RESUMO
BACKGROUND: Tungiasis is a neglected tropical disease caused by the adult female sand flea (Tunga penetrans). Dogs are considered important reservoirs of T. penetrans in Brazil. The aim of this study was to determine the monthly insecticidal efficacy of a single oral administration of fluralaner at a dose of 10-18 mg/kg (Bravecto® 1-Month, also registered as Defenza® in some countries; MSD Animal Health) in dogs naturally infested with T. penetrans. METHODS: This clinical trial was conducted in a rural community located in Ilhéus, Bahia, Brazil. A total of 64 dogs were selected and distributed in a completely randomized design between a treated group (TG) that received one single dose of Bravecto® 1-Month (Defenza®) and a negative control group (CG) that received no treatment. Each group was composed of 32 dogs. The evaluations took place on days 0, 7 ± 2, 14 ± 2, 21 ± 2, 28 ± 2, 35 ± 2, and 42 ± 2 post treatment, in which the dogs were inspected to evaluate the infestation stage and classify lesions associated with tungiasis. The primary efficacy was determined from the percentage of treated dogs free of fleas (stage II and III lesions) after administration of the formulation at each evaluation time. Secondary efficacy was based on the number of active lesions (stages II and III) in each group at each evaluation time. The clinical condition of the animals was defined based on the Severity Score for Acute Dog Tungiasis (SCADT), which is related to the number and severity of lesions. RESULTS: The primary efficacy of the product was greater than 95.0% from days 7 to 21 and reached 100.0% between days 28 and 42, with a significant association between treatment and infestation decline (P < 0.025) between days 7 and 42. Secondary drug efficacy was greater than 99.9% from days 7 to 21, reaching 100.0% between days 28 and 42 (P < 0.05). The treated dogs also scored lower on the SCADT than the control animals did during the entire clinical evaluation period (P < 0.05). CONCLUSIONS: A single administration of Bravecto® 1-Month (Defenza®) was effective in eliminating Tunga penetrans infestations, as well as in preventing parasitism for at least 42 days after treatment.
Assuntos
Doenças do Cão , Inseticidas , Isoxazóis , Tunga , Tungíase , Animais , Cães , Brasil , Isoxazóis/administração & dosagem , Isoxazóis/uso terapêutico , Doenças do Cão/tratamento farmacológico , Doenças do Cão/parasitologia , Feminino , Inseticidas/administração & dosagem , Inseticidas/uso terapêutico , Tunga/efeitos dos fármacos , Tungíase/tratamento farmacológico , Tungíase/veterinária , Tungíase/parasitologia , Administração Oral , Masculino , Método Duplo-Cego , Resultado do TratamentoRESUMO
BACKGROUND: Tungiasis is a neglected disease caused by Tunga penetrans that can be complicated by secondary infections and local tissue destruction. Adequate treatment is important, especially in vulnerable populations; potential treatment options proposed range from surgical extraction to the use of oral and topical medications. We aimed to perform a systematic review to assess the efficacy of topical, oral and surgical interventions for the treatment of tungiasis. METHODOLOGY/PRINCIPAL FINDINGS: The present review is registered in PROSPERO (CRD42021234741). On September 1, 2020, we searched PubMed, EMBASE, Scopus, Web of Science, Science Direct, Scielo and LILACS BVS. We included clinical trials and longitudinal observational studies that evaluated any topical, systemic or mechanical treatment for tungiasis. We used the Revised Cochrane Risk of Bias (RoB) Tool for Randomized Trials for clinical trial analysis. Qualitative and quantitative descriptive syntheses were performed. Our search strategy resulted in 3376 references. Subsequently, 2568 titles/abstracts and 114 full texts were screened. We finally included 19 articles; 9 were classified as clinical trials. Two and 3 articles presented low and some RoB, respectively, according to the tool. Only two articles tested the efficacy of oral medications (niridazole, ivermectin), with discouraging results. Six clinical trials evaluated topical products for the treatment of tungiasis; 2 evaluated dimeticone-based compounds and reported positive results in lesion reduction and cure. None reported significant adverse reactions. Surgical extraction was evaluated only in observational studies. CONCLUSIONS/SIGNIFICANCE: We conclude that, although surgical extraction is the most commonly used treatment, there is sufficient evidence supporting the use of occlusive agents, especially manufactured dimeticone-based products.
