scanning electron microscopy (SEM). Based on clinical, SEM and histological findings, the "Fortaleza classification" was elaborated. This allows the natural history of tungiasis to be divided into five stages: (1) the penetration phase, (2) the phase of beginning hypertrophy, (3) the white halo phase, (4) the involution phase and (5) residues in the host's skin. Based on morphological and functional criteria, stages 3 and 4 are divided into further substages. The proposed Fortaleza classification can be used for clinical and epidemiological purposes. It allows a more precise diagnosis, enables the assessment of chemotherapeutic approaches and helps to evaluate control measures at the community level.
... T. penetrans infests a broad range of sylvatic and domestic animals (Cooper 1967;Heukelbach et al. 2004;Rietschel 1989). In urban northeast Brazil, rats (Rattus rattus) are an important reservoir (Heukelbach et al. 2004). ...
Article
Full-text available
In Brazil tungiasis is endemic in many resource-poor communities, where various domestic and sylvatic animals act as reservoirs for this zoonosis. To determine the role of animal reservoirs in human tungiasis, a cross-sectional study was performed in a traditional fishing community in northeast Brazil. The human and the animal populations were examined for the presence of embedded sand fleas and the prevalence and the intensity of infestation were correlated. The overall prevalence of tungiasis in humans was 39% (95% CI 34-43%). Of six mammal species present in the village, only cats and dogs were found infested. The prevalence in these animals was 59% (95% CI 50-68%). In households, where infested pet animals were present, a higher percentage of household members had tungiasis (42% [95% CI 30-53%] versus 27% [20-33%], p=0.02), and the intensity of the infestation was higher (six lesions versus two lesions, p=0.01). The intensity of infestation in animals correlated with the intensity of infestation in humans (rho=0.3, p=0.02). Living in a household with an infested dog or cat led to a 1.6-fold (95% CI 1.1-2.3, p=0.015) increase in the odds for the presence of tungiasis in household members in the bivariate analysis and remained a significant risk factor in the multivariate regression analysis. The study shows that in this impoverished community tungiasis is highly prevalent in humans and domestic animals. In particular, it underlines the importance to include animals in control operation aiming at the reduction of disease occurrence in the human population.
Article
The parasitosis caused by Tunga penetrans is an important public health problem in Cameroon, even if there are only few reports of its presence in the country. With the aim to know the prevalence of this parasitosis in man, the season of infestation, the Province with higher infestation rate and the age group more infested, a first questionnaire have been done on 233 persons. After that, two investigations were carried out on the west Province that was recorded as the place with higher prevalence. In the first one, 537 pupils of the primary school were inspected, in the second one 384 swine were inspected in the piggeries and slaughterhouses. The first questionnaire showed that the 69,9 % of inter-viewers were infested almost one time in their life by T penetrans always during the dry season, with the major prevalence in the West Province where many piggeries are present. The investigation carried out on pupils, revealed that 49,2 % had T. penetrans lesions, while from the swine investigation 57,5 % of the animals were infested. Tungiasis results frequent in Cameroon, affecting specially people aged 5 to 12 years in the localities where the parasite is present in swine and where these animals are left wandering near houses.
Article
Tungiasis (sand flea disease) is caused by the penetration of females of Tunga penetrans into the skin of the feet. Within 2 weeks of penetration the burrowed flea increases its volume by a factor of 2,000. This is paralleled by intense inflammation of the surrounding tissue. Acute and chronic inflammation leads to the development of painful and debilitating clinical pathology. This results in impaired physical fitness and mobility. The social implications of tungiasis-associated morbidity are multifold. Children with tungiasis are teased and ridiculed, adults feel ashamed and stigmatized. There is anecdotal evidence that tungiasis negatively affects educational achievements. Impaired mobility and physical fitness will have a negative impact on household economics. Sand flea disease is common in resource-poor communities in South America and in sub-Saharan Africa with prevalence in the general population of up to 60%. In East Africa, it has re-emerged in epidemic dimensions in recent years. Hitherto, no effective drug treatment has been at hand. Traditional treatment, i.e., the manipulation of burrowed sand fleas with blunt and inappropriate instruments may facilitate the transmission of blood-derived pathogens. Prevention is feasible through regular application of a repellent based on coconut oil. Owing to its strong association with poverty, sand flea disease would be an excellent starting point for a community-based fight against rural poverty.
