The Experts below are selected from a list of 906 Experts worldwide ranked by ideXlab platform
Hermann Feldmeier - One of the best experts on this subject based on the ideXlab platform.
-
Clinical implications and treatment options of Tungiasis in domestic animals
Parasitology Research, 2021Co-Authors: Francis Mutebi, Hermann Feldmeier, Jurgen Krucken, Georg Samsom-himmelstjernaAbstract: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.
-
Very severe Tungiasis in Amerindians in the Amazon lowland of Colombia: A case series.
PLOS Neglected Tropical Diseases, 2019Co-Authors: Hollman Miller, Jovana Ocampo, Alvaro Ayala, Julian Trujillo, Hermann FeldmeierAbstract:Background Tungiasis is a parasitic skin disease caused by penetrating female sand fleas. By nature, Tungiasis is a self-limiting infection. However, in endemic settings re-infection is the rule and parasite load gradually accumulates over time. Intensity of infection and degree of morbidity are closely related. Methodology/principal findings This case series describes the medical history, the clinical pathology, the socio-economic and the environmental characteristics of very severe Tungiasis in five patients living in traditional Amerindian communities in the Amazon lowland of Colombia. Patients had between 400 and 1,300 penetrated sand fleas. The feet were predominantly affected, but clusters of embedded sand fleas also occurred at the ankles, the knees, the elbows, the hands, the fingers and around the anus. The patients were partially or totally immobile. Patients 1 and 3 were cachectic, patient 2 presented severe malnutrition. Patient 3 needed a blood transfusion due to severe anemia. All patients showed a characteristic pattern of pre-existing medical conditions and culture-dependent behavior facilitating continuous re-infection. In all cases intradomiciliary transmission was very likely. Conclusion/significance Although completely ignored in the literature, very severe Tungiasis occurs in settings where patients do not have access to health care and are stricken in a web of pre-existing illness, poverty and neglect. If not treated, very severe Tungiasis may end in a fatal disease course.
-
Multivariable analysis exploring the association of observational and interview data with severe Tungiasis amongst all Tungiasis cases.
2019Co-Authors: Lynne Elson, Susanne Wiese, Hermann Feldmeier, Ulrike FillingerAbstract:Multivariable analysis exploring the association of observational and interview data with severe Tungiasis amongst all Tungiasis cases.
-
Tungiasis-related life quality impairment in children living in rural Kenya
PLOS Neglected Tropical Diseases, 2018Co-Authors: Susanne Wiese, Lynne Elson, Hermann FeldmeierAbstract:Background Tungiasis (sand flea disease) is a neglected tropical skin disease caused by female sand fleas (Tunga spp.) embedded in the skin of the host. The disease is common in sub-Saharan Africa and predominantly affects children living in impoverished rural communities. In these settings Tungiasis is associated with important morbidity. Whether Tungiasis impairs life quality has never been studied. Methods The study was performed in 50 children with Tungiasis, living in resource-poor communities in coastal Kenya. Based on the Dermatology Life Quality Index (DLQI) a tool was developed to determine life quality impairment associated with Tungiasis in children, the Tungiasis-related Dermatology of Life Quality Index (Tungiasis-related-DLQI). Pain and itching were assessed using visual scales ranging from 0–3 points. The intensity of infection and the acute and chronic severity of Tungiasis were determined using standard methods. Results Seventy eight percent of the patients reported a moderate to very large effect of Tungiasis on life quality at the time of the diagnosis. The degree of impairment correlated with the number of viable sand fleas present in the skin (rho = 0.64, p < 0.001), the severity score of acute clinical pathology (rho = 0.74, p < 0.001), and the intensity of pain (rho = 0.82, p < 0.001). Disturbance of sleep and concentration difficulties were the most frequent restriction categories (86% and 84%, respectively). Four weeks after curative treatment, life quality had improved significantly. On the individual level the amelioration of life quality correlated closely with the regression of clinical pathology (rho = 0.61, p < 0.001). Conclusion The parasitic skin disease Tungiasis considerably impairs life quality in children in rural Kenya. After effective treatment, life quality improves rapidly.
