RESUMO
Tropical regions receive a significant part of the traveling population. It is very important that health professionals are familiar with the main tropical skin diseases and able to advice patients appropriately. This article reviews the main tropical diseases of travelers, with an emphasis on diagnosis, management, and prevention. Among others, cutaneous larva migrans, myiasis, tungiasis, Chagas disease, Dengue fever, African trypanosomiasis, filariasis, and leishmaniasis are discussed. Increasing awareness among travelers and health care professionals can help reduce morbidity and mortality. Continued research on new drugs and vaccines is needed to reduce the risks of tropical diseases.
Assuntos
Dermatopatias/terapia , Viagem , Doença de Chagas/diagnóstico , Doença de Chagas/prevenção & controle , Doença de Chagas/terapia , Exantema/diagnóstico , Exantema/prevenção & controle , Exantema/terapia , Humanos , Larva Migrans/diagnóstico , Larva Migrans/prevenção & controle , Larva Migrans/terapia , Leishmaniose/diagnóstico , Leishmaniose/prevenção & controle , Leishmaniose/terapia , Miíase/diagnóstico , Miíase/prevenção & controle , Miíase/terapia , Escabiose/diagnóstico , Escabiose/prevenção & controle , Escabiose/terapia , Dermatopatias/diagnóstico , Dermatopatias/prevenção & controle , Tripanossomíase Africana/diagnóstico , Tripanossomíase Africana/prevenção & controle , Tripanossomíase Africana/terapia , Tungíase/diagnóstico , Tungíase/prevenção & controle , Tungíase/terapia , Febre Amarela/diagnóstico , Febre Amarela/prevenção & controle , Febre Amarela/terapiaRESUMO
Tungiasis (sand flea disease) is caused by the penetration of females of Tunga penetrans into the skin of the feet. Within 2 weeks of penetration the burrowed flea increases its volume by a factor of 2,000. This is paralleled by intense inflammation of the surrounding tissue. Acute and chronic inflammation leads to the development of painful and debilitating clinical pathology. This results in impaired physical fitness and mobility. The social implications of tungiasis-associated morbidity are multifold. Children with tungiasis are teased and ridiculed, adults feel ashamed and stigmatized. There is anecdotal evidence that tungiasis negatively affects educational achievements. Impaired mobility and physical fitness will have a negative impact on household economics. Sand flea disease is common in resource-poor communities in South America and in sub-Saharan Africa with prevalence in the general population of up to 60%. In East Africa, it has re-emerged in epidemic dimensions in recent years. Hitherto, no effective drug treatment has been at hand. Traditional treatment, i.e., the manipulation of burrowed sand fleas with blunt and inappropriate instruments may facilitate the transmission of blood-derived pathogens. Prevention is feasible through regular application of a repellent based on coconut oil. Owing to its strong association with poverty, sand flea disease would be an excellent starting point for a community-based fight against rural poverty.
Assuntos
Administração em Saúde Pública , Tunga/patogenicidade , Tungíase/epidemiologia , África Subsaariana/epidemiologia , Animais , Países em Desenvolvimento , Humanos , Fatores Socioeconômicos , América do Sul/epidemiologia , Tungíase/patologia , Tungíase/psicologia , Tungíase/terapiaRESUMO
Tungiasis is a zoophilic and anthropophilic infestation caused by Tunga penetrans. It is endemic in Latin America and in the Caribbean. It occurs mainly in impoverished communities that have no access to basic sanitation and in individuals that visit contaminated areas. The most common penetration site of this ectoparasite is the periungueal region of the feet. The authors present its disseminated form occurring in a patient inhabiting a rural area.
