The efficacy of topical, oral and surgical interventions for the treatment of tungiasis: A systematic review of the literature.

<h4>Background</h4>Tungiasis is a neglected disease caused by Tunga penetrans that can be complicated by secondary infections and local tissue destruction. Adequate treatment is important, especially in vulnerable populations; potential treatment options proposed range from surgical extr...

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Autores principales:	Ana Carolina Tardin Martins, Amanda Ramos de Brito, Patrícia Shu Kurizky, Rodrigo Gurgel Gonçalves, Yago Ranniere Teixeira Santana, Fabiola Christian Almeida de Carvalho, Ciro Martins Gomes
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/97a78d8a1965478ea9494e8c09bf8ef7
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spelling	oai:doaj.org-article:97a78d8a1965478ea9494e8c09bf8ef72021-12-02T20:24:16ZThe efficacy of topical, oral and surgical interventions for the treatment of tungiasis: A systematic review of the literature.1935-27271935-273510.1371/journal.pntd.0009722https://doaj.org/article/97a78d8a1965478ea9494e8c09bf8ef72021-08-01T00:00:00Zhttps://doi.org/10.1371/journal.pntd.0009722https://doaj.org/toc/1935-2727https://doaj.org/toc/1935-2735<h4>Background</h4>Tungiasis is a neglected disease caused by Tunga penetrans that can be complicated by secondary infections and local tissue destruction. Adequate treatment is important, especially in vulnerable populations; potential treatment options proposed range from surgical extraction to the use of oral and topical medications. We aimed to perform a systematic review to assess the efficacy of topical, oral and surgical interventions for the treatment of tungiasis.<h4>Methodology/principal findings</h4>The present review is registered in PROSPERO (CRD42021234741). On September 1, 2020, we searched PubMed, EMBASE, Scopus, Web of Science, Science Direct, Scielo and LILACS BVS. We included clinical trials and longitudinal observational studies that evaluated any topical, systemic or mechanical treatment for tungiasis. We used the Revised Cochrane Risk of Bias (RoB) Tool for Randomized Trials for clinical trial analysis. Qualitative and quantitative descriptive syntheses were performed. Our search strategy resulted in 3376 references. Subsequently, 2568 titles/abstracts and 114 full texts were screened. We finally included 19 articles; 9 were classified as clinical trials. Two and 3 articles presented low and some RoB, respectively, according to the tool. Only two articles tested the efficacy of oral medications (niridazole, ivermectin), with discouraging results. Six clinical trials evaluated topical products for the treatment of tungiasis; 2 evaluated dimeticone-based compounds and reported positive results in lesion reduction and cure. None reported significant adverse reactions. Surgical extraction was evaluated only in observational studies.<h4>Conclusions/significance</h4>We conclude that, although surgical extraction is the most commonly used treatment, there is sufficient evidence supporting the use of occlusive agents, especially manufactured dimeticone-based products.Ana Carolina Tardin MartinsAmanda Ramos de BritoPatrícia Shu KurizkyRodrigo Gurgel GonçalvesYago Ranniere Teixeira SantanaFabiola Christian Almeida de CarvalhoCiro Martins GomesPublic Library of Science (PLoS)articleArctic medicine. Tropical medicineRC955-962Public aspects of medicineRA1-1270ENPLoS Neglected Tropical Diseases, Vol 15, Iss 8, p e0009722 (2021)
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 Ana Carolina Tardin Martins Amanda Ramos de Brito Patrícia Shu Kurizky Rodrigo Gurgel Gonçalves Yago Ranniere Teixeira Santana Fabiola Christian Almeida de Carvalho Ciro Martins Gomes The efficacy of topical, oral and surgical interventions for the treatment of tungiasis: A systematic review of the literature.
description	<h4>Background</h4>Tungiasis is a neglected disease caused by Tunga penetrans that can be complicated by secondary infections and local tissue destruction. Adequate treatment is important, especially in vulnerable populations; potential treatment options proposed range from surgical extraction to the use of oral and topical medications. We aimed to perform a systematic review to assess the efficacy of topical, oral and surgical interventions for the treatment of tungiasis.<h4>Methodology/principal findings</h4>The present review is registered in PROSPERO (CRD42021234741). On September 1, 2020, we searched PubMed, EMBASE, Scopus, Web of Science, Science Direct, Scielo and LILACS BVS. We included clinical trials and longitudinal observational studies that evaluated any topical, systemic or mechanical treatment for tungiasis. We used the Revised Cochrane Risk of Bias (RoB) Tool for Randomized Trials for clinical trial analysis. Qualitative and quantitative descriptive syntheses were performed. Our search strategy resulted in 3376 references. Subsequently, 2568 titles/abstracts and 114 full texts were screened. We finally included 19 articles; 9 were classified as clinical trials. Two and 3 articles presented low and some RoB, respectively, according to the tool. Only two articles tested the efficacy of oral medications (niridazole, ivermectin), with discouraging results. Six clinical trials evaluated topical products for the treatment of tungiasis; 2 evaluated dimeticone-based compounds and reported positive results in lesion reduction and cure. None reported significant adverse reactions. Surgical extraction was evaluated only in observational studies.<h4>Conclusions/significance</h4>We conclude that, although surgical extraction is the most commonly used treatment, there is sufficient evidence supporting the use of occlusive agents, especially manufactured dimeticone-based products.
format	article
author	Ana Carolina Tardin Martins Amanda Ramos de Brito Patrícia Shu Kurizky Rodrigo Gurgel Gonçalves Yago Ranniere Teixeira Santana Fabiola Christian Almeida de Carvalho Ciro Martins Gomes
author_facet	Ana Carolina Tardin Martins Amanda Ramos de Brito Patrícia Shu Kurizky Rodrigo Gurgel Gonçalves Yago Ranniere Teixeira Santana Fabiola Christian Almeida de Carvalho Ciro Martins Gomes
author_sort	Ana Carolina Tardin Martins
title	The efficacy of topical, oral and surgical interventions for the treatment of tungiasis: A systematic review of the literature.
title_short	The efficacy of topical, oral and surgical interventions for the treatment of tungiasis: A systematic review of the literature.
title_full	The efficacy of topical, oral and surgical interventions for the treatment of tungiasis: A systematic review of the literature.
title_fullStr	The efficacy of topical, oral and surgical interventions for the treatment of tungiasis: A systematic review of the literature.
title_full_unstemmed	The efficacy of topical, oral and surgical interventions for the treatment of tungiasis: A systematic review of the literature.
title_sort	efficacy of topical, oral and surgical interventions for the treatment of tungiasis: a systematic review of the literature.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/97a78d8a1965478ea9494e8c09bf8ef7
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The efficacy of topical, oral and surgical interventions for the treatment of tungiasis: A systematic review of the literature.

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