-
Correlation between individual decrease in severity of acute Tungiasis (Δ SSAT) and decrease in impairment of life quality (Δ Tungiasis-related DLQI) after treatment (rho = 0.61, p < 0.001); dotted line = regression curve.
2018Co-Authors: Susanne Wiese, Lynne Elson, Hermann FeldmeierAbstract:Correlation between individual decrease in severity of acute Tungiasis (Δ SSAT) and decrease in impairment of life quality (Δ Tungiasis-related DLQI) after treatment (rho = 0.61, p < 0.001); dotted line = regression curve.
Jorg Heukelbach - One of the best experts on this subject based on the ideXlab platform.
-
Seasonal variation and persistence of Tungiasis infestation in dogs in an endemic community, Bahia State (Brazil): longitudinal study.
Parasitology research, 2019Co-Authors: Tatiani Vitor Harvey, Jorg Heukelbach, Maíra Siles Assunção, Thalna Magalhães Fernandes, Christiane Maria Barcellos Magalhães Da Rocha, Renata Santiago Alberto CarlosAbstract:Tungiasis is a zoonosis neglected by authorities, health professionals, and affected populations. Domestic, synanthropic, and sylvatic animals serve as reservoirs for human infestation, and dogs are usually considered a main reservoir in endemic communities. To describe the seasonal variation and the persistence of Tungiasis in dogs, we performed quarterly surveys during a period of 2 years in a tourist village in the municipality of Ilheus, Bahia State, known to be endemic for Tungiasis. Prevalence in dogs ranged from 62.1% (43/66) in August 2013 to 82.2% (37/45) in November 2014, with no significant difference (p = 0.06). The prevalence of infestation remained high, regardless of rainfall patterns. Of the 31 dogs inspected at all surveys, period prevalence was 94% (29/31; 95% CI 79.3-98.2%) and persistence of infestation indicator [PII] was high (median PII = 6 surveys, q1 = 5, q3 = 7). Dogs
-
Tungiasis - A Neglected Disease with Many Challenges for Global Public Health
PLOS Neglected Tropical Diseases, 2014Co-Authors: Hermann Feldmeier, Uade Samuel Ugbomoiko, Pamela Sabina Mbabazi, Elizabeth Sentongo, Georg Von Samson-himmelstjerna, Jorg Heukelbach, Ingela KrantzAbstract:Tungiasis (sand flea disease) is a parasitic skin disease with origins in South America. It was introduced into sub-Saharan Africa in the 19th century [1]–[3]. Sand flea disease is a zoonosis caused by the penetration of female sand fleas into the skin. In humans, Tungiasis predominantly affects marginalized populations. Children and elderly people are especially susceptible to severe disease. Sand flea disease is the most frequent parasitic infection in many resource-poor communities. In animals like dogs, pigs, or ruminants, the infection has severe consequences with, for example, reduced milk production when the skin of the udder is affected. Despite the substantial disease burden caused by embedded sand fleas, Tungiasis is basically neglected by health care providers, policy makers, the scientific community, the pharmaceutical industry, and funding institutions [4]. Although not included in WHO's list of neglected tropical diseases (NTDs), Tungiasis bears all the hallmarks of an NTD to merit apprehension from the public health sector [5]–[7]. It occurs in resource-poor communities, causing considerable morbidity and loss of quality of life. Systematic data on disease occurrence are not available.
-
Jigger flea infestation (Tungiasis) in rural western Tanzania: high prevalence and severe morbidity
Transactions of The Royal Society of Tropical Medicine and Hygiene, 2012Co-Authors: Humphrey D. Mazigo, E. Bahemana, E.t. Konje, O. Dyegura, Benson R. Kidenya, Eliningaya J Kweka, Ladislaus L . Mnyone, Jorg HeukelbachAbstract:Epidemiologic and clinical data on the parasitic skin disease Tungiasis are limited from sub-Saharan Africa, and virtually nonexistent from the East African region. We performed a community-based cross-sectional study in two villages in Kasulu district, western Tanzania. Study participants were examined for the presence of Tungiasis and disease-associated morbidity. In total, 586 individuals >5 years of age were enrolled, and 249 (42.5%; 95% CI: 38.5-46.5) diagnosed with Tungiasis. The >= 45 year-olds showed highest prevalence of Tungiasis (71.1%) and most severe parasite load (median number of embedded fleas: 17.5; interquartile range: 15-22.5). Prevalence was slightly, but not significantly, higher in males than in females (45.3 vs 39.7%; p = 0.17). Itching (68.3%), pain (38.6%) and ulcers (30.1%) were common; 22.1% of individuals found it difficult to walk due to Tungiasis, and in 21.3% loss of toenails was observed. Considering the high prevalence and considerable morbidity in the population, we conclude that Tungiasis is a public health threat in the study villages and that the disease needs to be recognized by health authorities. Future studies on risk factors, animal reservoirs and evidence-based control measures are needed.
