Treatment of Tungiasis with dimeticone: a proof-of-principle study in rural Kenya.

Tungiasis (sand flea disease) is a neglected tropical disease, prevalent in resource-poor communities in South America and sub-Saharan Africa. It is caused by an inflammatory response against penetrated female sand fleas (Tunga penetrans) embedded in the skin of the host. Although associated with de...

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Autores principales:	Marlene Thielecke, Per Nordin, Nicholas Ngomi, Hermann Feldmeier
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/4597bd0a129142acb33de906ee5b85cd
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spelling	oai:doaj.org-article:4597bd0a129142acb33de906ee5b85cd2021-11-25T06:32:18ZTreatment of Tungiasis with dimeticone: a proof-of-principle study in rural Kenya.1935-27271935-273510.1371/journal.pntd.0003058https://doaj.org/article/4597bd0a129142acb33de906ee5b85cd2014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/25079375/?tool=EBIhttps://doaj.org/toc/1935-2727https://doaj.org/toc/1935-2735Tungiasis (sand flea disease) is a neglected tropical disease, prevalent in resource-poor communities in South America and sub-Saharan Africa. It is caused by an inflammatory response against penetrated female sand fleas (Tunga penetrans) embedded in the skin of the host. Although associated with debilitating acute and chronic morbidity, there is no proven effective drug treatment. By consequence patients attempt to remove embedded sand fleas with non-sterile sharp instruments, such as safety pins, a procedure that represents a health threat by itself. In this proof-of-principle study we compared the topical application of a mixture of two dimeticones of low viscosity (NYDA) to the topical application of a 0.05% solution of KMnO4 in 47 school children in an endemic area in rural Kenya. The efficacy of the treatment was assessed during a follow up period of seven days using viability signs of the embedded parasites, alterations in the natural development of lesion morphology and the degree of local inflammation as outcome measures. Seven days after treatment, in the dimeticone group 78% (95% CI 67-86%) of the parasites had lost all signs of viability as compared to 39% (95% CI 28-52%) in the KMnO4 group (p<0.001). In the dimeticone group 90% (95% CI 80-95%) of the penetrated sand fleas showed an abnormal development already after 5 days, compared to 53% (95% CI 40-66%; p<0.001) in the KMnO4 group. Seven days after treatment, signs of local skin inflammation had significantly decreased in the dimeticone group (p<0.001). This study identified the topical application of dimeticones of low viscosity (NYDA) as an effective means to kill embedded sand fleas. In view of the efficacy and safety of the topical treatment with dimeticone, the mechanical extraction of embedded sand fleas using hazardous instruments is no longer warranted.Marlene ThieleckePer NordinNicholas NgomiHermann FeldmeierPublic Library of Science (PLoS)articleArctic medicine. Tropical medicineRC955-962Public aspects of medicineRA1-1270ENPLoS Neglected Tropical Diseases, Vol 8, Iss 7, p e3058 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
spellingShingle	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Marlene Thielecke Per Nordin Nicholas Ngomi Hermann Feldmeier Treatment of Tungiasis with dimeticone: a proof-of-principle study in rural Kenya.
description	Tungiasis (sand flea disease) is a neglected tropical disease, prevalent in resource-poor communities in South America and sub-Saharan Africa. It is caused by an inflammatory response against penetrated female sand fleas (Tunga penetrans) embedded in the skin of the host. Although associated with debilitating acute and chronic morbidity, there is no proven effective drug treatment. By consequence patients attempt to remove embedded sand fleas with non-sterile sharp instruments, such as safety pins, a procedure that represents a health threat by itself. In this proof-of-principle study we compared the topical application of a mixture of two dimeticones of low viscosity (NYDA) to the topical application of a 0.05% solution of KMnO4 in 47 school children in an endemic area in rural Kenya. The efficacy of the treatment was assessed during a follow up period of seven days using viability signs of the embedded parasites, alterations in the natural development of lesion morphology and the degree of local inflammation as outcome measures. Seven days after treatment, in the dimeticone group 78% (95% CI 67-86%) of the parasites had lost all signs of viability as compared to 39% (95% CI 28-52%) in the KMnO4 group (p<0.001). In the dimeticone group 90% (95% CI 80-95%) of the penetrated sand fleas showed an abnormal development already after 5 days, compared to 53% (95% CI 40-66%; p<0.001) in the KMnO4 group. Seven days after treatment, signs of local skin inflammation had significantly decreased in the dimeticone group (p<0.001). This study identified the topical application of dimeticones of low viscosity (NYDA) as an effective means to kill embedded sand fleas. In view of the efficacy and safety of the topical treatment with dimeticone, the mechanical extraction of embedded sand fleas using hazardous instruments is no longer warranted.
format	article
author	Marlene Thielecke Per Nordin Nicholas Ngomi Hermann Feldmeier
author_facet	Marlene Thielecke Per Nordin Nicholas Ngomi Hermann Feldmeier
author_sort	Marlene Thielecke
title	Treatment of Tungiasis with dimeticone: a proof-of-principle study in rural Kenya.
title_short	Treatment of Tungiasis with dimeticone: a proof-of-principle study in rural Kenya.
title_full	Treatment of Tungiasis with dimeticone: a proof-of-principle study in rural Kenya.
title_fullStr	Treatment of Tungiasis with dimeticone: a proof-of-principle study in rural Kenya.
title_full_unstemmed	Treatment of Tungiasis with dimeticone: a proof-of-principle study in rural Kenya.
title_sort	treatment of tungiasis with dimeticone: a proof-of-principle study in rural kenya.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/4597bd0a129142acb33de906ee5b85cd
work_keys_str_mv	AT marlenethielecke treatmentoftungiasiswithdimeticoneaproofofprinciplestudyinruralkenya AT pernordin treatmentoftungiasiswithdimeticoneaproofofprinciplestudyinruralkenya AT nicholasngomi treatmentoftungiasiswithdimeticoneaproofofprinciplestudyinruralkenya AT hermannfeldmeier treatmentoftungiasiswithdimeticoneaproofofprinciplestudyinruralkenya
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Treatment of Tungiasis with dimeticone: a proof-of-principle study in rural Kenya.

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