Assuntos
Antiparasitários/administração & dosagem , Tungíase/parasitologia , Tungíase/cirurgia , Administração Oral , Administração Tópica , Animais , Ensaios Clínicos como Assunto , Humanos , Ivermectina/administração & dosagem , Niridazol/administração & dosagem , Tunga/efeitos dos fármacos , Tunga/fisiologia , Tungíase/tratamento farmacológicoRESUMO
Tungiasis is a public health problem in endemic resource-poor communities, where dogs are important reservoirs of Tunga spp., contributing significantly to the process of transmission of this zoonosis. In order to optimize the diagnosis of canine tungiasis, macroscopic morphological characteristics and clinical signs of the lesions were investigated, based on the inspection of 40 dogs infested by T. penetrans from an endemic rural community in northeastern Brazil. Of the 1546 lesions found in these dogs, including all stages of development of the parasite, 89.1% (1378) were located on the paw pads. Dogs aged up to 5 years had the greatest number of lesions. Dark pigmentation and hyperkeratosis of the paw pads made it difficult to identify the lesions. Among all the clinical signs observed were hyperemia (38; 95%), pain (32; 80%), fissure (11; 27.5%), onychogryphosis (29; 72.5%), cluster of lesions (26; 65%), hyperkeratosis (25; 62.5%), lameness (15; 37.5%), and fissure (11; 27.5%). Ectopic lesions were found especially in the nipples (64; 4.1%) and abdomen (51; 3.3%). The maximum diameter of the stage III neosomes was 6 mm. Dogs with a higher number of lesions had a higher degree of hyperkeratosis. Age over 1 year was associated with a higher rate of dispersion of the parasite in the environment (p = 0.04). The identification of the initial stages of tungiasis can guarantee a more effective control of the disease in dogs, which will mainly depend on the treatment of adult animals and the application of continuous preventive actions based on One Health in these communities.
Assuntos
Doenças do Cão/parasitologia , Tunga/fisiologia , Tungíase/veterinária , Animais , Brasil/epidemiologia , Doenças do Cão/epidemiologia , Doenças do Cão/patologia , Cães , Feminino , Masculino , Saúde Pública , Pele/parasitologia , Pele/patologia , Tunga/classificação , Tunga/genética , Tungíase/epidemiologia , Tungíase/parasitologia , Tungíase/patologia , Zoonoses/epidemiologia , Zoonoses/parasitologia , Zoonoses/patologiaRESUMO
BACKGROUND: Tungiasis is a neglected neotropical disease caused by penetration of Tunga spp. into the skin of the host. METHODS: Two primates were rescued from nearby different indigenous villages, and the clinical, pathological, and parasitological features of tungiasis were described. Flea identification occurred through their morphometry and was confirmed with the use of a dichotomous key. RESULTS: Monkey 1 was parasitized by 23 sand fleas and, after treatment, was assigned to the animal rehabilitation center. Monkey 2 was in poor body condition and died shortly after clinical examination. At necropsy, this primate was parasitized by 26 specimens of sand fleas. CONCLUSIONS: Both animals altered their tree behavior by staying on the ground for long periods. This parasitic relationship implies the possibility of enlargement of the sand flea dispersion. Thus, this is the first record of Tunga penetrans occurrence in wild Alouatta guariba clamitans.
Assuntos
Alouatta , Doenças dos Macacos/diagnóstico , Tunga/fisiologia , Tungíase/veterinária , Animais , Brasil , Feminino , Masculino , Doenças dos Macacos/parasitologia , Doenças dos Macacos/patologia , Tungíase/diagnóstico , Tungíase/parasitologia , Tungíase/patologiaRESUMO
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 Ilhéus, 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 < 1 year of age had a higher mean prevalence of 84.5%, as compared with 69.3% in the older dogs. No significant difference was found between the risk of infestation and age or sex (p = 0.61). Our data indicate that canine tungiasis persisted in the area during all periods of the year. The seasonal variation described in human studies from other endemic areas was not observed, most probably due to different rainfall patterns throughout the year. The study has important implications for the planning of integrated control measures in both humans and animal reservoirs, considering a One Health approach.
Assuntos
Doenças do Cão/parasitologia , Tunga/fisiologia , Tungíase/parasitologia , Tungíase/veterinária , Animais , Brasil/epidemiologia , Doenças do Cão/epidemiologia , Cães , Doenças Endêmicas/estatística & dados numéricos , Doenças Endêmicas/veterinária , Meio Ambiente , Feminino , Humanos , Estudos Longitudinais , Masculino , Prevalência , Estações do Ano , Inquéritos e Questionários , Tunga/genética , Tungíase/epidemiologiaRESUMO
Tungiasis is a cutaneous parasitosis caused by infestation of the skin by gravid fleas of the genus Tunga, mainly Tunga penetrans. This flea is very common in tropical and subtropical regions of the globe, but not in Europe. The infestation is acquired by walking barefoot or lying in places where the flea is present, usually beaches or sandy soils. We report two unrelated cases of imported tungiasis in Portugal that presented to our clinic in the same week. We draw attention to one of the most common dermatological diseases in travelers returning from tropical countries, the diagnosis of which is primarily clinical but nonetheless is largely unfamiliar to clinicians attending those patients.
