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Santana YRT, Andrade DDBC, Barroso DH, Silva AV, Oliveira LFC, Timbó RV, Araújo DD, de Andrade RR, Pellegrini MA, de Carvalho FCA, Martins LPF, Gomes CM. The Effectiveness of Topical Dimethicone Together with a One Health Approach for the Control of Tungiasis in the Sanumás Communities, Yanomami Territory, Amazon Rainforest: A Real-World Study. Trop Med Infect Dis 2023; 8:489. [PMID: 37999608 PMCID: PMC10674387 DOI: 10.3390/tropicalmed8110489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/23/2023] [Accepted: 10/25/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND The success of tungiasis treatment is highly dependent on adequate environmental control. METHODS This is a real-world observational cohort study designed to monitor the effectiveness of topical dimethicone together with a One Health approach for the control of tungiasis in the Sanumás communities, Amazon rainforest, Brazil. We followed up on 562 indigenous people and 81 domestic dogs for 1.5 years in a 3-month interval. A new molecular method for large-scale soil evaluation was also tested. The control of tungiasis was independently conducted by the Brazilian Ministry of Health and comprised topical dimethicone application (NYDA®) for humans, single-dose oral afoxolaner for dogs, and in-house soil fumigation with fipronil. The main outcome was the occurrence of tungiasis after the use of topical dimethicone together with the One Health approach. RESULTS A total of 49 of the 562 indigenous people had active tungiasis at enrollment (8.72%). Only three cases of tungiasis resulted in active lesions after the use of topical dimethicone together with the One Health approach, with two cases of recurrence. From the 6-month follow-up and after, soil infestation was not detected. CONCLUSIONS We conclude that the use of NYDA® together with animal and environmental interventions are effective measures for the control of tungiasis.
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Affiliation(s)
- Yago Ranniere Teixeira Santana
- Programa de Pós-Graduação em Ciências Médicas, Universidade de Brasília, Brasília 70910-900, Brazil; (Y.R.T.S.); (D.D.B.C.A.); (D.H.B.); (A.V.S.); (R.V.T.); (R.R.d.A.)
- Secretaria Especial de Saúde Indígena (SESAI), Ministério da Saúde do Brasil, Brasília 70723-040, Brazil;
- Programa de Pós-Graduação em Saúde Coletiva, Universidade de Brasília, Brasília 70910-900, Brazil
| | - Débora Dornelas Belchior Costa Andrade
- Programa de Pós-Graduação em Ciências Médicas, Universidade de Brasília, Brasília 70910-900, Brazil; (Y.R.T.S.); (D.D.B.C.A.); (D.H.B.); (A.V.S.); (R.V.T.); (R.R.d.A.)
| | - Daniel Holanda Barroso
- Programa de Pós-Graduação em Ciências Médicas, Universidade de Brasília, Brasília 70910-900, Brazil; (Y.R.T.S.); (D.D.B.C.A.); (D.H.B.); (A.V.S.); (R.V.T.); (R.R.d.A.)
| | - Andressa Vieira Silva
- Programa de Pós-Graduação em Ciências Médicas, Universidade de Brasília, Brasília 70910-900, Brazil; (Y.R.T.S.); (D.D.B.C.A.); (D.H.B.); (A.V.S.); (R.V.T.); (R.R.d.A.)
| | | | - Renata Velôzo Timbó
- Programa de Pós-Graduação em Ciências Médicas, Universidade de Brasília, Brasília 70910-900, Brazil; (Y.R.T.S.); (D.D.B.C.A.); (D.H.B.); (A.V.S.); (R.V.T.); (R.R.d.A.)
| | | | - Rafael Rocha de Andrade
- Programa de Pós-Graduação em Ciências Médicas, Universidade de Brasília, Brasília 70910-900, Brazil; (Y.R.T.S.); (D.D.B.C.A.); (D.H.B.); (A.V.S.); (R.V.T.); (R.R.d.A.)
| | - Marcos Antonio Pellegrini
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Roraima, Boa Vista 69304-000, Brazil; (M.A.P.); (F.C.A.d.C.)
| | | | | | - Ciro Martins Gomes
- Programa de Pós-Graduação em Ciências Médicas, Universidade de Brasília, Brasília 70910-900, Brazil; (Y.R.T.S.); (D.D.B.C.A.); (D.H.B.); (A.V.S.); (R.V.T.); (R.R.d.A.)
