McNeilly Hannah, Mutebi Francis, Reichert Felix, Thielecke Marlene, Banalyaki Mike L, Mukone George M, Arono Rebecca, Feldmeier Hermann
Edinburgh Medical School: Deanery of Biomedical Sciences, The University of Edinburgh, United Kingdom.
School of Veterinary Medicine and Animal Resources, College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala, Uganda.
PLoS Negl Trop Dis. 2025 Jun 5;19(6):e0013149. doi: 10.1371/journal.pntd.0013149. eCollection 2025 Jun.
Tungiasis is a widespread and debilitating zoonotic Neglected Tropical Disease (NTD). Manual extraction of the sand fleas with non-sterile sharp instruments is the most common but unsafe treatment method in affected communities. Topical application of a dimeticone oil formula (NYDA) has previously been shown to be a safe and effective method of killing embedded sand fleas. The objective of this study was to evaluate a two-year long humanitarian One Health tungiasis control project in 17 villages in Napak district, Karamoja region, Northeastern Uganda. The community-based intervention included quarterly systematic tungiasis detection and treatment with the dimeticone oil formula in residents and domestic animals in combination with community health promotion. In each of the eight quarterly tungiasis diagnosis and treatment rounds, between 3,674 and 5,155 residents were examined (coverage 73.6-89.9%). Overall, 12,540 tungiasis cases among residents were diagnosed and treated and 16 community dialogue meetings were held. Tungiasis prevalence among residents decreased from 62.8% to 5.7% in the two-year study period. While at baseline tungiasis was most prevalent in children and the elderly, at the end elderly women were the single most affected group. The prevalence of tungiasis-related walking difficulties in the community decreased from 11.5% to 0.5%, and pain and itching were greatly reduced. The number of animals present in the villages was low (between 79 and 414 per treatment round) and the prevalence of tungiasis in animals dropped from 14.2% to 0% throughout the two-year project. This implementation study shows that regular community-based treatment of tungiasis cases among humans and animals with dimeticone oil formula, combined with community engagement and health promotion, can reduce tungiasis prevalence and morbidity to very low levels within two years, even in a hyperendemic area where people live in extreme poverty.
潜蚤病是一种广泛传播且使人衰弱的人畜共患被忽视热带病（NTD）。在受影响社区，用非无菌锐器手动摘除沙蚤是最常见但不安全的治疗方法。先前已证明，局部涂抹二甲硅油配方（NYDA）是杀死嵌入沙蚤的一种安全有效方法。本研究的目的是评估在乌干达东北部卡拉莫贾地区纳帕克区的17个村庄开展的为期两年的人道主义“同一健康”潜蚤病控制项目。基于社区的干预措施包括每季度对居民和家畜进行系统性潜蚤病检测，并使用二甲硅油配方进行治疗，同时开展社区健康促进活动。在八个季度的潜蚤病诊断和治疗回合中，每次检查的居民人数在3674至5155人之间（覆盖率为73.6 - 89.9%）。总体而言，共诊断并治疗了居民中的12540例潜蚤病病例，并召开了16次社区对话会议。在为期两年的研究期内，居民中的潜蚤病患病率从62.8%降至5.7%。虽然在基线时，潜蚤病在儿童和老年人中最为普遍，但在项目结束时，老年女性成为受影响最严重的单一群体。社区中与潜蚤病相关的行走困难患病率从11.5%降至0.5%，疼痛和瘙痒也大幅减轻。村庄中的动物数量较少（每次治疗回合在79至414头之间），在整个两年项目期间，动物中的潜蚤病患病率从14.2%降至0%。这项实施研究表明，即使在人们生活极端贫困的高度流行地区，定期对人和动物中的潜蚤病病例进行基于社区的二甲硅油配方治疗，结合社区参与和健康促进，可在两年内将潜蚤病患病率和发病率降低到非常低的水平。
