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Clinical interventions for tungiasis (sand flea disease): a systematic review

Abrha, S, Heukelbach, J, Peterson, GM ORCID: 0000-0002-6764-3882, Christenson, JK, Carroll, S, Kosari, S, Bartholomeus, A, Feldmeier, H and Thomas, J 2021 , 'Clinical interventions for tungiasis (sand flea disease): a systematic review' , Lancet Infectious Diseases , pp. 1-12 , doi: 10.1016/S1473-3099(20)30853-7.

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Tungiasis (sand flea disease) is an epidermal parasitic skin disease occurring in resource-limited communities. Thereis no standard treatment for tungiasis, and available treatment options are scarce. To our knowledge, this is the firstsystematic review aimed to assess randomised controlled trials (RCTs) investigating interventions for tungiasis. Wesystematically 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 CochraneCollaboration’s risk of bias tool to assess the risk of bias and Jadad scale to quantify the methodological quality of theRCTs. Of the 1839 identified records, only eight RCTs involving 808 participants were included, and severalmethodological deficiencies were identified in most of the trials. Trial interventions included: oral drugs niridazoleand ivermectin and topical interventions of ivermectin lotion, metrifonate lotion, thiabendazole lotion, thiabendazoleointment, dimeticones (NYDA), and a neem seed and coconut oils-based mixture for treatment and coconut oil-basedlotion (Zanzarin) for prevention. The coconut oil-based lotion for prevention and dimeticones for treatment oftungiasis 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 alternativesof tungiasis in endemic settings.

Item Type: Article
Authors/Creators:Abrha, S and Heukelbach, J and Peterson, GM and Christenson, JK and Carroll, S and Kosari, S and Bartholomeus, A and Feldmeier, H and Thomas, J
Keywords: children, clinical interventions, neglected tropical disease, prevention, randomised clinical trials, review, sand flea disease, skin infection, tungiasis, Tunga penetrans, treatment
Journal or Publication Title: Lancet Infectious Diseases
Publisher: Lancet Ltd
ISSN: 1473-3099
DOI / ID Number: 10.1016/S1473-3099(20)30853-7
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© 2021 Elsevier Ltd. All rights reserved

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