- Programa de Pós-Graduação em Patologia Molecular, Universidade de Brasília, Brasília 70910-900, Brazil;
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Ahirirwe SR, Migisha R, Mwine P, Bulage L, Kwesiga B, Kadobera D, Ario AR. Investigation of human tungiasis cases, Sheema District, Uganda, November 2021-February 2022. Pan Afr Med J 2023; 46:71. [PMID: 38282773 PMCID: PMC10819847 DOI: 10.11604/pamj.2023.46.71.41277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 08/23/2023] [Indexed: 01/30/2024] Open
Abstract
Introduction no formal surveillance system exists in Uganda for jiggers (tungiasis); however, outbreaks are frequently reported in the media. On 27th January 2022, a news alert reported a jiggers' outbreak in Sheema District, Southwestern Uganda. We investigated to establish the magnitude of the problem and identify possible exposures associated with infestation to inform control measures. Methods we defined a confirmed case as visible Tunga penetrans (T. penetrans) in the skin of a resident of any of 6 villages in Bwayegamba Parish, Sheema District, in February 2022. A suspected case was self-reported T. penetrans infestation during the three months preceding the interview. We visited all households in the 3 most affected villages in Bwayegamba Parish to identify cases and conducted interviews to identify possible exposures. We described cases by person, place, and time. We assessed socioeconomic status, household construction, mitigation measures against jiggers, and observed participants and their environments for hygiene. We conducted 2 case-control studies. One compared case-households (with ≥1 case) with control-households (without any cases). The second compared individual cases (suspected and confirmed) to neighbourhood controls. Results among 278 households, we identified 60 case-patients, among whom 34 (57%) were male. Kiyungu West was the most affected village (attack rate=31/1,000). Cases had higher odds of being male (ORMH=2.3, 95% CI=1.3-4.0), <20 years of age (ORMH=2.0, 95%CI=1.1-3.6), unmarried (ORMH=2.97, 95% CI=1.7-5.2), unemployed (ORMH=3.28, 95% CI=1.8-5.8), and having poor personal hygiene (ORMH=3.73, 95% CI=2.0-7.4) than controls. In the household case-control study, case-households had higher odds of having dirty or littered compounds (ORMH=2.3, 95% CI=1.2-4.6) and lower odds of practicing mitigation measures against jiggers (ORMH=0.33, 95% CI=0.1-0.8) than control-households. Conclusion males, unemployed persons, and those with poor personal or household hygiene had increased odds of tungiasis in this outbreak. Multi-sectoral, tailored interventions that improve standards of living could reduce risk of tungiasis in this area. Adding tungiasis to national surveillance reporting tools could facilitate early identification of future outbreaks.
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Affiliation(s)
- Sherry Rita Ahirirwe
- Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda
| | - Richard Migisha
- Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda
| | - Patience Mwine
- Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda
| | - Lilian Bulage
- Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda
| | - Benon Kwesiga
- Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda
| | - Daniel Kadobera
- Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda
| | - Alex Riolexus Ario
- Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda
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Rasoamialy-Soa Razanakolona L, Raharisoa A, Soankasina AH, De La Croix Jaonasoa J, Nicolas P, Antilahy JA, Chebbah D, Akhoundi M, Izri A. Clinical and epidemiological survey of tungiasis in Madagascar. Travel Med Infect Dis 2022; 50:102449. [PMID: 36113754 DOI: 10.1016/j.tmaid.2022.102449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 08/25/2022] [Accepted: 09/02/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Tungiasis is a dermal parasitic infection, classified as a neglected tropical disease. Madagascar is one of endemic countries which have been committed for decades to control the tungiasis as a public health issue. Despite this medical importance, little is known about the prevalence and epidemiology of the disease in this country. METHODS A descriptive cross-sectional survey was performed in two endemic foci of Antananarivo and Toamasina. RESULTS In total, 2971 suspected individuals were surveyed. Of them, 643 individuals were excluded due to absence or refusing clinical examinations. Therefore, 2328 individuals with aforementioned criteria were clinically examined, 320 cases (13.7%) were found infected by Tunga penetrans. Of these 320 infected cases, 241 individuals came from rural regions against 79 from urban areas. The sex ratio of infected cases was 1.15 with an age average of 34.7 years old. Most of them were illiterate (185/320, 57.8%) with no habit of feet washing (210/320, 65.6%). The majority (198/320, 61.9%) inhabited in the houses constructed by falafa providing a suitable breeding location for Tunga ectoparasites. Based on clinical examination, most of the patients (298/320, 93.1%) had the lesions on their toes followed by those possessed the lesions on the plantar (140/320, 43.7%). The lesion stages of IV and V were observed in 49.1% (157/320) of visited patients which were more common in rural regions (86%) than in urban areas (14%). For treatment, removing the fleas using needle (122/320, 38.1%), followed by the application of petroleum (100/320, 31.2%) were among the most traditional remedies used by our patients. CONCLUSION This investigation highlights a high burden of tungiasis in studied endemic foci in particular in rural regions. These results can be helpful in control management strategies against this parasitosis in Madagascar.
