皮肤幼虫移行症在苏丹的突然出现与传播:一项病例系列研究呼吁采取紧急行动。

Sudden emergence and spread of cutaneous larva migrans in Sudan: A case series calls for urgent actions.

作者信息

Ahmed Ayman, Hemaida Maisa Aldai, Hagelnur Amel Ahmed, Eltigani Hala Fathi, Siddig Emmanuel Edwar

机构信息

Institute of endemic diseases, University of Khartoum, Khartoum, Sudan.

Swiss Tropical and Public Health Institute (Swiss TPH), Allschwil, Switzerland.

出版信息

IDCases. 2023 May 5;32:e01789. doi: 10.1016/j.idcr.2023.e01789. eCollection 2023.

Abstract

Cutaneous larva migrans (CLM) is a self-limiting dermatosis parasitic disease that is caused by zoonotic hookworm mainly infects cats, dogs, and accidentally humans. The disease affects hosts through the invasion and the migration of the hookworm larva into top layers of the skin. The disease occurs in tropical and subtropical regions; where people commonly are infected when sitting or barefoot walking on places contaminated with feces of infected cats or dogs. Due to self-limiting nature of the disease, the exact burden and prevalence are commonly underestimated. In this communication, we investigated all cases presented to the skin-diseases outpatient clinic' at the reference hospital of Tropical Diseases Medicine in Khartoum state between January 2019 and January 2021. This is the first-ever a case series report of cutaneous larva migrans in Sudan. We identified 15 cases of CLM presented with rash (100 %), redness of skin (67 %), and only adults were presented with larva crawling under their skins (27 %). Infection sites were (53 %) leg, (40 %) foot, only 7 % showed abdominal infection. The majority of patients were children or young adults, 47 % of them are ≤5 year-old, male to female ratio is 2.75:1. Duration of infection was one to three weeks and all patients fully recovered after treatment with albendazole. This urges for One Health interventions including deworming cats and dogs, improving water, sanitation, and hygiene, community-engagement and raising awareness in area with risk of infection.

摘要

皮肤幼虫移行症(CLM)是一种自限性皮肤寄生虫病,由人畜共患的钩虫引起,主要感染猫、狗,偶尔也感染人类。该病通过钩虫幼虫侵入并移行至皮肤表层来感染宿主。该病发生在热带和亚热带地区;人们通常在坐在或赤脚行走在被感染猫或狗的粪便污染的地方时被感染。由于该病具有自限性,其确切负担和患病率通常被低估。在本交流中,我们调查了2019年1月至2021年1月期间在喀土穆州热带病医学参考医院皮肤科门诊就诊的所有病例。这是苏丹有史以来首例皮肤幼虫移行症病例系列报告。我们确定了15例皮肤幼虫移行症病例,均出现皮疹(100%)、皮肤发红(67%),只有成年人出现幼虫在皮下爬行(27%)。感染部位为腿部(53%)、足部(40%),只有7%表现为腹部感染。大多数患者为儿童或青年,其中47%年龄≤5岁,男女比例为2.75:1。感染持续时间为1至3周,所有患者在接受阿苯达唑治疗后均完全康复。这促使采取“同一健康”干预措施,包括给猫和狗驱虫、改善水、环境卫生和个人卫生、社区参与以及在有感染风险的地区提高认识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9edf/10189479/5cce921162fd/gr1.jpg

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