-
A simple method for rapid community assessment of Tungiasis.
Tropical medicine & international health : TM & IH, 2010Co-Authors: Liana Ariza, Thomas Wilcke, Uade Samuel Ugbomoiko, Hermann Feldmeier, Anne Jackson, M. Gomide, Jorg HeukelbachAbstract:Objective: To evaluate a rapid assessment method to estimate the overall prevalence of Tungiasis and severity of disease in endemic communities. Methods: We analysed data from 10 population-based surveys on Tungiasis, performed in five endemic communities in Brazil and Nigeria between 2001 and 2008. To assess the association between occurrence of Tungiasis on six defined topographic areas of the feet and the true prevalence/prevalence of severe disease, linear regression analyses were performed. Estimated prevalences were calculated for each of the 10 surveys and compared to true prevalences. We then selected the most useful topographic localization to define a rapid assessment method, based on the strength of association and operational aspects. Results: In total, 7121 individuals of the five communities were examined. Prevalence of Tungiasis varied between 21.1% and 54.4%. The presence of periungual lesions on the toes was identified as the most useful rapid assessment to estimate the prevalence of Tungiasis (absolute errors: −4% to +3.6%; R2 = 96%; P 20 lesions) was also estimated by the method (absolute errors: −3.1% to +2.5%; R2 = 76%; P = 0.001). Conclusion: Prevalence of Tungiasis and prevalence of severe disease can be reliably estimated in communities with distinct cultural and geographical characteristics, by applying a simple and rapid epidemiological method. This approach will help to detect high-risk communities and to monitor control measures aimed at the reduction of Tungiasis.
-
Tungiasis infestation in Tanzania
Journal of infection in developing countries, 2010Co-Authors: Humphrey D. Mazigo, Emmanuel Behamana, Maria Zinga, Jorg HeukelbachAbstract:Tungiasis is caused by the jigger flea Tunga penetrans. We describe a case of severe infestation from Kigoma region, Western Tanzania. A 19-year-old male with epilepsy and mental disability presented with ulcerated and inflamed toes. Clinical examination revealed the presence of approximately 810 embedded jigger fleas on the feet, and another 60 lesions on the hands. The patient presented with fissures on the feet, hands and soles. He had difficulty walking and erythematous, oedematous, ulcerated and inflamed skin around the feet. Living conditions were precarious. The patient was assisted to extract the embedded fleas and his feet were washed with disinfectants. Oral antibiotics were given. The case shows that the disease may reach high parasite loads in Tanzanian individuals, with consequently severe pathology. There have been single reports of returning tourists from Tanzania with Tungiasis, but the epidemiological situation and the geographic occurrence of the disease in this country are not known. Systematic studies are needed to increase knowledge on the epidemiological situation of tungasis in Tanzania and to identify endemic areas.
Susanne Wiese - One of the best experts on this subject based on the ideXlab platform.
-
Multivariable analysis exploring the association of observational and interview data with severe Tungiasis amongst all Tungiasis cases.
2019Co-Authors: Lynne Elson, Susanne Wiese, Hermann Feldmeier, Ulrike FillingerAbstract:Multivariable analysis exploring the association of observational and interview data with severe Tungiasis amongst all Tungiasis cases.