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Affiliation(s)
| | - Annie Raharisoa
- Laboratoire de Biologie Médicale, Centre Hospitalier Régional de Référence Itasy, Miarinarivo, Madagascar
| | - Abel Hermann Soankasina
- Département de Biologie Médicale, Hôpital Joseph Ravoahangy Andrianavalona, Antananarivo, Madagascar
| | - Jean De La Croix Jaonasoa
- Laboratoire de Biologie Médicale, Centre Hospitalier Régional de Référence Sambava, Sambava, Madagascar
| | - Patrick Nicolas
- Biochemistry Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord University, Bobigny, France
| | - Jimmy Anders Antilahy
- Parasitology-Mycology Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord University, Bobigny, France
| | - Dahlia Chebbah
- Parasitology-Mycology Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord University, Bobigny, France
| | - Mohammad Akhoundi
- Parasitology-Mycology Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord University, Bobigny, France.
| | - Arezki Izri
- Parasitology-Mycology Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord University, Bobigny, France; Unité des Virus Émergents (UVEAix-Marseille Univ-IRD 190-Inserm 1207-IHU Méditerranée Infection), Marseille, France
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Mwai J, Nyole D, Abdi MH, Omogi J. Factors associated with tungiasis among school-age children in Kwale County, rural Kenya. Int Health 2022; 15:85-92. [PMID: 35390149 PMCID: PMC9808516 DOI: 10.1093/inthealth/ihac013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/03/2022] [Accepted: 03/14/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The parasitic disease tungiasis, caused by the flea Tunga penetrans, remains an important public health problem among children and the elderly. The study assessed the factors influencing prevention and control of tungiasis infection among school-age children in Kwale County, Kenya. METHODS A cross-sectional survey was conducted in five villages in Lunga Lunga subcounty among 538 children ages 5-14 y. The study employed a mobile application tool in collecting sociodemographic, knowledge, perception and practice data on prevention and control of tungiasis with frequencies and bivariate and multivariate regression analysis used. RESULTS The prevalence of tungiasis was found to be 62.1% (328/528), with fathers' education level, place of residence and wearing shoes being factors associated with infection. Those who wore shoes were less likely to be infected compared with those who did not (odds ratio 0.059 [95% confidence interval 0.29 to 0.12]). Children living in Dzombo B and Kinyungu were less likely to be infected with tungiasis compared with those living in Bandu, holding other factors constant. CONCLUSION Creating awareness of the cause of tungiasis remains of key public importance. Hygiene promotion, including wearing of shoes and the general cleanliness of the environment at the community level, needs to be implemented.
