Faculty of Health, University of Canberra, Bruce, Canberra, ACT, Australia; Department of Pharmaceutics, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
Postgraduate Program of Public Health, School of Medicine, Federal University of Ceará, Fortaleza, Brazil.
Lancet Infect Dis. 2021 Aug;21(8):e234-e245. doi: 10.1016/S1473-3099(20)30853-7. Epub 2021 Jul 5.
Tungiasis (sand flea disease) is an epidermal parasitic skin disease occurring in resource-limited communities. There is no standard treatment for tungiasis, and available treatment options are scarce. To our knowledge, this is the first systematic review aimed to assess randomised controlled trials (RCTs) investigating interventions for tungiasis. We systematically searched databases including MEDLINE (EBSCOhost), CENTRAL, CINAHL, PubMed, Web of Science, SciELO, LILACS and Embase (Scopus) for RCTs in any language, from inception of the databases until June 12, 2021. RCTs exploring preventive and therapeutic interventions for tungiasis were eligible. We used the revised Cochrane Collaboration's risk of bias tool to assess the risk of bias and Jadad scale to quantify the methodological quality of the RCTs. Of the 1839 identified records, only eight RCTs involving 808 participants were included, and several methodological deficiencies were identified in most of the trials. Trial interventions included: oral drugs niridazole and ivermectin and topical interventions of ivermectin lotion, metrifonate lotion, thiabendazole lotion, thiabendazole ointment, dimeticones (NYDA), and a neem seed and coconut oils-based mixture for treatment and coconut oil-based lotion (Zanzarin) for prevention. The coconut oil-based lotion for prevention and dimeticones for treatment of tungiasis have displayed the most promise. Most of the RCTs included in this study had low methodological quality. There is a clear unmet need for high-quality RCTs examining safe and effective prevention and treatment alternatives of tungiasis in endemic settings.
匐行疹（沙蚤病）是一种发生在资源有限社区的表皮寄生性皮肤病。目前尚无针对匐行疹的标准治疗方法，且现有的治疗选择也很有限。据我们所知，这是首次旨在评估针对匐行疹的干预措施的随机对照试验（RCT）的系统评价。我们系统地检索了数据库，包括 MEDLINE（EBSCOhost）、CENTRAL、CINAHL、PubMed、Web of Science、SciELO、LILACS 和 Embase（Scopus），检索了所有语言的 RCT，检索时间为数据库建立之初至 2021 年 6 月 12 日。符合条件的 RCT 必须是针对预防和治疗匐行疹的干预措施进行的研究。我们使用修订后的 Cochrane 协作风险偏倚工具评估 RCT 的风险偏倚，并使用 Jadad 量表量化 RCT 的方法学质量。在 1839 条鉴定记录中，仅有 8 项 RCT 符合纳入标准，共涉及 808 名参与者，但大多数试验均存在若干方法学缺陷。试验干预措施包括：口服药物硝呋莫司和伊维菌素以及局部干预伊维菌素洗剂、敌百虫洗剂、噻苯达唑洗剂、噻苯达唑软膏、二甲硅油（NYDA）以及一种基于印楝种子和椰子油的混合物用于治疗和基于椰子油的洗剂（Zanzarin）用于预防。基于椰子油的预防洗剂和二甲硅油的治疗匐行疹的效果最有前景。本研究纳入的 RCT 大多方法学质量较低。在流行地区，迫切需要高质量的 RCT 来评估安全有效的预防和治疗匐行疹的替代方法。