Assuntos
Doenças do Pé/diagnóstico , Doenças do Pé/parasitologia , Viagem , Tungíase/diagnóstico , África , Animais , Brasil , Dermoscopia , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Portugal , Tunga , Tungíase/parasitologiaRESUMO
La tungiasis es una ectoparasitosis causada por la penetración en la piel de la pulga hembra Tunga penetrans. Esta enfermedad no es específica del hombre y se distribuye en regiones cálidas y secas alrededor del mundo. Se adquiere por contacto directo con el suelo en donde habitan los parásitos adultos. En zonas endémicas, su alta prevalencia se asocia a pobreza y falta de acceso al sistema de salud. Además es frecuente entre viajeros que visitan regiones endémicas y que regresan a sus lugares de origen. Presentamos un caso típico de tungiasis en un paciente 39 años que había realizado un viaje reciente a zona endémica. (AU)
Tungiasis is an ectoparasitosis caused by penetration into the skin of the female flea Tunga penetrans. This disease is not human-specific and is distributed worldwide in warm, dry regions. It is acquired by direct contact with the soil where the adult parasites live. In endemic areas, its high prevalence is associated with poverty and lack of access to the health system. It is also frequent among travelers visiting endemic regions and returning to their places of origin. We present a typical case of tungiasis in a 39 year old patient who had made a recent trip to an endemic area. (AU)
Assuntos
Humanos , Animais , Masculino , Feminino , Criança , Adulto , Pessoa de Meia-Idade , Idoso , Tungíase/diagnóstico , Tungíase/patologia , Argentina/epidemiologia , Fatores Socioeconômicos , Infecções Bacterianas/complicações , Áreas de Pobreza , Fatores de Risco , Doenças Endêmicas , DDT/uso terapêutico , Tunga/classificação , Tungíase/cirurgia , Tungíase/etiologia , Tungíase/parasitologia , Tungíase/prevenção & controle , Doença Relacionada a Viagens , Barreiras ao Acesso aos Cuidados de Saúde , Acessibilidade aos Serviços de Saúde , Repelentes de Insetos/uso terapêuticoRESUMO
Tunga penetrans (Siphonaptera, Tungidae) is a flea that infests humans and a variety of domestic and wild animals. Burrowing of the female flea under the skin causes tungiasis, a disease that manifests in skin lesions that if untreated, can progress to severe complications. In this paper, we report the first case of T. penetrans in a wild giant anteater (Myrmecophaga tridactyla) from Argentina. We describe the lesions and discuss the potential role of the giant anteater as a host or reservoir for this flea.
Assuntos
Doenças do Pé/veterinária , Tunga , Tungíase/veterinária , Xenarthra/parasitologia , Animais , Argentina/epidemiologia , Doenças do Pé/parasitologia , Masculino , Tungíase/epidemiologia , Tungíase/parasitologiaRESUMO
This review focuses on the neosomes, morphology, and taxonomy of adult species of the genus Tunga, complementing the previously published data on the phylogeny, ecology, and pathogenic role. Neosomes are structures formed after penetration of adult females into the skin of hosts resulting in significant enlargement, being the most characteristic and most frequently observed form in hosts. Neosomes can be differentiated by shape, measurements, and sites of attachment to principal hosts. The taxonomic value and morphometric data of the most widely used characteristics to separate species - such as frontal curvature, head chaetotaxy, preoral internal sclerotization, ventral and dorsal genal lobes, eyes, maxillary palps, fusion of pronotum and mesonotum, metacoxae, metatarsi chaetotaxy, spermatheca (females), manubrium, basimere, telomere, and phallosome (males) - are comparatively analyzed. The sexes, individual variations, undescribed species, higher taxa, as well as a proposal for division of the genus into two subgenera (Tunga and Brevidigita) are presented (as previously given by Wang). A key for females, males, and gravid females (neosomes) also is included for identifying the 13 known species. Data on host specificity and geographical distribution may also support the identification of Tunga species because some sand fleas and their hosts may have co-evolved.
Assuntos
Tunga , Estruturas Animais/ultraestrutura , Animais , Feminino , Masculino , Caracteres Sexuais , Especificidade da Espécie , Tunga/anatomia & histologia , Tunga/classificação , Tunga/crescimento & desenvolvimento , Tunga/ultraestrutura , Tungíase/parasitologiaRESUMO
Tunga trimamillata is a species of sand flea occurring in Ecuador and Peru parasitizing cattle, goat, sheep, swine, and man. This is the first report of this species in Brazil, having been found on the hooves of cows in Barretos, São Paulo State, and Felixlândia, Minas Gerais State, and previously misidentified as Tunga penetrans. A previous report concerning Hydrochoerus hydrochaeris from Rio Novo, Minas Gerais State, may also be attributed to that species of sand flea, a possible the primary host. Given the large geographical distribution of T. trimamillata, the vast cattle population in Brazil, and the high number of individuals subject to the risk of tungiasis, the number of cases attributed to this sand flea will most likely increase over time.