Controlling tungiasis in an impoverished community: an intervention study.
BACKGROUND: In Brazil, tungiasis is endemic in some resource-poor communities where various domestic and sylvatic animals act as reservoirs for this zoonosis. To determine the effect of control measures on the prevalence and intensity of infestation of human and animal tungiasis, a repeated cross-se...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2008-01-01
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| Series: | PLoS Neglected Tropical Diseases |
| Online Access: | http://europepmc.org/articles/PMC2565488?pdf=render |
| _version_ | 1819058525994745856 |
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| author | Daniel Pilger Stefan Schwalfenberg Jörg Heukelbach Lars Witt Norbert Mencke Adak Khakban Hermann Feldmeier |
| author_facet | Daniel Pilger Stefan Schwalfenberg Jörg Heukelbach Lars Witt Norbert Mencke Adak Khakban Hermann Feldmeier |
| author_sort | Daniel Pilger |
| collection | DOAJ |
| description | BACKGROUND: In Brazil, tungiasis is endemic in some resource-poor communities where various domestic and sylvatic animals act as reservoirs for this zoonosis. To determine the effect of control measures on the prevalence and intensity of infestation of human and animal tungiasis, a repeated cross-sectional survey with intervention was carried out. METHODOLOGY/PRINCIPAL FINDINGS: In a traditional fishing community in Northeast Brazil, humans and reservoir animals were treated, and premise-spraying using an insecticide was done, while a second fishing community served as a control. Both communities were followed up 10 times during a 12-month period. At baseline, prevalence of tungiasis was 43% (95% confidence interval [CI]: 35%-51%) and 37% (95% CI: 31%-43%) in control and intervention villages, respectively. During the study, prevalence of tungiasis dropped to 10% (95% CI: 8%-13%; p<0.001) in the intervention village, while the prevalence remained at a high level in the control village. However, after one year, at the end of the study, in both communities the prevalence of the infestation had reached pre-intervention levels. Whereas the intensity of infestation was significantly reduced in the intervention community (p<0.001), and remained low at the end of the study (p<0.001), it did not change in the control village. CONCLUSION/SIGNIFICANCE: Our study shows that a reduction of prevalence and intensity of infestation is possible, but in impoverished communities a long-lasting reduction of disease occurrence can only be achieved by the regular treatment of infested humans, the elimination of animal reservoirs, and, likely, through environmental changes. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN27670575. |
| first_indexed | 2024-12-21T13:56:36Z |
| format | Article |
| id | doaj.art-13bca421ef09487294115f90e5a80ae2 |
| institution | Directory Open Access Journal |
| issn | 1935-2735 |
| language | English |
| last_indexed | 2024-12-21T13:56:36Z |
| publishDate | 2008-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Neglected Tropical Diseases |
| spelling | doaj.art-13bca421ef09487294115f90e5a80ae22022-12-21T19:01:30ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27352008-01-01210e32410.1371/journal.pntd.0000324Controlling tungiasis in an impoverished community: an intervention study.Daniel PilgerStefan SchwalfenbergJörg HeukelbachLars WittNorbert MenckeAdak KhakbanHermann FeldmeierBACKGROUND: In Brazil, tungiasis is endemic in some resource-poor communities where various domestic and sylvatic animals act as reservoirs for this zoonosis. To determine the effect of control measures on the prevalence and intensity of infestation of human and animal tungiasis, a repeated cross-sectional survey with intervention was carried out. METHODOLOGY/PRINCIPAL FINDINGS: In a traditional fishing community in Northeast Brazil, humans and reservoir animals were treated, and premise-spraying using an insecticide was done, while a second fishing community served as a control. Both communities were followed up 10 times during a 12-month period. At baseline, prevalence of tungiasis was 43% (95% confidence interval [CI]: 35%-51%) and 37% (95% CI: 31%-43%) in control and intervention villages, respectively. During the study, prevalence of tungiasis dropped to 10% (95% CI: 8%-13%; p<0.001) in the intervention village, while the prevalence remained at a high level in the control village. However, after one year, at the end of the study, in both communities the prevalence of the infestation had reached pre-intervention levels. Whereas the intensity of infestation was significantly reduced in the intervention community (p<0.001), and remained low at the end of the study (p<0.001), it did not change in the control village. CONCLUSION/SIGNIFICANCE: Our study shows that a reduction of prevalence and intensity of infestation is possible, but in impoverished communities a long-lasting reduction of disease occurrence can only be achieved by the regular treatment of infested humans, the elimination of animal reservoirs, and, likely, through environmental changes. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN27670575.http://europepmc.org/articles/PMC2565488?pdf=render |
| spellingShingle | Daniel Pilger Stefan Schwalfenberg Jörg Heukelbach Lars Witt Norbert Mencke Adak Khakban Hermann Feldmeier Controlling tungiasis in an impoverished community: an intervention study. PLoS Neglected Tropical Diseases |
| title | Controlling tungiasis in an impoverished community: an intervention study. |
| title_full | Controlling tungiasis in an impoverished community: an intervention study. |
| title_fullStr | Controlling tungiasis in an impoverished community: an intervention study. |
| title_full_unstemmed | Controlling tungiasis in an impoverished community: an intervention study. |
| title_short | Controlling tungiasis in an impoverished community: an intervention study. |
| title_sort | controlling tungiasis in an impoverished community an intervention study |
| url | http://europepmc.org/articles/PMC2565488?pdf=render |
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