School ofTropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom.
PLoS Negl Trop Dis. 2024 Jul 23;18(7):e0012341. doi: 10.1371/journal.pntd.0012341. eCollection 2024 Jul.
Tungiasis is a cutaneous parasitosis caused by the female flea Tunga penetrans. Two-component dimeticone (NYDA) is the only treatment for tungiasis recommended by the World Health Organization; however, this topical drug is not available in Kenya. In Western Kenya, sodium carbonate is commonly used in the treatment of tungiasis. This study evaluated the 7-day cure rates for tungiasis by comparing sodium carbonate and NYDA treatments in Homa Bay County, Kenya.
METHODOLOGY/PRINCIPAL FINDINGS: This was a randomized, observer-blinded, parallel-treatment cohort trial. Twenty-three eligible children with 126 flea infections were matched and randomized. All participants received both treatments, with one treatment on each foot. We recorded all health conditions/information, including inflammation scores and adverse events. Observations were performed on days 3, 5, and 7 using a digital microscope to confirm dead or live fleas based on the viability signs. Twenty-three children aged 3-13 years were analyzed. The proportion of dead fleas on day 7 was higher after NYDA treatment than after 5% sodium carbonate treatment (87% versus 64%, respectively, P = 0.01) NYDA. Median survival was 5 days for both treatments; NYDA had significantly higher trend of flea non-viability rate than 5% sodium carbonate (P<0.01). There were no significant differences in the inflammation score or pain/itchiness between the two treatments. On the last day, 14 children indicated their preference for NYDA in future treatment of tungiasis, whereas nine children preferred the 5% sodium carbonate solution.
CONCLUSIONS/SIGNIFICANCE: NYDA was significantly more effective than 5% sodium carbonate for tungiasis treatment. Both treatments were safe but the children preferred NYDA more. Future studies with more participants and an extended observation period are warranted to confirm our findings. The findings suggest that NYDA should be made more available in tungiasis endemic area.
UMIN-CTR; UMIN 000044320.
疥疮是由雌性跳蚤 Tunga penetrans 引起的皮肤寄生虫病。二组分二甲硅油（NYDA）是世界卫生组织推荐的唯一治疗疥疮的药物；然而，这种局部药物在肯尼亚并不供应。在肯尼亚西部，碳酸钠常用于治疗疥疮。本研究在肯尼亚霍马湾县通过比较碳酸钠和 NYDA 治疗，评估了疥疮的 7 天治愈率。
方法/主要发现： 这是一项随机、观察者盲、平行治疗队列试验。对 23 名符合条件的儿童的 126 例跳蚤感染进行了匹配和随机分组。所有参与者都接受了两种治疗方法，每只脚各一种。我们记录了所有健康状况/信息，包括炎症评分和不良事件。使用数字显微镜在第 3、5 和 7 天进行观察，根据存活迹象确认死或活跳蚤。分析了 23 名年龄在 3-13 岁的儿童。NYDA 治疗后第 7 天死亡的跳蚤比例高于 5%碳酸钠治疗组（分别为 87%和 64%，P=0.01）。两种治疗方法的中位存活时间均为 5 天；NYDA 的跳蚤非存活率明显高于 5%碳酸钠（P<0.01）。两种治疗方法的炎症评分或疼痛/瘙痒均无显著差异。最后一天，14 名儿童表示在未来治疗疥疮时更喜欢 NYDA，而 9 名儿童更喜欢 5%碳酸钠溶液。
结论/意义： NYDA 治疗疥疮的效果明显优于 5%碳酸钠。两种治疗方法均安全，但儿童更喜欢 NYDA。需要更多参与者和延长观察期的未来研究来证实我们的发现。研究结果表明，应在疥疮流行地区提供更多的 NYDA。
UMIN-CTR；UMIN 44320。