Assuntos
Dermatoses do Pé/diagnóstico , Tungíase/diagnóstico , Adulto , Dermatoses do Pé/terapia , Humanos , Masculino , Tungíase/terapiaRESUMO
A tungíase é uma infestação zooantropofílica causada pela Tunga penetrans. É endêmica na América Latina e no Caribe. Ocorre, principalmente, em comunidades carentes e sem saneamento básico e em indivíduos que visitam áreas contaminadas. O local mais comum de penetração do ectoparasita é a região periungueal dos pés. Os autores mostram a ocorrência de uma forma disseminada num habitante da zona rural.
Tungiasis is a zoophilic and anthropophilic infestation caused by Tunga penetrans. It is endemic in Latin America and in the Caribbean. It occurs mainly in impoverished communities that have no access to basic sanitation and in individuals that visit contaminated areas. The most common penetration site of this ectoparasite is the periungueal region of the feet. The authors present its disseminated form occurring in a patient inhabiting a rural area.
Assuntos
Adulto , Humanos , Masculino , Dermatoses do Pé/diagnóstico , Tungíase/diagnóstico , Dermatoses do Pé/terapia , Tungíase/terapiaRESUMO
There are six diseases that WHO considers as the major threat in developing countries, leprosy, filariasis, malaria, schistosomiasis, Chagas disease and leishmaniasis; and of these only malaria does not present skin lesions. These diseases are among the so called tropical diseases found in countries of tropical climate, usually infections and infestations considered exotic and rare in European and North American countries. It is extremely important for doctors of all countries to be able to provide correct pre travel counseling and to make early diagnosis and treatment, thus avoiding dissemination of these dieases to non endemic areas. The authors review some important tropical diseases seen in Brazil, as paracoccidiodomycosis, lobomycosis, myiasis, tungiasis, and cutaneous schistosomiasis and discuss new information about them.
Assuntos
Dermatopatias Infecciosas , Brasil , Humanos , Lobomicose/diagnóstico , Lobomicose/terapia , Miíase/diagnóstico , Miíase/terapia , Paracoccidioidomicose/diagnóstico , Paracoccidioidomicose/terapia , Esquistossomose/diagnóstico , Esquistossomose/terapia , Dermatopatias Infecciosas/diagnóstico , Dermatopatias Infecciosas/terapia , Dermatopatias Parasitárias/diagnóstico , Dermatopatias Parasitárias/terapia , Medicina Tropical , Tungíase/diagnóstico , Tungíase/terapiaRESUMO
INTRODUCTION: Tungiasis, the skin infestation with the flea Tunga penetrans, occurs in poor communities. Objective. To present a study of this condition among native Amerindians from Vaupés (Colombia). METHODS: After reviewing this topic, we present a description of the geographic area and the housing of the affected subjects; animal carriers infected with this zoonosis were also detected. We illustrate the clinical aspects and complications. Patients were treated with creolin (liquid cresol). We modified the floor of malocas in two communities using wet clay, and we educated the community on this parasite. RESULTS: About 95% of the 33,000 inhabitants of Vaupés are native Amerindians. Some households have dry sandy floors, where food leftovers attract dogs infested with tungiasis. From 1996 to 2007 we confirmed 942 human cases of this parasitic disease. Among the native communities, 3 to 8 per 1,000 persons and 62% of the dogs have tungiasis. Feet were affected in 98% of the patients. Severe cases, with more than 20 lesions, occurred among children and the elderly. Complications included secondary infections, pain, anonychia (loss of toenails), toe deformities, amputation of toes and walking problems. Three patients died as a result of sepsis originating from toe infections. Topic use of liquid creolin and extraction of the parasite cured the problem in humans and dogs. Floor modifications eradicated the problem in one community. CONCLUSIONS: Tungiasis is an intradomiciliary disease. Favorable conditions for infestations include dry sandy floors and infected dogs. Treatment of the floors with creolin and wet clay resulted in control of one focus of the disease; this method could be applied more widely. This is the first known research study on tungiasis in Colombia, a disease that affected the soldiers of the Spanish Conquistador Gonzalo Jiménez de Quesada in the 1500s.