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
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.