-
Tungiasis-related life quality impairment in children living in rural Kenya
PLOS Neglected Tropical Diseases, 2018Co-Authors: Susanne Wiese, Lynne Elson, Hermann FeldmeierAbstract:Background Tungiasis (sand flea disease) is a neglected tropical skin disease caused by female sand fleas (Tunga spp.) embedded in the skin of the host. The disease is common in sub-Saharan Africa and predominantly affects children living in impoverished rural communities. In these settings Tungiasis is associated with important morbidity. Whether Tungiasis impairs life quality has never been studied. Methods The study was performed in 50 children with Tungiasis, living in resource-poor communities in coastal Kenya. Based on the Dermatology Life Quality Index (DLQI) a tool was developed to determine life quality impairment associated with Tungiasis in children, the Tungiasis-related Dermatology of Life Quality Index (Tungiasis-related-DLQI). Pain and itching were assessed using visual scales ranging from 0–3 points. The intensity of infection and the acute and chronic severity of Tungiasis were determined using standard methods. Results Seventy eight percent of the patients reported a moderate to very large effect of Tungiasis on life quality at the time of the diagnosis. The degree of impairment correlated with the number of viable sand fleas present in the skin (rho = 0.64, p < 0.001), the severity score of acute clinical pathology (rho = 0.74, p < 0.001), and the intensity of pain (rho = 0.82, p < 0.001). Disturbance of sleep and concentration difficulties were the most frequent restriction categories (86% and 84%, respectively). Four weeks after curative treatment, life quality had improved significantly. On the individual level the amelioration of life quality correlated closely with the regression of clinical pathology (rho = 0.61, p < 0.001). Conclusion The parasitic skin disease Tungiasis considerably impairs life quality in children in rural Kenya. After effective treatment, life quality improves rapidly.
-
Tungiasis-related life quality impairment in children living in rural Kenya.
Public Library of Science (PLoS), 2018Co-Authors: Susanne Wiese, Lynne Elson, Hermann FeldmeierAbstract:Tungiasis (sand flea disease) is a neglected tropical skin disease caused by female sand fleas (Tunga spp.) embedded in the skin of the host. The disease is common in sub-Saharan Africa and predominantly affects children living in impoverished rural communities. In these settings Tungiasis is associated with important morbidity. Whether Tungiasis impairs life quality has never been studied.The study was performed in 50 children with Tungiasis, living in resource-poor communities in coastal Kenya. Based on the Dermatology Life Quality Index (DLQI) a tool was developed to determine life quality impairment associated with Tungiasis in children, the Tungiasis-related Dermatology of Life Quality Index (Tungiasis-related-DLQI). Pain and itching were assessed using visual scales ranging from 0-3 points. The intensity of infection and the acute and chronic severity of Tungiasis were determined using standard methods.Seventy eight percent of the patients reported a moderate to very large effect of Tungiasis on life quality at the time of the diagnosis. The degree of impairment correlated with the number of viable sand fleas present in the skin (rho = 0.64, p < 0.001), the severity score of acute clinical pathology (rho = 0.74, p < 0.001), and the intensity of pain (rho = 0.82, p < 0.001). Disturbance of sleep and concentration difficulties were the most frequent restriction categories (86% and 84%, respectively). Four weeks after curative treatment, life quality had improved significantly. On the individual level the amelioration of life quality correlated closely with the regression of clinical pathology (rho = 0.61, p < 0.001).The parasitic skin disease Tungiasis considerably impairs life quality in children in rural Kenya. After effective treatment, life quality improves rapidly
-
Correlation between severity of Tungiasis measured by SSAT and the Tungiasis-related DLQI (rho = 0.74, p < 0.001); dotted line = regression curve.
2018Co-Authors: Susanne Wiese, Lynne Elson, Hermann FeldmeierAbstract:Correlation between severity of Tungiasis measured by SSAT and the Tungiasis-related DLQI (rho = 0.74, p < 0.001); dotted line = regression curve.
-
Correlation between individual decrease in severity of acute Tungiasis (Δ SSAT) and decrease in impairment of life quality (Δ Tungiasis-related DLQI) after treatment (rho = 0.61, p < 0.001); dotted line = regression curve.
