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Clinical Trial
. 2008;2(10):e324.
doi: 10.1371/journal.pntd.0000324. Epub 2008 Oct 22.

Controlling tungiasis in an impoverished community: an intervention study

Daniel Pilger  1 , Stefan Schwalfenberg, Jörg Heukelbach, Lars Witt, Norbert Mencke, Adak Khakban, Hermann Feldmeier
Affiliations
Clinical Trial

Controlling tungiasis in an impoverished community: an intervention study

Daniel Pilger et al. PLoS Negl Trop Dis. 2008.

Abstract

Background: In Brazil, tungiasis is endemic in some resource-poor communities where various domestic and sylvatic animals act as reservoirs for this zoonosis. To determine the effect of control measures on the prevalence and intensity of infestation of human and animal tungiasis, a repeated cross-sectional survey with intervention was carried out.

Methodology/principal findings: In a traditional fishing community in Northeast Brazil, humans and reservoir animals were treated, and premise-spraying using an insecticide was done, while a second fishing community served as a control. Both communities were followed up 10 times during a 12-month period. At baseline, prevalence of tungiasis was 43% (95% confidence interval [CI]: 35%-51%) and 37% (95% CI: 31%-43%) in control and intervention villages, respectively. During the study, prevalence of tungiasis dropped to 10% (95% CI: 8%-13%; p<0.001) in the intervention village, while the prevalence remained at a high level in the control village. However, after one year, at the end of the study, in both communities the prevalence of the infestation had reached pre-intervention levels. Whereas the intensity of infestation was significantly reduced in the intervention community (p<0.001), and remained low at the end of the study (p<0.001), it did not change in the control village.

Conclusion/significance: Our study shows that a reduction of prevalence and intensity of infestation is possible, but in impoverished communities a long-lasting reduction of disease occurrence can only be achieved by the regular treatment of infested humans, the elimination of animal reservoirs, and, likely, through environmental changes.

Trial registration: Controlled-Trials.com ISRCTN27670575.

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Conflict of interest statement

Norbert Mencke is a senior scientist at Bayer Health Care, Monheim, Germany, a company which produces insecticides.

Figures

Figure 1
Figure 1. Point prevalences of tungiasis during study period.
Explanatory text: Grey areas mark the intervention period in (A) the human population and (B) the animal population. Numbers indicate type and onset of interventions (see Table 1).
Figure 2
Figure 2. Intensity of infestation during study period.
Explanatory text: Intensity of infestation in humans (A) and animals (B); pre-intervention, immediately after the intervention, and after one year of follow-up.
See this image and copyright information in PMC

References

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