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    Tungiasis Presenting as Onychomycosis: Probably the First Report of Flea Infestation of the Nail Observed Using Modified Potassium Hydroxide Mount Technique.
    Cureus 2018 Mar 5;10(3):e2278. Epub 2018 Mar 5.
    Department of Microbiology, Prathima Institute of Medical Sciences.
    Tungiasis is an infection/infestation of the flea . These are bloodsucking ectoparasitic insects belonging to the phylum Arthropoda, and they do not possess wings, but they have long legs enabling them to jump up to 30 cm high. The fleas are usually present on the skin and in the hair of domestic and wild animals and are prevalent throughout the world. Read More

    Tungiasis: Outbreak investigation of a zoonosis during overseas deployment.
    Med J Armed Forces India 2017 Oct 15;73(4):375-379. Epub 2017 Nov 15.
    Classified Specialist (Surgery), Command Hospital (Western Command), Chandimandir, India.
    Background: Tungiasis is an ectoparasitosis caused by the sand flea . It is endemic in the under privileged communities of Latin America, the Caribbean and Sub Saharan Africa with geographic and seasonal variations even within endemic areas. We describe investigation of an outbreak of Tungiasis in troops deployed as part of UN peacekeeping force in Central Africa. Read More

    Tungiasis: A Rare Parasitic Infestation in Genitals of a Native Male from Kathmandu.
    J Nepal Health Res Counc 2018 Jan 1;15(3):295-297. Epub 2018 Jan 1.
    Institute of Medicine, Trbhuvan University Teaching Hospital Maharajgunj Kathmandu, Nepal.
    Tungiasis is a common parasitic infection inmany parts of the world, including South and Central America and parts of Africa. It is rare in other places, such as in India and Pakistan and imported cases have been reported in Taiwan, Italy, the United States of America, etc. Our diagnosis was made based on histopathologiocal features of the parasite, which corresponds too ther reports and description of tungiasis. Read More

    Tungiasis-related life quality impairment in children living in rural Kenya.
    PLoS Negl Trop Dis 2018 01 8;12(1):e0005939. Epub 2018 Jan 8.
    Institute of Microbiology and Hygiene, University Medicine Berlin, Germany.
    Background: Tungiasis (sand flea disease) is a neglected tropical skin disease caused by female sand fleas (Tunga spp.) embedded in the skin of the host. The disease is common in sub-Saharan Africa and predominantly affects children living in impoverished rural communities. Read More

    Tungiasis: a poorly-known diagnosis in Europe. Two paradigmatic cases from Portugal.
    Acta Dermatovenerol Alp Pannonica Adriat 2017 Dec;26(4):115-117
    Department of Dermatology, Hospital de Braga, Braga, Portugal.
    Tungiasis is a cutaneous parasitosis caused by infestation of the skin by gravid fleas of the genus Tunga, mainly Tunga penetrans. This flea is very common in tropical and subtropical regions of the globe, but not in Europe. The infestation is acquired by walking barefoot or lying in places where the flea is present, usually beaches or sandy soils. Read More

    Disseminated tungiasis.
    An Bras Dermatol 2017 Sep-Oct;92(5):727-728
    Dermatology Service of the Universidade Federal do Mato Grosso do Sul (UFMS) - Campo Grande (MS), Brazil.
    The authors report an unusual case of disseminated tungiasis in a 52-year-old patient living in the city of Campo Grande, state of Mato Grosso do Sul, who had crusted-papular-nodular lesions located in feet, hands, and right thigh. Diagnosis was confirmed by dermoscopy and anatomopathological examination. Read More

    Animal and human tungiasis-related knowledge and treatment practices among animal keeping households in Bugiri District, South-Eastern Uganda.
    Acta Trop 2018 Jan 7;177:81-88. Epub 2017 Oct 7.
    Institute of Microbiology and Hygiene, Charité University Medicine, Berlin Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin, Germany.
    Background: Zoonotic tungiasis caused by Tunga penetrans remains a serious public and animal health problem among endemic villages in Uganda and many sub Saharan African countries. Studies on human and animal tungiasis-related knowledge and treatment practices in endemic communities have never been undertaken, a limitation to development of sustainable control measures.

    Methods: A cross sectional study using semi-structured questionnaires (Supplementary file S1) was conducted among 236 animal rearing households in 10 endemic villages in Bugiri District, South-Eastern Uganda. Read More

    Prevalence, intensity and risk factors of tungiasis in Kilifi County, Kenya: I. Results from a community-based study.
    PLoS Negl Trop Dis 2017 Oct 9;11(10):e0005925. Epub 2017 Oct 9.
    Institute of Microbiology and Hygiene, Charité University Medicine, Berlin, Germany.
    Background: Tungiasis is a neglected tropical disease caused by female sand fleas (Tunga penetrans) embedded in the skin. The disease is associated with important morbidity. Tungiasis is endemic along the Coast of Kenya with a prevalence ranging from 11% to 50% in school-age children. Read More

    High-resolution infrared thermography: a new tool to assess tungiasis-associated inflammation of the skin.
    Trop Med Health 2017 15;45:23. Epub 2017 Sep 15.
    Institute for Microbiology and Hygiene, Charité University Medicine, Berlin, Germany.
    Background: Tungiasis is highly prevalent in low- and middle-income countries but remains often under diagnosed and untreated eventually leading to chronic sequels. The objective of the study was to assess whether tungiasis-associated inflammation can be detected and quantified by high-resolution infrared thermography (HRIT) and whether after removal of the parasite inflammation resolves rapidly.

