title: Investigations on the biology, epidemiology, pathology, and control of Tunga penetrans in Brazil: VII. The importance of animal reservoirs for human infestation.
abstract: In Brazil tungiasis is endemic in many resource-poor communities, where various domestic and sylvatic animals act as reservoirs for this zoonosis. To determine the role of animal reservoirs in human tungiasis, a cross-sectional study was performed in a traditional fishing community in northeast Brazil. The human and the animal populations were examined for the presence of embedded sand fleas and the prevalence and the intensity of infestation were correlated. The overall prevalence of tungiasis in humans was 39% (95% CI 34-43%). Of six mammal species present in the village, only cats and dogs were found infested. The prevalence in these animals was 59% (95% CI 50-68%). In households, where infested pet animals were present, a higher percentage of household members had tungiasis (42% [95% CI 30-53%] versus 27% [20-33%], p=0.02), and the intensity of the infestation was higher (six lesions versus two lesions, p=0.01). The intensity of infestation in animals correlated with the intensity of infestation in humans (rho=0.3, p=0.02). Living in a household with an infested dog or cat led to a 1.6-fold (95% CI 1.1-2.3, p=0.015) increase in the odds for the presence of tungiasis in household members in the bivariate analysis and remained a significant risk factor in the multivariate regression analysis. The study shows that in this impoverished community tungiasis is highly prevalent in humans and domestic animals. In particular, it underlines the importance to include animals in control operation aiming at the reduction of disease occurrence in the human population.
authors.affiliation: Institute for Microbiology and Hygiene, Charité-University of Medicine, Campus Benjamin Franklin, Hindenburgdamm 27, 12203, Berlin, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Pilger
authors.forename: Stefan
authors.initials: S
authors.lastname: Schwalfenberg
authors.forename: Jörg
authors.initials: J
authors.lastname: Heukelbach
authors.forename: Lars
authors.initials: L
authors.lastname: Witt
authors.forename: Heinz
authors.initials: H
authors.lastname: Mehlhorn
authors.forename: Norbert
authors.initials: N
authors.lastname: Mencke
authors.forename: Adak
authors.initials: A
authors.lastname: Khakban
authors.forename: Hermann
authors.initials: H
authors.lastname: Feldmeier
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000829:Animals, Domestic; D001938:Brazil / Q000453:epidemiology; D002371:Cat Diseases / Q000453:epidemiology* / Q000469:parasitology / Q000473:pathology; D002415:Cats; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004197:Disease Reservoirs / Q000469:parasitology / Q000662:veterinary*; D004283:Dog Diseases / Q000453:epidemiology* / Q000469:parasitology / Q000473:pathology / Q000517:prevention & control; D004285:Dogs; D004478:Ectoparasitic Infestations / Q000453:epidemiology* / Q000469:parasitology / Q000473:pathology / Q000517:prevention & control; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population; D005423:Siphonaptera / Q000502:physiology*