Article
Full-text available
Tungiasis is a zoonosis caused by Tunga penetrans. In Brazil, tungiasis is endemic in many resource-poor communities, in which various domestic and sylvatic animals act as reservoirs. Eighty laboratory-raised Wistar rats were exposed to T. penetrans in areas of intense transmission: a fishing village and an urban shantytown in Ceará State, northeast Brazil. The topographic distribution of lesions in Wistar rats was compared with the distribution of lesions in humans in the same area. Our results show that the topographic distribution of embedded sand fleas was almost identical in Wistar rats and humans and that lesions were confined to the feet. In humans, 76% of all lesions were located periungually, whereas in Wistar rats, 67% of lesions were located at the distal end of the digits (P = 0.73). Both had the majority of lesions at the toes and digits: 70.2% versus 65.7% (P = 0.79). The Wistar rat model mirrors human tungiasis in topographic distribution.
Article
Tungiasis is a parasitic disease of humans and animals caused by fleas (Siphonaptera) belonging to the genus Tunga. Two species, Tunga penetrans (L.) and Tunga trimamillata, out of 10 described to date, are known to affect man or domestic animals; the other eight are exclusive to a few species of wild mammals. Tunga penetrans and T. trimamillata originated from Latin America, although the first species is also found in sub-Saharan Africa (between 20 degrees N and 25 degrees S). Hundreds of millions of people are at risk of infection in more than 70 nations, mostly in developing countries. The second species has been reported only in Ecuador and Peru. Males and non-fertilized females of Tunga are haematophagous ectoparasites; pregnant females penetrate the skin where, following dilatation of the abdomen, they increase enormously in size (neosomy) and cause inflammatory and ulcerative processes of varying severity. The importance of Tunga infection in humans concerns its frequent localization in the foot, which sometimes causes very serious difficulty in walking, thereby reducing the subject's ability to work and necessitating medical and surgical intervention. Tungiasis in domestic animals can be responsible for economic losses resulting from flea-induced lesions and secondary infections. Because tungiasis represents a serious problem for tropical public health and because of the recent description of a new species (Tunga trimamillata), it seems appropriate to review current knowledge of the morphology, molecular taxonomy, epidemiology, pathology, treatment and control of sand fleas of the genus Tunga.
Article
Tungiasis is a cutaneous ectoparasitosis caused by the female sand flea Tunga penetrans whose higher prevalence occurs in Sub-Saharan Africa, South América and the Caribbean. We report a case of a 23 year old chilean male who presented dermal lesions suggestive of tungiasis on his return from Brazil. The diagnosis was confirmed by biopsy, identifying the arthropod and an egg from one of the lesions. The natural history, co-morbidities and treatment options were reviewed.
Article
A case is described of Tunga penetrans infection in the feet of a tourist returning from South America to Scotland. The condition had initially mimicked verrucae vulgaris, but microscopic examination of the lesions together with the travel history allowed the diagnosis of tungiasis to be made. This is the first case reported in Scotland.
Article
Full-text available
This paper describes patterns of infestation with Tunga penetrans (L., 1758) within the poor community of Araruama municipality, State of Rio de Janeiro, Brazil, assessed by the number of persons and domestic animals parasitized. The overall prevalence of infestation was 49.2% (211 parasitized hosts) of the 429 examined. Humans (p < 0.01) and dogs (p < 0.01) were the most important hosts with 62.6% and 35.6% respectively. Dogs were considered as the potential infestation source to humans. Considering sex and age groups, both measures showed a significant difference (p < 0.01): female (62.2% infested of 143 examined) and male (43.9% infested of 98 examined). All age classes were found infested with significant difference (G = 42.5; p < 0.01) and most of the infestation occurred in children in the 0-9-year old category (27.3%). In contrast and based on mean of chigoe burden per person, the parasitic intensity was significantly higher on male than on female in all age categories, except for the 50+ (H = 27.1; p < 0.01) and decreasing with the increase of age (chi2 = 69.7, A = -124.6, p < 0.01). Growing urbanization, improved housing and sewage systems, use of appropriate footwear, examination of the feet principally in young children, antitetanus prophylaxis and reduction of stray dogs population are the major prophylactic methods recommended.
