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Hermann Feldmeier - One of the best experts on this subject based on the ideXlab platform.
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Control of Tungiasis through Intermittent Application of a Plant-Based Repellent: An Intervention Study in a Resource-Poor Community in Brazil
2013Co-Authors: John Buckendahl, Jorg Heukelbach, Liana Ariza, Judith Dorothea Kehr, Martin Seidenschwang, Hermann FeldmeierAbstract:Background: Tungiasis, an Ectoparasitosis caused by the female sand flea Tunga penetrans, is an important health problem in many impoverished communities in the tropics. Sand flea disease is associated with a broad spectrum of clinical pathology and severe sequels are frequent. Treatment options are limited. Methodology/Principal Findings: We assessed the effectiveness of the intermittent application of the plant-based repellent Zanzarin to reduce infestation intensity and tungiasis-associated morbidity in a resource-poor community in Brazil, characterized by a very high attack rate. The study population was randomized into three cohorts. Initially, during a period of four weeks, the repellent was applied twice daily to the feet of all cohort members. This reduced the number of embedded sandfleas to 0 in 98 % of the participants. Thereafter members of cohort A applied the repellent every second week twice daily for one week, members of cohort B every fourth week for one week, and members of cohort C served as controls. Infestation intensity and tungiasis-associated morbidity were monitored during five months. The intermittent application of Zanzarin for one week every second week significantly reduced infestation intensity from a median 4 lesions (IQR 1–9) during the whole transmission season. In contrast, in cohort B (application of the repellent every fourth week) the infestation intensity remained twice as high (median 8 lesions, IQR 9–16; p = 0.0035), and in the control cohort C 3.5 times as high (median 14 lesions; IQR 7–26; p = 0.004 during the transmission season). Tungiasis-related acute pathology remaine
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Communities: Case Series
2013Co-Authors: Severe Tungiasis In Underprivileged, Margit Eisele, Hermann Feldmeier, Rômulo César Sabóia-moura, Jorg HeukelbachAbstract:Tungiasis is caused by infestation with the sand flea (Tunga penetrans). This Ectoparasitosis is endemic in economically depressed communities in South American and African countries. Tungiasis is usually considered an entomologic nuisance and does not receive much attention from healthcare professionals. During a study on tungiasisrelated disease in an economically depressed area in Fortaleza, northeast Brazil, we identified 16 persons infested with an extremely high number of parasites. These patients had>50 lesions each and showed signs of intense acute and chronic inflammation. Superinfection of the lesions had led to pustule formation, suppuration, and ulceration. Debilitating sequelae, such as loss of nails and difficulty in walking, were constant. In economically depressed urban neighborhoods characterized by a high transmission potential, poor housing conditions, social neglect, and inadequate healthcare behavior, tungiasis may develop into severe disease. Tungiasis is a common, but neglected, health problem in economically depressed communities in South American and sub-Saharan African countries (1–5). This Ectoparasitosis is caused by the sand flea (Tunga penetrans, Siphonaptera: Tungidae, Tunginae), also called the jigger flea. The female jigger flea penetrates into the skin of its host, undergoes a peculiar hypertrophy, expels several hundred eggs for a period of <3 weeks, and eventually dies. The shriveled carcass is then sloughed from the epidermis by host repair mechanisms (6,7). Within 10 days, the flea increases its volume by a factor of approximately 2,000, finally reaching the size of a pea. Through its hindquarters, which serve for breathing, defecating, and expulsing eggs, the flea remains in contact with the air, leaving a sore (240–500 µm) in the skin; the sore is an entry point for pathogenic microorganisms (8). The preferred localization for jiggers is the periungual region of the toes, but lesions may occur on any part of the body (9). Tungiasis, a zoonosis, affects a broad range of domestic and peridomestic animals, such as dogs, cats, pigs, an
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Investigations on the biology, epidemiology, pathology and control of Tunga penetrans in Brazil. VI. Natural history of the infestation in laboratory-raised Wistar rats
Parasitology Research, 2007Co-Authors: Hermann Feldmeier, Lars Witt, Raphael A. C. Capaz, Oliver Meckes, Stefan Schwalfenberg, Pedro Marcos Linardi, Ronaldo A. Ribeiro, Eric Van Marck, Heinz Mehlhorn, Norbert MenckeAbstract: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.