2018Co-Authors: Susanne Wiese, Lynne Elson, Hermann FeldmeierAbstract:Correlation between individual decrease in severity of acute Tungiasis (Δ SSAT) and decrease in impairment of life quality (Δ Tungiasis-related DLQI) after treatment (rho = 0.61, p < 0.001); dotted line = regression curve.
Francis Mutebi - One of the best experts on this subject based on the ideXlab platform.
-
Clinical implications and treatment options of Tungiasis in domestic animals
Parasitology Research, 2021Co-Authors: Francis Mutebi, Hermann Feldmeier, Jurgen Krucken, Georg Samsom-himmelstjernaAbstract: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.
-
Animal and human Tungiasis-related knowledge and treatment practices among animal keeping households in Bugiri District, South-Eastern Uganda.
Acta tropica, 2017Co-Authors: Francis Mutebi, Norbert Mencke, Charles Waiswa, Jurgen Krucken, Georg Von Samson-himmelstjerna, Wilfred Eneku, Tamale Andrew, Hermann FeldmeierAbstract:Abstract Background Zoonotic Tungiasis caused by Tunga penetrans remains a serious public and animal health problem among endemic villages in Uganda and many sub Saharan African countries. Studies on human and animal Tungiasis-related knowledge and treatment practices in endemic communities have never been undertaken, a limitation to development of sustainable control measures. Methods A cross sectional study using semi-structured questionnaires (Supplementary file S1) was conducted among 236 animal rearing households in 10 endemic villages in Bugiri District, South-Eastern Uganda. Focus group discussions and observation checklists were used to validate and clarify the findings. Results Most respondents knew the aetiology (89.4%), clinical signs (98%) and the ecology of T. penetrans as well as the major risk factors of human Tungiasis (65.2%). In contrast, very few respondents were aware of animal Tungiasis. Only 4.8% of those with infected animals on the compound knew that some of their animals were infected and 13.6% of the respondents had ever seen Tungiasis-affected animals. Pigs (13.1%, n = 31) and dogs (0.85%, n = 2) were the only T. penetrans animal hosts known to animal owners. Affected humans were treated by extraction of embedded sand fleas using non-sterile sharp instruments in all households that reported occurrence of human Tungiasis at least once (n = 227). Also, affected animals were mainly treated by mechanical removal of embedded sand fleas in households that have ever experienced animal Tungiasis (four out of 12; 33.3%). In a few instances, plant and animal pesticides (n = 3) and other chemicals such as grease, paraffin and wood preservative (n = 3) were also used to treat animal Tungiasis. Conclusion The study revealed a high level of knowledge on human Tungiasis but inadequate knowledge on the zoonotic nature of Tungiasis. Commonly applied methods for treatment of human and animal Tungiasis are a health hazard by themselves. Concerted i.e. One Health-based efforts aiming at promoting appropriate treatment of Tungiasis, adequate living conditions and increased awareness on Tungiasis in the communities are indicated in order to eliminate Tungiasis-associated disease.
-
high intensity of tunga penetrans infection causing severe disease among pigs in busoga south eastern uganda
BMC Veterinary Research, 2017Co-Authors: Francis Mutebi, Norbert Mencke, Hermann Feldmeier, Charles Waiswa, Jurgen Krucken, Wilfred Eneku, Georg Von SamsonhimmelstjernaAbstract:Towards the improvement of stakeholders’ awareness of animal Tungiasis, we report 10 unusual severe clinical cases of pig Tungiasis which were associated with very high infection intensities of T. penetrans in an endemic area. Morbidity of ten pigs with high sand flea intensities detected during high transmission seasons in an endemic area in Busoga sub region, Uganda is described in detail. The cases of pigs presented with a very high number of embedded sand fleas (median = 276, range = 141–838). Acute manifestations due to severe Tungiasis included ulcerations (n = 10), abscess formation (n = 6) and lameness (n = 9). Chronic morphopathological presentations were overgrowth of claws (n = 5), lateral deviation of dew claws (n = 6), detachment (n = 5) or loss of dew claws (n = 1). Treatment of severe cases with a topical insecticidal aerosol containing chlorfenvinphos, dichlorvos and gentian violet resolved acute morbidity and facilitated healing by re-epithelialisation. The presentations of Tungiasis highlighted in this report show that high intensities of embedded T. penetrans can cause a severe clinical disease in pigs. Effective Tungiasis preventive measures and early diagnosis for treatment could be crucial to minimize its effects on animal health.
