Tunga Penetrans: Painful Lesions on the Feet—The First Imported Case from Guinea-Bissau

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Abstract

Tungiasis is an endemic disease in certain poor areas around the world. Imported infestations in travelers are becoming more frequent and can lead to considerable morbidity. We report a case of a 50 year-old-man who returned from a trip to Guinea-Bissau with an infection caused by Tunga penetrans.

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Severe tungiasis in underprivileged communities: case series from Brazil.

Jorg Heukelbach, M Eisele, Hermann Feldmeier … (2003)

Tungiasis is caused by infestation with the sand flea (Tunga penetrans). This ectoparasitosis is endemic in economically depressed communities in South American and African countries. Tungiasis is usually considered an entomologic nuisance and does not receive much attention from healthcare professionals. During a study on tungiasis-related disease in an economically depressed area in Fortaleza, northeast Brazil, we identified 16 persons infested with an extremely high number of parasites. These patients had >50 lesions each and showed signs of intense acute and chronic inflammation. Superinfection of the lesions had led to pustule formation, suppuration, and ulceration. Debilitating sequelae, such as loss of nails and difficulty in walking, were constant. In economically depressed urban neighborhoods characterized by a high transmission potential, poor housing conditions, social neglect, and inadequate healthcare behavior, tungiasis may develop into severe disease.

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Tungiasis: a neglected health problem of poor communities.

J. Heukelbach, G Hesse, A. La Rosa … (2001)

Tungiasis is caused by the flea Tunga penetrans. Growing urbanization, improved housing and use of appropriate footwear presumably have led to an overall reduction of the occurrence of this ectoparasitosis within the last decades. However, it is still highly prevalent where people live in extreme poverty, occurring in many Latin American and African countries. Although the infection has long been known, data on the ectoparasite's biology and the epidemiology of the disease are scant. Methods for treatment, prevention and control have never been evaluated in a scientific manner. Tungiasis remains an important public health problem for the very poor, a problem neglected by those who are affected, by the medical profession and by the scientific community.

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Tungiasis: high prevalence, parasite load, and morbidity in a rural community in Lagos State, Nigeria.

Uade Samuel Ugbomoiko, Jorg Heukelbach, I Ofoezie (2007)

Tungiasis is common in resource-poor populations throughout Latin America, the Caribbean, and sub-Saharan Africa, but epidemiologic data from Africa on this ectoparasitosis are scarce. A cross-sectional study was carried out in a representative sample of a rural community in Lagos State, 54 km west of Lagos (Nigeria). In the dry season, 142 households of the community were randomly selected and visited. Family members were examined for the presence of tungiasis. The localization, number, and stage of penetrated fleas, as well as the associated morbidity, were documented. Five hundred and fifty-seven individuals were examined, 299 (53.7%) males and 258 (46.3%) females. In total, 252 (45.2%; 95% confidence interval, 41.1-49.5) were infested with Tunga penetrans. The prevalence was highest between the ages of 5 and 14 years, decreased in adults, and increased again in the elderly. There was no statistically significant difference between the prevalence in males and females (47.2% vs. 43.0%; P = 0.3). Almost 95% of lesions were localized on the feet. Ten per cent of individuals presented with sand fleas on the hands and elbows. The median parasite load was six (interquartile range, 3-16). Individuals aged 60 years or over had significantly more lesions (median of 41 lesions; P < 0.01). About one-third of the study participants found it difficult to walk; in 10% of cases, fissures were present. Superinfection was common. The prevalence of tungiasis and the parasite load were high, and the severity of the disease was considerable. The prevalence and parasite burden showed a characteristic distribution. In western Nigeria, tungiasis needs to be regarded as an important public health problem.

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Author and article information

Journal

Journal ID (nlm-ta): Case Report Med

Journal ID (publisher-id): CRIM

Title: Case Reports in Medicine

Publisher: Hindawi Publishing Corporation

ISSN (Print): 1687-9627

ISSN (Electronic): 1687-9635

Publication date (Print): 2010

Publication date (Electronic): 16 December 2010

Volume: 2010

Electronic Location Identifier: 681302

Affiliations

¹Serviço de Dermatologia, Centro Hospitalar do Porto, HSA, Edifício das Consultas Externas, Ex CICAP, Rua D. Manuel II, 4099-001 Oporto, Portugal

²Serviço de Infecciologia, Hospital de São João, 4200-319 Oporto, Portugal

Author notes

*A. Rosmaninho: arisrosmaninho@ 123456gmail.com

Academic Editor: Thomas J. Zgonis

Article

DOI: 10.1155/2010/681302

PMC ID: 3014856

PubMed ID: 21209743

SO-VID: 5d47baa5-b854-4714-a05a-c3434f1db5e5

License:

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.