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INFESTATION OF WISTAR RATS WITH TUNGA PENETRANS IN DIFFERENT MICROENVIRONMENTS
The American journal of tropical medicine and hygiene, 2007Co-Authors: Lars Witt, Stefan Schwalfenberg, Ronaldo A. Ribeiro, Jorg Heukelbach, Gundel Harms, Hermann FeldmeierAbstract: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.
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Identifying risk factors for tungiasis and heavy infestation in a resource-poor community in northeast Brazil.
Transactions of The Royal Society of Tropical Medicine and Hygiene, 2005Co-Authors: Marion Muehlen, Thomas Wilcke, Benedikt Winter, Hermann Feldmeier, Jorg HeukelbachAbstract:Summary Tungiasis is a neglected parasitic skin disease caused by penetration of female sand fleas into the epidermis. The Ectoparasitosis is widespread in resource-poor communities in South America, the Caribbean and sub-Saharan Africa. To identify risk factors for the presence of sand fleas and severe infestation in an endemic community, we examined the entire population of a traditional fishing village for the presence of embedded sand fleas and determined the number and type of lesions. Demographic, behavioural and environmental characteristics of the population were assessed using a structured questionnaire. Multivariable analysis showed that both occurrence of tungiasis and heavy infestation were significantly related to poor housing conditions (odds ratio [OR] = 4.7, 95% CI 1.4–15.8), lack of health education (OR = 4.1, 95% CI 2.0–8.6) and presence of animals on the compound (OR = 1.9, 95% CI 1.1–3.4). Contrary to common belief, a protective effect of frequent use of closed footwear could not be demonstrated. Based on the population attributable fractions calculated for the major risk factors identified, we conclude that several low-cost interventions would have a considerable impact on the occurrence of tungiasis and heavy infestation.
Jorg Heukelbach - One of the best experts on this subject based on the ideXlab platform.
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Control of Tungiasis through Intermittent Application of a Plant-Based Repellent: An Intervention Study in a Resource-Poor Community in Brazil
2013Co-Authors: John Buckendahl, Jorg Heukelbach, Liana Ariza, Judith Dorothea Kehr, Martin Seidenschwang, Hermann FeldmeierAbstract:Background: Tungiasis, an Ectoparasitosis caused by the female sand flea Tunga penetrans, is an important health problem in many impoverished communities in the tropics. Sand flea disease is associated with a broad spectrum of clinical pathology and severe sequels are frequent. Treatment options are limited. Methodology/Principal Findings: We assessed the effectiveness of the intermittent application of the plant-based repellent Zanzarin to reduce infestation intensity and tungiasis-associated morbidity in a resource-poor community in Brazil, characterized by a very high attack rate. The study population was randomized into three cohorts. Initially, during a period of four weeks, the repellent was applied twice daily to the feet of all cohort members. This reduced the number of embedded sandfleas to 0 in 98 % of the participants. Thereafter members of cohort A applied the repellent every second week twice daily for one week, members of cohort B every fourth week for one week, and members of cohort C served as controls. Infestation intensity and tungiasis-associated morbidity were monitored during five months. The intermittent application of Zanzarin for one week every second week significantly reduced infestation intensity from a median 4 lesions (IQR 1–9) during the whole transmission season. In contrast, in cohort B (application of the repellent every fourth week) the infestation intensity remained twice as high (median 8 lesions, IQR 9–16; p = 0.0035), and in the control cohort C 3.5 times as high (median 14 lesions; IQR 7–26; p = 0.004 during the transmission season). Tungiasis-related acute pathology remaine
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Communities: Case Series