Article
Full-text available
Tungiasis is caused by the penetration of the female sand flea Tunga penetrans into the epidermis of its host. Human infestation with this ectoparasite is hyper-endemic in many resource-poor communities in sub-Saharan Africa, the Caribbean and South America and is associated with considerable morbidity. Currently, there is no effective drug available to treat tungiasis (or at least none for which a parasiticidal effect has been clearly demonstrated). In an attempt to fill this gap, the effects of treatment with topical ivermectin (lotion), thiabendazole (ointment and lotion), metrifonate (lotion) or placebo lotion were compared in a randomized trial. A total of 108 subjects with 169 tungiasis-infested feet participated in the study. The results show that topical ivermectin, metrifonate or thiabendazole can each significantly reduce the number of lesions caused by embedded sand fleas. Further studies are needed to optimise the doses and administration of these compounds.
Article
Tungiasis is a zoonotic ectoparasitosis caused by the sand flea Tunga penetrans L. (Siphonaptera: Tungidae). This disease is hyperendemic in poor communities of north-east Brazil, causing considerable morbidity in affected human populations, but the animal reservoirs have not been investigated previously in Brazil. To assess the prevalence and intensity of T. penetrans infection in domestic and peri-domestic animals, as well as in the human population, we surveyed two typical communities of north-east Brazil: an urban slum and a traditional fishing village. In the slum we examined 849 humans, 121 cats, 82 dogs, 2 pigs, 2 rabbits, 1 monkey and 56 rodents, comprising 34 rats (Rattus rattus L.) and 22 mice (Mus domesticus L). In the fishing village we examined 505 humans, 68 dogs, 37 cats, 7 donkeys, 4 cattle, 3 pigs and 1 monkey. Tungiasis was common among dogs and cats of both communities, with respective prevalence rates of 67.1% (95% CI: 55.8-77.1) and 30.9% (95% CI: 20.2-43.3) in dogs, 49.6% (95% CI: 40.4-58.8) and 32.4% (95% CI: 18.0-49.8) in cats. Slum rats were 41.2% (95% CI: 24.6-59.3) infested, but the other animals were not. Human prevalence rates were 54.4% (95% CI: 51.0-57.8) in the slum and 52.1% (95% CI: 47.6-56.5) in the fishing village. High prevalence rates (range 31-67%) of tungiasis in humans, pets and rats (but apparently not other animals) indicate the need for an eco-epidemiological approach to control of this anthropo-zoonotic problem.
Article
The parasitic skin disease tungiasis occurs in many resource-poor communities in Latin America, the Caribbean and sub-Saharan Africa. The sand flea, Tunga penetrans, most commonly penetrates into the skin of the feet. Many individuals harbor a large number of embedded parasites and show significant morbidity. Standard treatment consists of surgical extraction of the flea and application of a topical antibiotic. There are no drugs available with proven effectiveness. Clinical trials performed in the last few years did not show very promising results. Thus, surgical extraction still remains the treatment of choice in patients with a low parasite load, such as tourists returning from endemic areas. Probably the best approach to reduce tungiasis-associated morbidity in heavily affected individuals is the application of a repellent to prevent the penetration of sand fleas. In the future, we should see new exciting data on the biology, epidemiology, therapy and control of tungiasis.