-
High intensity of Tunga penetrans infection causing severe disease among pigs in Busoga, South Eastern Uganda
BMC Veterinary Research, 2017Co-Authors: Francis Mutebi, Norbert Mencke, Hermann Feldmeier, Charles Waiswa, Jurgen Krucken, Wilfred Eneku, Georg Von Samson-himmelstjernaAbstract:Background Towards the improvement of stakeholders’ awareness of animal Tungiasis, we report 10 unusual severe clinical cases of pig Tungiasis which were associated with very high infection intensities of T. penetrans in an endemic area. Results Morbidity of ten pigs with high sand flea intensities detected during high transmission seasons in an endemic area in Busoga sub region, Uganda is described in detail. The cases of pigs presented with a very high number of embedded sand fleas (median = 276, range = 141–838). Acute manifestations due to severe Tungiasis included ulcerations ( n = 10), abscess formation ( n = 6) and lameness ( n = 9). Chronic morphopathological presentations were overgrowth of claws ( n = 5), lateral deviation of dew claws ( n = 6), detachment ( n = 5) or loss of dew claws ( n = 1). Treatment of severe cases with a topical insecticidal aerosol containing chlorfenvinphos, dichlorvos and gentian violet resolved acute morbidity and facilitated healing by re-epithelialisation. Conclusions The presentations of Tungiasis highlighted in this report show that high intensities of embedded T. penetrans can cause a severe clinical disease in pigs. Effective Tungiasis preventive measures and early diagnosis for treatment could be crucial to minimize its effects on animal health.
-
successful treatment of severe Tungiasis in pigs using a topical aerosol containing chlorfenvinphos dichlorphos and gentian violet
PLOS Neglected Tropical Diseases, 2016Co-Authors: Francis Mutebi, Georg Von Samsonhimmelstjerna, Hermann Feldmeier, Charles Waiswa, Jeanne Bukeka Muhindo, Jurgen KruckenAbstract: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.
Jurgen Krucken - One of the best experts on this subject based on the ideXlab platform.
-
Clinical implications and treatment options of Tungiasis in domestic animals
Parasitology Research, 2021Co-Authors: Francis Mutebi, Hermann Feldmeier, Jurgen Krucken, Georg Samsom-himmelstjernaAbstract: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.
-
Animal and human Tungiasis-related knowledge and treatment practices among animal keeping households in Bugiri District, South-Eastern Uganda.
Acta tropica, 2017Co-Authors: Francis Mutebi, Norbert Mencke, Charles Waiswa, Jurgen Krucken, Georg Von Samson-himmelstjerna, Wilfred Eneku, Tamale Andrew, Hermann FeldmeierAbstract:Abstract Background Zoonotic Tungiasis caused by Tunga penetrans remains a serious public and animal health problem among endemic villages in Uganda and many sub Saharan African countries. Studies on human and animal Tungiasis-related knowledge and treatment practices in endemic communities have never been undertaken, a limitation to development of sustainable control measures. Methods A cross sectional study using semi-structured questionnaires (Supplementary file S1) was conducted among 236 animal rearing households in 10 endemic villages in Bugiri District, South-Eastern Uganda. Focus group discussions and observation checklists were used to validate and clarify the findings. Results Most respondents knew the aetiology (89.4%), clinical signs (98%) and the ecology of T. penetrans as well as the major risk factors of human Tungiasis (65.2%). In contrast, very few respondents were aware of animal Tungiasis. Only 4.8% of those with infected animals on the compound knew that some of their animals were infected and 13.6% of the respondents had ever seen Tungiasis-affected animals. Pigs (13.1%, n = 31) and dogs (0.85%, n = 2) were the only T. penetrans animal hosts known to animal owners. Affected humans were treated by extraction of embedded sand fleas using non-sterile sharp instruments in all households that reported occurrence of human Tungiasis at least once (n = 227). Also, affected animals were mainly treated by mechanical removal of embedded sand fleas in households that have ever experienced animal Tungiasis (four out of 12; 33.3%). In a few instances, plant and animal pesticides (n = 3) and other chemicals such as grease, paraffin and wood preservative (n = 3) were also used to treat animal Tungiasis. Conclusion The study revealed a high level of knowledge on human Tungiasis but inadequate knowledge on the zoonotic nature of Tungiasis. Commonly applied methods for treatment of human and animal Tungiasis are a health hazard by themselves. Concerted i.e. One Health-based efforts aiming at promoting appropriate treatment of Tungiasis, adequate living conditions and increased awareness on Tungiasis in the communities are indicated in order to eliminate Tungiasis-associated disease.