2013Co-Authors: Severe Tungiasis In Underprivileged, Margit Eisele, Hermann Feldmeier, Rômulo César Sabóia-moura, Jorg HeukelbachAbstract:Tungiasis is caused by infestation with the sand flea (Tunga penetrans). This Ectoparasitosis is endemic in economically depressed communities in South American and African countries. Tungiasis is usually considered an entomologic nuisance and does not receive much attention from healthcare professionals. During a study on tungiasisrelated disease in an economically depressed area in Fortaleza, northeast Brazil, we identified 16 persons infested with an extremely high number of parasites. These patients had>50 lesions each and showed signs of intense acute and chronic inflammation. Superinfection of the lesions had led to pustule formation, suppuration, and ulceration. Debilitating sequelae, such as loss of nails and difficulty in walking, were constant. In economically depressed urban neighborhoods characterized by a high transmission potential, poor housing conditions, social neglect, and inadequate healthcare behavior, tungiasis may develop into severe disease. Tungiasis is a common, but neglected, health problem in economically depressed communities in South American and sub-Saharan African countries (1–5). This Ectoparasitosis is caused by the sand flea (Tunga penetrans, Siphonaptera: Tungidae, Tunginae), also called the jigger flea. The female jigger flea penetrates into the skin of its host, undergoes a peculiar hypertrophy, expels several hundred eggs for a period of <3 weeks, and eventually dies. The shriveled carcass is then sloughed from the epidermis by host repair mechanisms (6,7). Within 10 days, the flea increases its volume by a factor of approximately 2,000, finally reaching the size of a pea. Through its hindquarters, which serve for breathing, defecating, and expulsing eggs, the flea remains in contact with the air, leaving a sore (240–500 µm) in the skin; the sore is an entry point for pathogenic microorganisms (8). The preferred localization for jiggers is the periungual region of the toes, but lesions may occur on any part of the body (9). Tungiasis, a zoonosis, affects a broad range of domestic and peridomestic animals, such as dogs, cats, pigs, an
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Severe tungiasis in northwest Tanzania: a case series
PAGEPress Publications, 2011Co-Authors: Humphrey D. Mazigo, Emmanuel Bahemana, Ocimund Dyegura, Ladslaus L. Mnyone, Eliningaya J. Kweka, Maria Zinga, Eveline T. Konje, Rebecca Waihenyakeni, Jorg HeukelbachAbstract:Tungiasis is caused by infestation with the sand flea (Tunga penetrans). This Ectoparasitosis is endemic in economically depressed communities in South American and African countries. However, data on the epidemiology of tungiasis in Tanzania are very limited and the disease does not receive much attention from health care professionals. During a community cross sectional survey in northwest Tanzania, we identified five individuals extremely infested with high number of parasites. A total of 435 lesions were recorded with patients presenting with >75 lesions and showed signs of intense acute and chronic inflammation. Superinfection of the lesions characterized by pustule formation, suppuration and ulceration were common. Loss of nails and walking difficulty was also observed. In Tanzanian communities living under extreme poverty characterized by poor housing condition and inadequate health services, tungiasis may cause severe morbidities. Further studies on risk factors and disease-related behavior of affected populations are needed to design adequate control measures
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INFESTATION OF WISTAR RATS WITH TUNGA PENETRANS IN DIFFERENT MICROENVIRONMENTS
The American journal of tropical medicine and hygiene, 2007Co-Authors: Lars Witt, Stefan Schwalfenberg, Ronaldo A. Ribeiro, Jorg Heukelbach, Gundel Harms, Hermann FeldmeierAbstract: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.
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Identifying risk factors for tungiasis and heavy infestation in a resource-poor community in northeast Brazil.
