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      Assessing the potentials of two local topical ointments as affordable treatment against tungiasis infestation: A self-experimentation in Igbokoda, Nigeria

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          Abstract

          Infestations caused by penetration of Tunga penetrans (Siphonaptera: Hectopsyllidae) in cutaneous sub-layers present morbidities and resulting mortalities if surgical treatment remains the obtainable. Considering the neglected nature of this infestation and the absence of marketable product, we report an observation on the use of grounded naphthalene in kerosene ointment, and powder of Piper guineense in coconut oil ointment as affordable treatment of embedded tungiasis flea in Igbokoda. A total of 80 individuals partitioned into two groups of 40 individuals each were assigned the locally made topical ointment irrespective of stages of tungiasis lesions. The mean of stage I, II and III tungiasis lesions treated with grounded naphthalene in kerosene ointment respectively decreased from 1.83, 3.42 and 3.89 to 0 after 5–6 days ( p < .05). Also, the mean of stage I, II and III tungiasis lesions treated with grounded P. guineense ointment respectively decreased from 1.52, 3.10 and 5.00 to 0 after 6 to 7 days of treatment exposure ( p < .05). Very high significant difference between stages and exposure days of participants assigned the two topical ointment was recorded p < .0001 and p = .0005 respectively. Naphthalene ointment and to a lesser extent P. guineense ointment is best to control and hinder development cycle of embedded fleas irrespective of infested part and stage of infection.

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          Most cited references23

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          Fleas and flea-borne diseases.

          Flea-borne infections are emerging or re-emerging throughout the world, and their incidence is on the rise. Furthermore, their distribution and that of their vectors is shifting and expanding. This publication reviews general flea biology and the distribution of the flea-borne diseases of public health importance throughout the world, their principal flea vectors, and the extent of their public health burden. Such an overall review is necessary to understand the importance of this group of infections and the resources that must be allocated to their control by public health authorities to ensure their timely diagnosis and treatment.
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            Investigations on the biology, epidemiology, pathology and control of Tunga penetrans in Brazil: I. Natural history of tungiasis in man.

            Tungiasis is an important health problem in poor communities in Brazil and is associated with severe morbidity, particularly in children. The causative agent, the female flea Tunga penetrans, burrows into the skin of its host, where it develops, produces eggs and eventually dies. From the beginning of the penetration to the elimination of the carcass of the ectoparasite by skin repair mechanisms, the whole process takes 4-6 weeks. The present study is based on specimens from 86 patients, for some of whom the exact time of penetration was known. Lesions were photographed, described in detail and biopsied. Biopsies were examined histologically and by means of scanning electron microscopy (SEM). Based on clinical, SEM and histological findings, the "Fortaleza classification" was elaborated. This allows the natural history of tungiasis to be divided into five stages: (1) the penetration phase, (2) the phase of beginning hypertrophy, (3) the white halo phase, (4) the involution phase and (5) residues in the host's skin. Based on morphological and functional criteria, stages 3 and 4 are divided into further substages. The proposed Fortaleza classification can be used for clinical and epidemiological purposes. It allows a more precise diagnosis, enables the assessment of chemotherapeutic approaches and helps to evaluate control measures at the community level.
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              Tungiasis: high prevalence, parasite load, and morbidity in a rural community in Lagos State, Nigeria.

              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

                Contributors
                Journal
                Parasite Epidemiol Control
                Parasite Epidemiol Control
                Parasite Epidemiology and Control
                Elsevier
                2405-6731
                22 July 2020
                November 2020
                22 July 2020
                : 11
                : e00168
                Affiliations
                [a ]Department of Animal and Environmental Biology, Delta State University, Abraka, Nigeria
                [b ]Department of Zoology, University of Ibadan, Ibadan, Nigeria
                Author notes
                [* ]Corresponding author at: Department of Animal and Environmental Biology, Delta State University, Abraka, Nigeria. enwemiwevictor@ 123456gmail.com
                Article
                S2405-6731(20)30037-4 e00168
                10.1016/j.parepi.2020.e00168
                7388766
                32743082
                6c977253-c7bd-4600-9385-157f62b9335e
                © 2020 The Authors

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 24 June 2020
                : 18 July 2020
                : 19 July 2020
                Categories
                Original Research article

                local topical ointments,treatment,tungiasis infestation,self-experimentation,igbokoda

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