title: Investigations on the biology, epidemiology, pathology and control of Tunga penetrans in Brazil. II. Prevalence, parasite load and topographic distribution of lesions in the population of a traditional fishing village.
abstract: Tungiasis is hyperendemic in many poor communities in Brazil and is associated with considerable morbidity. In order to understand the factors that determine the distribution of this ectoparasitosis in a rural community, an epidemiological study was carried out in a traditional fishing village in Ceará State, north-eastern Brazil. Based on active case detection and voluntary participation, 91% of the population (belonging to 95% of all families) was examined. Embedded fleas were looked for over all parts of the body, counted, and the lesions were staged. The overall prevalence of infestation was 51.3% (95% CI: 47.0-55.5). More males than females were infested (54.8% vs 48.3%); however, this difference was not statistically significant. Age-specific prevalence rates followed an S-shaped curve with peaks in children aged 5-9 years and people elder than 60 years. The parasite burden was high (range 1-145 lesions; arithmetic mean: 8.9) and particularly elevated in males, children <15 years and the elderly. The distribution of the parasite burden was uneven within the population with the majority of the lesions in a few individuals: the 23 subjects (8% of all infested) with severe infestation (>30 lesions) accounted for 1,366 of the 2,493 lesions (54.8%) documented. The study shows that tungiasis is a highly prevalent ectoparasitosis in this deprived community with a peculiar distribution of prevalence and parasite burden.
authors.affiliation: Institute of International Health, Free University of Berlin, 12203 Berlin, Germany.
authors.forename: Marion
authors.initials: M
authors.lastname: Muehlen
authors.forename: Jörg
authors.initials: J
authors.lastname: Heukelbach
authors.forename: Thomas
authors.initials: T
authors.lastname: Wilcke
authors.forename: Benedikt
authors.initials: B
authors.lastname: Winter
authors.forename: Heinz
authors.initials: H
authors.lastname: Mehlhorn
authors.forename: Hermann
authors.initials: H
authors.lastname: Feldmeier
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000818:Animals; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004478:Ectoparasitic Infestations / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D017678:Sex Distribution; D005423:Siphonaptera / Q000472:pathogenicity* / Q000502:physiology