Transactions of The Royal Society of Tropical Medicine and Hygiene, 2005Co-Authors: Marion Muehlen, Thomas Wilcke, Benedikt Winter, Hermann Feldmeier, Jorg HeukelbachAbstract:Summary Tungiasis is a neglected parasitic skin disease caused by penetration of female sand fleas into the epidermis. The Ectoparasitosis is widespread in resource-poor communities in South America, the Caribbean and sub-Saharan Africa. To identify risk factors for the presence of sand fleas and severe infestation in an endemic community, we examined the entire population of a traditional fishing village for the presence of embedded sand fleas and determined the number and type of lesions. Demographic, behavioural and environmental characteristics of the population were assessed using a structured questionnaire. Multivariable analysis showed that both occurrence of tungiasis and heavy infestation were significantly related to poor housing conditions (odds ratio [OR] = 4.7, 95% CI 1.4–15.8), lack of health education (OR = 4.1, 95% CI 2.0–8.6) and presence of animals on the compound (OR = 1.9, 95% CI 1.1–3.4). Contrary to common belief, a protective effect of frequent use of closed footwear could not be demonstrated. Based on the population attributable fractions calculated for the major risk factors identified, we conclude that several low-cost interventions would have a considerable impact on the occurrence of tungiasis and heavy infestation.
Facultad De Ciencias Veterinarias - One of the best experts on this subject based on the ideXlab platform.
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Zoonosis parasitarias en el barrio El Molino : Los caninos como bioindicadores de infecciones reemergentes
2020Co-Authors: Facultad De Ciencias VeterinariasAbstract:El área motivo de estudio posee características ecoepidemiológicas riesgosas para la salud humana, animal y ambiental. El ambiente ribereño, la población precarizada, con conductas higiénico-sanitarias inadecuadas favorecen la transmisión de enfermedades. El grupo de trabajo viene realizando tareas en el lugar, ininterrumpidamente desde el año 2005. Por tal motivo se cuenta con la apertura de la comunidad, así como una excelente comunicación mas allá de la temática abordada en el marco de los proyectos. Se observa una elevada prevalencia de enteroparasitosis en humanos y caninos, dioctofimosis canina y Ectoparasitosis zoonóticas, así como casos aislados de Leptospirosis, Brucelosis, Dirofilariosis y Tumor de Sticker. Los pobladores no cuentan con recursos para trasladarse hasta centros asistenciales. Mediante tareas dirigidas a distintos grupos comunitarios a través de personas con efecto multiplicador, nos proponemos modificar de manera sustentable la situación epidemiológica actual. Acciones concretas como talleres de salud bucodental, biología, parasitología, tenencia responsable, mascotismo, diagnósticos, tratamientos, esterilizaciones, nefrectomías y visitas a las facultades, redundarán en el logro de los objetivos. Como producto se ilustrarán tres cuentos sobre la problemática ambiental dirigidos a los mas pequeños.Línea temática: Salud Integral y ComunitariaConvocatoria: Convocatoria Ordinaria 2018Facultad de Ciencias VeterinariasFacultad de Ciencias ExactasFacultad de Ciencias Naturales y MuseoFacultad de Bellas ArtesFacultad de OdontologíaFacultad de Ciencias Agrarias y ForestalesFacultad de Periodismo y Comunicación Socia
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Zoonosis parasitarias en el barrio El Molino : Los caninos como bioindicadores de infecciones reemergentes bajo el concepto "un mundo, una salud"