-
high intensity of tunga penetrans infection causing severe disease among pigs in busoga south eastern uganda
BMC Veterinary Research, 2017Co-Authors: Francis Mutebi, Norbert Mencke, Hermann Feldmeier, Charles Waiswa, Jurgen Krucken, Wilfred Eneku, Georg Von SamsonhimmelstjernaAbstract:Towards the improvement of stakeholders’ awareness of animal Tungiasis, we report 10 unusual severe clinical cases of pig Tungiasis which were associated with very high infection intensities of T. penetrans in an endemic area. Morbidity of ten pigs with high sand flea intensities detected during high transmission seasons in an endemic area in Busoga sub region, Uganda is described in detail. The cases of pigs presented with a very high number of embedded sand fleas (median = 276, range = 141–838). Acute manifestations due to severe Tungiasis included ulcerations (n = 10), abscess formation (n = 6) and lameness (n = 9). Chronic morphopathological presentations were overgrowth of claws (n = 5), lateral deviation of dew claws (n = 6), detachment (n = 5) or loss of dew claws (n = 1). Treatment of severe cases with a topical insecticidal aerosol containing chlorfenvinphos, dichlorvos and gentian violet resolved acute morbidity and facilitated healing by re-epithelialisation. The presentations of Tungiasis highlighted in this report show that high intensities of embedded T. penetrans can cause a severe clinical disease in pigs. Effective Tungiasis preventive measures and early diagnosis for treatment could be crucial to minimize its effects on animal health.
-
High intensity of Tunga penetrans infection causing severe disease among pigs in Busoga, South Eastern Uganda
BMC Veterinary Research, 2017Co-Authors: Francis Mutebi, Norbert Mencke, Hermann Feldmeier, Charles Waiswa, Jurgen Krucken, Wilfred Eneku, Georg Von Samson-himmelstjernaAbstract:Background Towards the improvement of stakeholders’ awareness of animal Tungiasis, we report 10 unusual severe clinical cases of pig Tungiasis which were associated with very high infection intensities of T. penetrans in an endemic area. Results Morbidity of ten pigs with high sand flea intensities detected during high transmission seasons in an endemic area in Busoga sub region, Uganda is described in detail. The cases of pigs presented with a very high number of embedded sand fleas (median = 276, range = 141–838). Acute manifestations due to severe Tungiasis included ulcerations ( n = 10), abscess formation ( n = 6) and lameness ( n = 9). Chronic morphopathological presentations were overgrowth of claws ( n = 5), lateral deviation of dew claws ( n = 6), detachment ( n = 5) or loss of dew claws ( n = 1). Treatment of severe cases with a topical insecticidal aerosol containing chlorfenvinphos, dichlorvos and gentian violet resolved acute morbidity and facilitated healing by re-epithelialisation. Conclusions The presentations of Tungiasis highlighted in this report show that high intensities of embedded T. penetrans can cause a severe clinical disease in pigs. Effective Tungiasis preventive measures and early diagnosis for treatment could be crucial to minimize its effects on animal health.
-
successful treatment of severe Tungiasis in pigs using a topical aerosol containing chlorfenvinphos dichlorphos and gentian violet
PLOS Neglected Tropical Diseases, 2016Co-Authors: Francis Mutebi, Georg Von Samsonhimmelstjerna, Hermann Feldmeier, Charles Waiswa, Jeanne Bukeka Muhindo, Jurgen KruckenAbstract: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.