Article
Full-text available
Tungiasis is a neglected parasitic skin disease caused by the permanent penetration of the female sand flea (also called jigger flea) Tunga penetrans into the skin of its host. After penetration, most commonly on the feet, the flea undergoes an impressing hypertrophy, and some days later the abdominal segments of the flea have enlarged up to the size of about 1 cm. The flea infestation is associated with poverty and occurs in many resource-poor communities in the Caribbean, South America and Africa. In this review, a historical overview on tungiasis is given. The natural history, pathology, epidemiology, diagnosis, therapy and control of the parasitic skin disease are discussed. It is concluded that tungiasis is an important parasitosis causing considerable morbidity in affected populations. Future studies are needed to increase the knowledge on the biology, pathophysiology, epidemiology, therapy and control of the ectoparasite.
Article
Tungiasis is a parasitic and zoonotic skin disease caused by the sand flea Tunga penetrans-also called the jigger flea, which burrows into human skin, usually on the feet. The ectoparasitosis occurs in many economically depressed communities in the Caribbean, South America and Africa, and affects sporadically travellers to endemic areas. Usually, only one or two lesions are found in travellers, whereas the local populations commonly harbour dozens, sometimes even hundreds of lesions, associated with severe morbidity. We review case reports of tungiasis in returned travellers in terms of history, epidemiological and clinical aspects, and the importance of the ectoparasitosis for travel medicine is discussed. It is concluded that tungiasis is more than merely an exotic nuisance, since it is an important health problem in endemic areas. Untrained dermatologists can diagnose and treat tungiasis properly; fleas should be extracted as early as possible to avoid secondary infections.
Article
Full-text available
Tungiasis is endemic in many countries in Latin America, the Caribbean and sub-Saharan Africa, and it is associated with severe morbidity. The pathophysiological and immunological characteristics of the ectoparasitosis are not well understood, and no effective therapy is currently available. The aim of this study was to describe the natural history of tungiasis in laboratory-raised Wistar rats. The rats were exposed in the laboratory to the parasite or were kept in a natural environment with an intense transmission of Tunga penetrans. The time course of the infestation was determined, and lesions were photographed, described clinically in detail and biopsied. Biopsies were examined histopathologically and by light and scanning electron microscopy. Based on these findings, the natural history of tungiasis in Wistar rats was described and divided in five stages. Our data show that the natural history of tungiasis in Wistar rats and humans is almost identical, except that in the animals, the basement membrane disrupts 5 days after penetration and provokes an intense infiltration of the dermis, while in humans, the basement membrane remains intact. The study indicates that the Wistar rat is an appropriate model for the study of clinical and pathological aspects of tungiasis. Using this model should enable a better understanding of the pathophysiology and immunology of the ectoparasitosis.
Article
Full-text available
The parasitic skin disease tungiasis (caused by the flea Tunga penetrans) affects resource-poor communities in Latin America, the Caribbean and sub-Saharan Africa. Prevalences in endemic areas are high, and severe pathology occurs commonly. However, risk factors for infestation have never been assessed in Africa. A cross-sectional study was conducted in Erekiti, a rural community in Lagos State (Nigeria), where tungiasis is endemic. Individuals were examined clinically for the presence of tungiasis, and a questionnaire was applied. Data from 643 individuals (86.6% of the target population) were analyzed; 252 (42.5%) were infested with T. penetrans. In the multivariate logistic regression analysis, presence of pigs on the compounds (adjusted odds ratio = 17.98; 95% confidence interval: 5.55-58.23), sand or clay floor inside houses (9.33; 5.06-17.19), and having the common resting place outside the house (7.14; 4.0-14.29) were the most important risk factors identified. The regular use of closed footwear (0.34; 0.18-0.62) and the use of insecticides indoors (0.2; 0.05-0.83) were protective against infestation. The population attributable fractions associated with tungiasis were: sand or clay floor inside the house (73.7%), resting usually outside the house (65.5%), no regular use of closed footwear (51.1%), and pigs on the compound (37.9%). The presence of tungiasis in Erekiti is determined to an important extent by a limited number of modifiable variables. Effective and sustainable intervention measures addressing these factors need to be implemented in this and other West African communities with high disease burden.
ResearchGate has not been able to resolve any references for this publication.