2020Co-Authors: Facultad De Ciencias VeterinariasAbstract:El área motivo de estudio posee características ecoepidemiológicas riesgosas para la salud humana, animal y ambiental. El ambiente ribereño, la población precarizada, con conductas higiénico-sanitarias inadecuadas favorecen la transmisión de enfermedades. El grupo de trabajo viene realizando tareas en el lugar, ininterrumpidamente desde el año 2005. Por tal motivo se cuenta con la apertura de la comunidad, así como una excelente comunicación mas allá de la temática abordada en el marco de los proyectos. Se observó una elevada prevalencia de enteroparasitosis en humanos y caninos, dioctofimosis canina y Ectoparasitosis zoonóticas, así como casos aislados de Leptospirosis, Brucelosis, Dirofilariosis y Tumor de Sticker. Los pobladores no cuentan con recursos para trasladarse hasta centros asistenciales. Mediante tareas dirigidas a distintos grupos comunitarios a través de personas con efecto multiplicador, nos proponemos modificar de manera sustentable la situación epidemiológica actual. Acciones concretas como educación para la salud, diagnósticos, tratamientos, esterilizaciones, desratización y fumigación, redundarán en el logro de los objetivos. Se motivará y dará participación a pobladores interesados, con el fin de generar el necesario cambio de actitudes, e incorporación de aptitudes que otorguen sostenibilidad al trabajo. Como producto se desarrollará un cuento ilustrado sobre la problemática dirigido a los mas pequeños.Línea temática: Salud Integral y ComunitariaConvocatoria: Convocatoria Ordinaria 2016Facultad de Ciencias VeterinariasFacultad de Ciencias Agrarias y ForestalesFacultad de Ciencias ExactasFacultad de Ciencias Naturales y MuseoFacultad de Bellas ArtesFacultad de Odontologí
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Capacitación y acciones sobre enfermedades transmisibles : Propuestas para la mitigación de sus efectos y disminución de su dispersión
2015Co-Authors: Facultad De Ciencias VeterinariasAbstract:El área motivo de estudio posee características ecoepidemiológicas riesgosas para la salud humana y animal. El ambiente ribereño, la población precarizada, con conductas higiénico-sanitarias inadecuadas favorecen la transmisión de enfermedades. El grupo de trabajo viene realizando tareas en el lugar, ininterrumpidamente desde el año 2005. Por tal motivo se cuenta con la apertura de la comunidad, así como una excelente comunicación mas allá de la temática abordada en el marco de los proyectos. Se observó una elevada prevalencia de enteroparasitosis en humanos y caninos, dioctofimosis canina y Ectoparasitosis zoonóticas, así como casos aislados de Leptospirosis, Brucelosis, Dirofilariosis y Tumor de Sticker. Los pobladores no cuentan con recursos para trasladarse hasta centros asistenciales. Mediante tareas dirigidas a distintos grupos comunitarios a través de personas con efecto multiplicador, nos proponemos modificar de manera sustentable la situación epidemiológica actual. Acciones concretas como educación para la salud, diagnósticos, tratamientos, esterilizaciones, desratización y fumigación, redundarán en el logro de los objetivos. Se motivará y dará participación a pobladores interesados, con el fin de generar el necesario cambio de actitudes, e incorporación de aptitudes que otorguen sostenibilidad al trabajo. Como producto se desarrollará un video sobre la problemática dirigido a los mas pequeños.Línea temática: SaludConvocatoria: Convocatoria 2015Facultad de Ciencias VeterinariasFacultad de Ciencias Agrarias y ForestalesFacultad de Ciencias Naturales y MuseoFacultad de Bellas ArtesFacultad de OdontologíaFacultad de Ciencias Exacta
Heinz Mehlhorn - One of the best experts on this subject based on the ideXlab platform.
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Investigations on the biology, epidemiology, pathology and control of Tunga penetrans in Brazil. VI. Natural history of the infestation in laboratory-raised Wistar rats
Parasitology Research, 2007Co-Authors: Hermann Feldmeier, Lars Witt, Raphael A. C. Capaz, Oliver Meckes, Stefan Schwalfenberg, Pedro Marcos Linardi, Ronaldo A. Ribeiro, Eric Van Marck, Heinz Mehlhorn, Norbert MenckeAbstract: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.
