title: A simple intervention to prevent cutaneous larva migrans among devotees of the Nallur Temple in Jaffna, Sri Lanka.
abstract: BACKGROUND
  A cross sectional study conducted during the annual festival at Nallur temple in Jaffna, Sri Lanka, in 2010, showed that the prevalence of cutaneous larva migrants (CLM) among the devotees who performed the side roll ritual was 58.2% (95%CI: 51.2%-65.0%).
  
  
  OBJECTIVE
  To test the hypothesis that the deworming stray dogs around the temple premises effectively reduces the prevalence of CLM among devotees.
  
  
  RESULTS
  All stray dogs (8) in the vicinity of the temple were treated, with mebendazole (100 mg) crushed and filled into sausages, 10 days before the commencement of festival in 2011. The same procedure was repeated a week later to ensure complete coverage. A cross-sectional study was conducted among 200 systematically selected devotees in August 2011 using an interviewer-administered questionnaire and the clinical examination of the skin. Baermann's technique was used for the recovery of nematode larvae from 40 soil samples collected from the temple premises. Ten samples of dog faeces collected from the same premises were also examined for nematode eggs. Prevalence of CLM among devotees in 2010 (Pre intervention) and 2011(Post intervention) were compared to test the hypothesis. Prevalence of CLM declined from 58% to 8% (Chi-square = 112.90, p<0.001) following the intervention. None of the subjects practiced new precautionary measures compared to the previous year. Soil and fecal samples were negative for parasites.
  
  
  CONCLUSIONS
  Regular dog deworming is an important and effective method for the prevention of CLM among the devotees doing side roll ritual and represents a pragmatic intervention that municipal authorities could perform on annual basis.
authors.affiliation: Division of Parasitology, Department of Pathology, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka. selvamkannathasan@gmail.com
authors.forename: Selvam
authors.initials: S
authors.lastname: Kannathasan
authors.forename: Arumugam
authors.initials: A
authors.lastname: Murugananthan
authors.forename: Nadarajah
authors.initials: N
authors.lastname: Rajeshkannan
authors.forename: Nilanthi Renuka
authors.initials: NR
authors.lastname: de Silva
mesh_terms: D000328:Adult; D000818:Animals; D002562:Ceremonial Behavior; D004285:Dogs; D006801:Humans; D007815:Larva Migrans / Q000453:epidemiology / Q000517:prevention & control*; D008875:Middle Aged; D012067:Religion; D012987:Soil / Q000469:parasitology; D013188:Sri Lanka / Q000453:epidemiology; D055815:Young Adult
chemical_list: D012987:Soil