Tungíase: doença negligenciada causando patologia grave
Tungíase: doença negligenciada causando patologia grave Tungíase: doença negligenciada causando patologia grave
Tropical Medicine and International Health volume 15 no 7 pp 856–864 july 2010 L. Ariza et al. Rapid community assessment of tungiasis Table 1 Characteristics of communities and surveys Community Country regularly, and cross-checks were performed to reduce observer bias. Study design Survey No. In all surveys, data were collected according to identical procedures. The body of study participants was examined clinically for the presence of tungiasis, excluding the genital areas. In the first surveys conducted in Brazil, 20 lesions in an individual). We then selected the most useful localization to define a rapid assessment method based on the strength of 858 ª 2010 Blackwell Publishing Ltd
Tropical Medicine and International Health volume 15 no 7 pp 856–864 july 2010 L. Ariza et al. Rapid community assessment of tungiasis Figure 2 Right foot of a patient with approximately 100 sand flea lesions with several periungual lesions. Periungual site is exemplified by circles around the toe nail. association (R 2 ) and operational aspects, such as time needed to perform an examination, simplicity and disturbance to the individuals. R 2 indicates the per cent of variation of one variable that can be explained by linear relationship with another variable. Ethical aspects Studies were approved by the respective Ethical Review Boards (Ethical Review Board of the Federal University of Ceará, Ethical Committee of the School of Medical Sciences of Alagoas, Brazil; ad hoc Ethical Committee of Cascavel Municipality, and Ethical Committee of the University of Ilorin, Nigeria). Meetings with community health workers and village representatives were held prior to the studies, in which objectives were explained in detail. Informed written consent was obtained from individuals or their caretakers. In case of illiteracy, the informed consent form was read out by one of the investigators, and approval was obtained by thumb prints. In Nigeria, the traditional chiefs of Badagry (Ankra) and of local communities (Baales) also approved the study. Results General characteristics In total, 7121 individuals were included in the 10 surveys. This corresponded to 57.8–91.1% of the respective target populations (Table 2). Median age of the populations ranged between 13.5 and 20 years. Prevalence and severity of tungiasis varied considerably between and within communities (Table 2), with point Table 2 Characteristics of study populations and infestation status in 10 population-based surveys Brazil Nigeria 1 2 3 4 5 6 7 8 9 10 Survey No. Individuals 548 ⁄ 605 505 ⁄ 605 535 ⁄ 605 1185 ⁄ 1468 1192 ⁄ 1468 849 ⁄ 1468 1015 ⁄ 1146 990 ⁄ 1087 186 ⁄ 260 116 ⁄ 160 examined ⁄ total (90.6%) (83.5%) (88.4%) (80.7%) (81.2%) (57.8%) (88.6%) (91.1%) (71.5%) (72.5%) population (% of target population) Prevalence of 51.3% 52.1% 31.2% 33.6% 23.7% 54.4% 21.1% 28.9% 51.1% 41.8% tungiasis (95% CI) (47.1–55.5) (47.7–56.5) (27.3–35.2) (30.9–36.3) (21.3–26.2) (51.1–57.8) (18.6–23.6) (26.1–31.7) (43.8–58.3) (28.4–55.3) Male ⁄ female 1.1 1.0 1.3 1.7 1.6 1.3 1.2 1.2 1.3 1.1 prevalence ratio Number of lesions: Median (IQR ) 2 (1–6) 3 (1–8) 3 (1–8) 3 (1–9) 2 (1–5) 3 (1–8) 2 (1–3) 2 (1–4) 6 (2–15) 3 (2–11) Maximum 145 199 78 158 50 115 42 45 75 40 Prevalence of 6.0% 6.5% 2.8% 2.2% 1.3% 4.7% 0.1% 0.8% 10.2% 5.2% severe tungiasisà (4.2–8.4) (4.5–9.1) (1.6–4.6) (1.4–3.2) (0.8–2.2) (3.4–6.4) (0.0–0.5) (0.3–1.6) (6.3–15.5) (1.9–10.9) (95% CI) ª 2010 Blackwell Publishing Ltd 859 Interquartile range. à>20 lesions.
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Tropical Medicine and International Health volume 15 no 7 pp 856–864 july 2010<br />
L. Ariza et al. Rapid community assessment of tungiasis<br />
Table 1 Characteristics of communities and surveys<br />
Community Country<br />
regularly, and cross-checks were performed to reduce<br />
observer bias.<br />
Study design<br />
Survey<br />
No.<br />
In all surveys, data were collected according to identical<br />
procedures. The body of study participants was examined<br />
clinically for the presence of tungiasis, excluding the genital<br />
areas. In the first surveys conducted in Brazil, 20 lesions in<br />
an individual).<br />
We then selected the most useful localization to define<br />
a rapid assessment method based on the strength of<br />
858 ª 2010 Blackwell Publishing Ltd
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