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Investigations on the biology, epidemiology, pathology and control of Tunga penetrans in Brazil: IV. Clinical and histopathology
Parasitology Research, 2004Co-Authors: Hermann Feldmeier, Margit Eisele, Ronaldo Ribeiro, Eric Van Marck, Heinz Mehlhorn, Jorg HeukelbachAbstract:Tungiasis is a parasitic skin disease caused by the sand flea Tunga penetrans . This Ectoparasitosis is endemic in South America, the Caribbean and sub-Saharan Africa, where it is an important but neglected health problem in resource-poor communities. As part of a study on tungiasis-related morbidity in a typical slum in Fortaleza, Brazil, we identified 86 individuals with tungiasis. Lesions were counted, classified according to the stage of development, and clinical pathology was documented. One hundred and nine lesions were biopsied and examined by histological sectioning. The patients had between 1 and 145 lesions (median 14.5), the majority occurring in clusters. In all, 77% of patients reported severe pain at the site of the lesion, and 52% had one or more nails lost or severely deformed. Intense inflammation and/or fissures hindered 45% of the patients from walking normally. Signs of superinfection were observed in 29%, and signs of generalised inflammation in 2% of patients. Clinical pathology was significantly related to the number of lesions, and the total number of parasites present correlated with the number of fleas occurring in clusters. Clinical pathology was frequently accompanied by a pathological alteration of the epidermis (predominantly hyperplasia, parakeratosis, hyperkeratosis, and spongiosis) and the dermis. Tungiasis causes a broad spectrum of clinical and histopathological alterations, and is a serious health threat in a typical, impoverished community in northeast Brazil. The clinical pathology is closely related to the parasite burden of an individual and the clustering of embedded fleas at certain predilection sites.
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investigations on the biology epidemiology pathology and control of tunga penetrans in brazil ii prevalence parasite load and topographic distribution of lesions in the population of a traditional fishing village
Parasitology Research, 2003Co-Authors: Marion Muehlen, Thomas Wilcke, Benedikt Winter, Jorg Heukelbach, Heinz Mehlhorn, Hermann FeldmeierAbstract:Tungiasis is hyperendemic in many poor communities in Brazil and is associated with considerable morbidity. In order to understand the factors that determine the distribution of this Ectoparasitosis in a rural community, an epidemiological study was carried out in a traditional fishing village in Ceara State, north-eastern Brazil. Based on active case detection and voluntary participation, 91% of the population (belonging to 95% of all families) was examined. Embedded fleas were looked for over all parts of the body, counted, and the lesions were staged. The overall prevalence of infestation was 51.3% (95% CI: 47.0–55.5). More males than females were infested (54.8% vs 48.3%); however, this difference was not statistically significant. Age-specific prevalence rates followed an S-shaped curve with peaks in children aged 5–9 years and people elder than 60 years. The parasite burden was high (range 1–145 lesions; arithmetic mean: 8.9) and particularly elevated in males, children 30 lesions) accounted for 1,366 of the 2,493 lesions (54.8%) documented. The study shows that tungiasis is a highly prevalent Ectoparasitosis in this deprived community with a peculiar distribution of prevalence and parasite burden.
Margit Eisele - One of the best experts on this subject based on the ideXlab platform.