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Affiliation(s)
- Judy Mwai
- Kenya Medical Research Institute-CPHR
| | - Diana Nyole
- ITROMID-Jomo Kenyatta University of Agriculture and Technology
| | | | - Jarim Omogi
- Corresponding author: Tel: +254720573449; E-mail:
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Jorga SD, Lulu Dessie Y, Reshad Kedir M, Donacho DO. Prevalence of Tungiasis and its risk factors of among children of Mettu woreda, southwest Ethiopia, 2020. PLoS One 2022; 17:e0262168. [PMID: 34986188 PMCID: PMC8730454 DOI: 10.1371/journal.pone.0262168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 12/20/2021] [Indexed: 11/18/2022] Open
Abstract
Tungiasis is caused by the flea tunga penetrans and results in painful skin lesions, skin infections, and permanent disability. However, limited information is available that shows the magnitude of the problem and its risk factors that help for intervention in Ethiopia. The goal of this study was to determine the prevalence and risk factors of tungiasis in children aged 5 to 14 in Mettu woreda in 2020. A community based cross sectional study was conducted among randomly selected kebeles of Mettu woreda, in Southwest Ethiopia. To select study participants, multistage sampling was used. The data were collected through physical examination of the children, interview of parents/guardians of the children, and observation of the home environment using checklists and questionnaires. The descriptive analysis was done for socio-demographic characteristics, prevalence of tungiasis, and housing conditions. A logistic regression analysis was performed, and variables in multivariable regression reported odds ratios and their 95% confidence intervals once the variables were identified using a p-value of 0.05 as a risk factor of statistical significance. The prevalence of tungiasis among children 5–14 years of age in Mettu rural woreda was 52 percent (n = 821). As a risk factor, large family size (AOR: 2.9, 95% CI: 2.13, 4.40); school attendance (AOR: 1.5, 95% CI: 1.02, 2.18), floor inside the house (AOR: 3.8, 95% CI: 1.76, 8.43); having sleeping bed (AOR: 0.16, 95% CI: 0.03, 0.82); access to protected water sources (AOR: 0.24, 95% CI: 0.15, 0.39); access to improved toilet facilities(AOR: 0.63: 95% CI: 0.44, 0.89); access to electric services (AOR: 0.30, 95% CI: 0.15, 0.62); and lack of own farmland (AOR: 0.36, 95% CI: 0.26, 0.50) were found. Therefore, planning and implementation of interventions focus on those risk factors that are particularly important. Water, sanitation and hygiene interventions, and livelihood improvement interventions are required to solve the problem in the setting.
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Affiliation(s)
- Sime Daba Jorga
- Department of Public Health, College of Health Science, Mettu University, Metu, Ethiopia
| | - Yohannes Lulu Dessie
- Department of Nursing, College of Health Science, Mettu University, Metu, Ethiopia
| | - Mohammed Reshad Kedir
- Department of Public Health, College of Health Science, Mettu University, Metu, Ethiopia
| | - Dereje Oljira Donacho
- Department of Health Informatics, College of Health Science, Mettu University or Department of Environmental Health Science and Technology, Jimma University, Jimma, Ethiopia
- * E-mail:
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Lv W, Liu L, Zhuang SJ. Dynamics and optimal control in transmission of tungiasis diseases. INT J BIOMATH 2021. [DOI: 10.1142/s1793524521500765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This paper aims to model the transmission of tungiasis disease and assess the optimal control schemes to stop its occurrence. Based on the development stage of fleas and propagation process of diseases, we propose a human-flea model without control, in which the susceptible-infected in latent stage-infectious populations and the egg-larva-pupa-adult stage of fleas are all in involved. In the light of the Lyapunov function method, we prove global stability of equilibria. The model is extended by reformulating it as an optimal control problem, with the use of four time-dependent controls, to assess the impact of individual protection, treatment and two flea control strategies (killing adult fleas and reduction of eggs and larvae). By using Pontryagin’s maximum principle, we characterize the optimal control. Using the data of human and flea in Brazil and Nigeri, numerical simulations are performed. The numerical results show that enhancing the protection and treatment of people and increasing the killing efficacy of flea adults would contribute to prevent and control the spread of the disease appreciably.
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Affiliation(s)
- Wei Lv
- Department of Mathematics, Shanghai University, Shanghai 200444, P. R. China
| | - Lu Liu
- Department of Mathematics, Shanghai University, Shanghai 200444, P. R. China
| | - Shi-Jia Zhuang
- Department of Mathematics, Shanghai University, Shanghai 200444, P. R. China
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