title: Successful Treatment of Severe Tungiasis in Pigs Using a Topical Aerosol Containing Chlorfenvinphos, Dichlorphos and Gentian Violet.
abstract: BACKGROUND
  In endemic communities, zoonotic tungiasis, a severe skin disease caused by penetrating female sand fleas, is a public health hazard causing significant human and animal morbidity. No validated drugs are currently available for treatment of animal tungiasis. Due to the reservoir in domestic animals, integrated management of human and animal tungiasis is required to avert its negative effects.
  
  
  RESULTS
  A topical aerosol containing chlorfenvinphos 4.8%, dichlorphos 0.75% and gentian violet 0.145% licensed to treat tick infestations, myiasis and wound sepsis in animals in the study area, was tested for its potential tungicidal effects in a randomized controlled field trial against pig tungiasis in rural Uganda. Animals with at least one embedded flea were randomized in a treatment (n = 29) and a control (n = 26) group. One week after treatment, 58.6% of the treated pigs did not show any viable flea lesion whereas all control pigs had at least one viable lesion. After treatment the number of viable lesions (treated median = 0, overall range = 0-18 vs. control median = 11.5, range = 1-180) and the severity score for estimating acute pathology in pig tungiasis (treated median = 1, range = 0-3.5 vs. control median = 7, range = 0-25) were significantly lower in treated than in control pigs (p < 0.001). In the treatment group the median number of viable flea lesions decreased from 8.5 to 0 (p < 0.001). Similarly, the median acute severity score dropped from 6 to 1 (p < 0.001). Every pig in the treatment group showed a decrease in the number of viable fleas and tungiasis-associated acute morbidity while medians for both increased in the control group.
  
  
  CONCLUSIONS
  The study demonstrates that a topical treatment based on chlorfenvinphos, dichlorphos and gentian violet is highly effective against pig tungiasis. Due to its simplicity, the new approach can be used for the treatment of individual animals as well as in mass campaigns.
authors.affiliation: School of Veterinary Medicine and Animal Resources, College of Veterinary Medicine, Animal Resources and Bio-security, Makerere University, Kampala, Uganda.
authors.forename: Francis
authors.initials: F
authors.lastname: Mutebi
authors.affiliation: Institute for Parasitology and Tropical Veterinary Medicine, Freie Universität Berlin, Berlin, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: von Samson-Himmelstjerna
authors.affiliation: Institute of Microbiology and Hygiene, Charité University Medicine, Berlin, Campus Benjamin Franklin, Berlin, Germany.
authors.forename: Hermann
authors.initials: H
authors.lastname: Feldmeier
authors.affiliation: School of Veterinary Medicine and Animal Resources, College of Veterinary Medicine, Animal Resources and Bio-security, Makerere University, Kampala, Uganda.
authors.forename: Charles
authors.initials: C
authors.lastname: Waiswa
authors.affiliation: National Drug Authority, Kampala, Uganda.
authors.forename: Jeanne
authors.initials: J
authors.lastname: Bukeka Muhindo
authors.affiliation: Institute for Parasitology and Tropical Veterinary Medicine, Freie Universität Berlin, Berlin, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Krücken
mesh_terms: D000287:Administration, Topical; D000336:Aerosols / Q000627:therapeutic use*; D000818:Animals; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D002709:Chlorfenvinphos / Q000008:administration & dosage* / Q000009:adverse effects; D004197:Disease Reservoirs; D004338:Drug Combinations; D005260:Female; D058267:Flea Infestations / Q000188:drug therapy*; D005840:Gentian Violet / Q000008:administration & dosage*; D006801:Humans; D007306:Insecticides / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D034421:Sus scrofa; D013552:Swine; D013553:Swine Diseases / Q000188:drug therapy* / Q000469:parasitology; D058253:Tunga / Q000187:drug effects*; D058285:Tungiasis / Q000188:drug therapy* / Q000453:epidemiology / Q000469:parasitology; D014454:Uganda / Q000453:epidemiology
chemical_list: D000336:Aerosols; D000891:Anti-Infective Agents, Local; D004338:Drug Combinations; D007306:Insecticides; D002709:Chlorfenvinphos; D005840:Gentian Violet