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Communities: Case Series
2013Co-Authors: Severe Tungiasis In Underprivileged, Margit Eisele, Hermann Feldmeier, Rômulo César Sabóia-moura, Jorg HeukelbachAbstract:Tungiasis is caused by infestation with the sand flea (Tunga penetrans). This Ectoparasitosis is endemic in economically depressed communities in South American and African countries. Tungiasis is usually considered an entomologic nuisance and does not receive much attention from healthcare professionals. During a study on tungiasisrelated disease in an economically depressed area in Fortaleza, northeast Brazil, we identified 16 persons infested with an extremely high number of parasites. These patients had>50 lesions each and showed signs of intense acute and chronic inflammation. Superinfection of the lesions had led to pustule formation, suppuration, and ulceration. Debilitating sequelae, such as loss of nails and difficulty in walking, were constant. In economically depressed urban neighborhoods characterized by a high transmission potential, poor housing conditions, social neglect, and inadequate healthcare behavior, tungiasis may develop into severe disease. Tungiasis is a common, but neglected, health problem in economically depressed communities in South American and sub-Saharan African countries (1–5). This Ectoparasitosis is caused by the sand flea (Tunga penetrans, Siphonaptera: Tungidae, Tunginae), also called the jigger flea. The female jigger flea penetrates into the skin of its host, undergoes a peculiar hypertrophy, expels several hundred eggs for a period of <3 weeks, and eventually dies. The shriveled carcass is then sloughed from the epidermis by host repair mechanisms (6,7). Within 10 days, the flea increases its volume by a factor of approximately 2,000, finally reaching the size of a pea. Through its hindquarters, which serve for breathing, defecating, and expulsing eggs, the flea remains in contact with the air, leaving a sore (240–500 µm) in the skin; the sore is an entry point for pathogenic microorganisms (8). The preferred localization for jiggers is the periungual region of the toes, but lesions may occur on any part of the body (9). Tungiasis, a zoonosis, affects a broad range of domestic and peridomestic animals, such as dogs, cats, pigs, an
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Investigations on the biology, epidemiology, pathology and control of Tunga penetrans in Brazil: IV. Clinical and histopathology
Parasitology Research, 2004Co-Authors: Hermann Feldmeier, Margit Eisele, Ronaldo Ribeiro, Eric Van Marck, Heinz Mehlhorn, Jorg HeukelbachAbstract:Tungiasis is a parasitic skin disease caused by the sand flea Tunga penetrans . This Ectoparasitosis is endemic in South America, the Caribbean and sub-Saharan Africa, where it is an important but neglected health problem in resource-poor communities. As part of a study on tungiasis-related morbidity in a typical slum in Fortaleza, Brazil, we identified 86 individuals with tungiasis. Lesions were counted, classified according to the stage of development, and clinical pathology was documented. One hundred and nine lesions were biopsied and examined by histological sectioning. The patients had between 1 and 145 lesions (median 14.5), the majority occurring in clusters. In all, 77% of patients reported severe pain at the site of the lesion, and 52% had one or more nails lost or severely deformed. Intense inflammation and/or fissures hindered 45% of the patients from walking normally. Signs of superinfection were observed in 29%, and signs of generalised inflammation in 2% of patients. Clinical pathology was significantly related to the number of lesions, and the total number of parasites present correlated with the number of fleas occurring in clusters. Clinical pathology was frequently accompanied by a pathological alteration of the epidermis (predominantly hyperplasia, parakeratosis, hyperkeratosis, and spongiosis) and the dermis. Tungiasis causes a broad spectrum of clinical and histopathological alterations, and is a serious health threat in a typical, impoverished community in northeast Brazil. The clinical pathology is closely related to the parasite burden of an individual and the clustering of embedded fleas at certain predilection sites.
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Severe tungiasis in underprivileged communities: case series from Brazil.
Emerging infectious diseases, 2003Co-Authors: Hermann Feldmeier, Margit Eisele, Rômulo César Sabóia-moura, Jorg HeukelbachAbstract:Tungiasis is caused by infestation with the sand flea (Tunga penetrans). This Ectoparasitosis is endemic in economically depressed communities in South American and African countries. Tungiasis is usually considered an entomologic nuisance and does not receive much attention from healthcare professionals. During a study on tungiasis-related disease in an economically depressed area in Fortaleza, northeast Brazil, we identified 16 persons infested with an extremely high number of parasites. These patients had >50 lesions each and showed signs of intense acute and chronic inflammation. Superinfection of the lesions had led to pustule formation, suppuration, and ulceration. Debilitating sequelae, such as loss of nails and difficulty in walking, were constant. In economically depressed urban neighborhoods characterized by a high transmission potential, poor housing conditions, social neglect, and inadequate healthcare behavior, tungiasis may develop into severe disease.
