RESUMEN
BACKGROUND: The success of tungiasis treatment is highly dependent on adequate environmental control. METHODS: This is a real-world observational cohort study designed to monitor the effectiveness of topical dimethicone together with a One Health approach for the control of tungiasis in the Sanumás communities, Amazon rainforest, Brazil. We followed up on 562 indigenous people and 81 domestic dogs for 1.5 years in a 3-month interval. A new molecular method for large-scale soil evaluation was also tested. The control of tungiasis was independently conducted by the Brazilian Ministry of Health and comprised topical dimethicone application (NYDA®) for humans, single-dose oral afoxolaner for dogs, and in-house soil fumigation with fipronil. The main outcome was the occurrence of tungiasis after the use of topical dimethicone together with the One Health approach. RESULTS: A total of 49 of the 562 indigenous people had active tungiasis at enrollment (8.72%). Only three cases of tungiasis resulted in active lesions after the use of topical dimethicone together with the One Health approach, with two cases of recurrence. From the 6-month follow-up and after, soil infestation was not detected. CONCLUSIONS: We conclude that the use of NYDA® together with animal and environmental interventions are effective measures for the control of tungiasis.
RESUMEN
BACKGROUND: Tungiasis is a disease associated with extreme poverty. We aimed to evaluate the prevalence of tungiasis in six different settlements of the Sanumás indigenous community in a remote area in the Auaris region, Yanomami territory, Brazil. METHODS: We conducted an observational study to detect clinical and epidemiological factors associated with tungiasis using a cross-sectional strategy and multivariate logistic regression. Soil analysis was performed by visual and microscopic methods. RESULTS: We examined 555 persons, 45 of whom had active tungiasis; 18 cases were classified as mild, 16 as moderate and 11 as severe. The disease was significantly more prevalent in children than in adults (odds ratio (OR) 15.77; 95% confidence interval (CI) = 5.34-67.91; p < 0.001). Soil infestation was significantly related to the occurrence of human tungiasis (OR = 12.29; 95% CI = 3.75-45.88). The sex and GPS location of the houses were not related to the occurrence of tungiasis. CONCLUSIONS: We conclude that tungiasis is an important problem in the Sanumás community, especially for children. We suggest that interruption of the off-host transmission cycle, together with regular treatment [human and animal interventions], must be prioritized to achieve control of tungiasis in indigenous populations.
RESUMEN
O acordo TRIPS enrijeceu as normas de garantias de propriedade intelectual n os países signatários da Organização Mundial do Comercio (OMC) e, atualmente, caracteriza-se como um grande desafio aos países em desenvolvimento, bem como à promoção da inovação em saúde. A Organização Mundial da Saúde (OMS) iniciou trabalhos para discutir os impactos dos direitos de propriedade intelectual e a saúde pública. Tem por objetivo analisar as discussões realizadas na OMS sobre propriedade intelectual e a saúde publica, no período entre 2006 e 2016. A inovação e a promoção da inovação são fundamentais para o desenvolvimento de novas tecnologias e produtos para a saúde, e devem enquadrar-se em uma estrutura m ais ampla de esforços intersetoriais para melhorar a saúde e desenvolvimento dos países. É evidente o papel da inovação em relação à consolidação e sustentabilidade do Sistema Único e Saúde, assim como possui função fundamental no desenvolvimento de tecnologias portadoras de futuro, e que no caso dos países em desenvolvimento e menos desenvolvidos, deve estar focada na resolutividade das doenças mais prevalentes nestes países
