title: High exposure to Tunga penetrans (Linnaeus, 1758) correlates with intensity of infestation.
abstract: Tungiasis is a parasitic skin disease widespread in resource-poor urban and rural communities in Brazil. Inhabitants of an urban slum in Northeast Brazil were examined for the presence of tungiasis lesions and followed-up twice a week for a period of three weeks. Each time the number, stages, and topographic localization of lesions were recorded on a documentation sheet. The infestation rate (number of newly embedded sand fleas per individual and day) remained stable during the observation period. The infestation rate was significantly related to the intensity of infestation (total number of lesions present) (rho = 0.70, p < 0.0001) and the proportion of viable lesions (rho = 0.28, p < 0.0001). The results indicate that in an endemic area the infestation intensity and the proportion of viable lesions can be used as a proxy to assess the exposure of individuals at risk for tungiasis. Persistently high infestation rates during the transmission season favour the use of prevention measures against invading sand fleas (such as a repellent) rather than a drug to kill already embedded parasites.
authors.affiliation: Department of Medical Microbiology and Immunology of Infection, Institute of Infection Medicine, Charité-University Medicine, Berlin, Germany.
authors.forename: Hermann
authors.initials: H
authors.lastname: Feldmeier
authors.forename: Judith Dorothea
authors.initials: JD
authors.lastname: Kehr
authors.forename: Gabriele
authors.initials: G
authors.lastname: Poggensee
authors.forename: Jörg
authors.initials: J
authors.lastname: Heukelbach
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004478:Ectoparasitic Infestations / Q000453:epidemiology* / Q000469:parasitology; D019353:Endemic Diseases; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011156:Population Density; D011203:Poverty; D012720:Severity of Illness Index; D005423:Siphonaptera