    Methods: Patients with tungiasis were identified through active case finding. Read More

    Secondary bacterial infections and antibiotic resistance among tungiasis patients in Western, Kenya.
    PLoS Negl Trop Dis 2017 Sep 8;11(9):e0005901. Epub 2017 Sep 8.
    Center for Traditional Medicine and Drug Research, Kenya Medical Research Institute, Nairobi, Kenya.
    Tungiasis or jigger infestation is a parasitic disease caused by the female sand flea Tunga penetrans. Secondary infection of the lesions caused by this flea is common in endemic communities. This study sought to shed light on the bacterial pathogens causing secondary infections in tungiasis lesions and their susceptibility profiles to commonly prescribed antibiotics. Read More

    The prevalence and association with health-related quality of life of tungiasis and scabies in schoolchildren in southern Ethiopia.
    PLoS Negl Trop Dis 2017 Aug 3;11(8):e0005808. Epub 2017 Aug 3.
    London School of Hygiene and Tropical Medicine, London, United Kingdom.
    Background: The prevalence of skin disease in low and middle income countries is high and communicable skin diseases are a significant public health problem. Tungiasis is an ectoparasite infestation caused by the flea Tunga penetrans, which has a widespread geographical distribution. Tungiasis causes painful skin lesions and may affect activities of daily living. Read More

    High intensity of Tunga penetrans infection causing severe disease among pigs in Busoga, South Eastern Uganda.
    BMC Vet Res 2017 Jun 29;13(1):206. Epub 2017 Jun 29.
    Institute for Parasitology and Tropical Veterinary Medicine, Freie Universität Berlin, 14163, Berlin, Germany.
    Background: Towards the improvement of stakeholders' awareness of animal tungiasis, we report 10 unusual severe clinical cases of pig tungiasis which were associated with very high infection intensities of T. penetrans in an endemic area.

    Results: Morbidity of ten pigs with high sand flea intensities detected during high transmission seasons in an endemic area in Busoga sub region, Uganda is described in detail. Read More

    Canine tungiasis: High prevalence in a tourist region in Bahia state, Brazil.
    Prev Vet Med 2017 Apr 20;139(Pt A):76-81. Epub 2017 Feb 20.
    UESC, Universidade Estadual de Santa Cruz, Departamento de Ciências Agrárias e Ambientais, Programa de Pós-Graduação em Ciência Animal, Ilhéus, Bahia, Brazil. Electronic address:
    Tungiasis is a parasitic skin disease neglected by authorities, health professionals, and the general population. Its occurrence is significantly associated with poverty. A cross-sectional study was conducted to describe the prevalence of tungiasis, associated clinical signs and risk factors of the canine population at a tourist site in the city of Ilhéus, Bahia (northeast Brazil). Read More

    Treatment of tungiasis with a two-component dimeticone: a comparison between moistening the whole foot and directly targeting the embedded sand fleas.
    Trop Med Health 2017 10;45. Epub 2017 Mar 10.
    Institute of Microbiology and Hygiene, Campus Benjamin Franklin, Charité University Medicine, Berlin, Germany.
    Background: Tungiasis (sand flea disease) is caused by the penetration of female sand fleas (, Siphonaptera) into the skin. It belongs to the neglected tropical diseases and is prevalent in South America, the Caribbean and sub-Saharan Africa. Tungiasis predominantly affects marginalized populations and resource-poor communities in both urban and rural areas. Read More

    Disseminated tungiasis in a 78-year-old woman from Tanzania: a case report.
    J Med Case Rep 2016 Dec 20;10(1):354. Epub 2016 Dec 20.
    Unit of Research, Jakaya Kikwete Cardiac Institute, PO Box 65141, Dar es Salaam, Tanzania.
    Background: Tungiasis is one of the neglected tropical diseases; it affects up to 40% of individuals living in societies with poor housing and sanitation standards. In endemic areas, Tunga infestation, which predominantly affects the periungual areas of the lower limbs in humans, is associated with considerable morbidity and poor quality of life.

    Case Presentation: A 78-year-old woman of African descent presented with pain, inflammation, suppuration, ulceration, and deformation of digits of all four limbs. Read More

    Successful Treatment of Severe Tungiasis in Pigs Using a Topical Aerosol Containing Chlorfenvinphos, Dichlorphos and Gentian Violet.
    PLoS Negl Trop Dis 2016 Oct 11;10(10):e0005056. Epub 2016 Oct 11.
    Institute for Parasitology and Tropical Veterinary Medicine, Freie Universität Berlin, Berlin, Germany.
    Background: In endemic communities, zoonotic tungiasis, a severe skin disease caused by penetrating female sand fleas, is a public health hazard causing significant human and animal morbidity. No validated drugs are currently available for treatment of animal tungiasis. Due to the reservoir in domestic animals, integrated management of human and animal tungiasis is required to avert its negative effects. Read More

    Prevalence and risk factors associated with tungiasis in Mayuge district, Eastern Uganda.
    Pan Afr Med J 2016 24;24:77. Epub 2016 May 24.
    Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.
    Introduction: Tungiasis is an endemic but neglected health problem in Uganda especially in resource poor communities. It is largely affecting rural communities in the Eastern, West Nile and Central regions. This study assessed prevalence and risk factors associated with tungiasis in Mayuge district, Eastern Uganda. Read More

    Prevalence and clinical aspects of tungiasis in south-west Nigerian schoolchildren.
    Trop Doct 2017 Jan 8;47(1):34-38. Epub 2016 Jul 8.
    Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza, Brazil
    Tungiasis is highly prevalent in resource-poor communities in sub-Saharan Africa, but studies among schoolchildren are scanty. We assessed prevalence, parasite load and clinical aspects of tungiasis in schoolchildren in south-western Nigeria. A total of 545 schoolchildren was examined. Read More

    Got the Travel Bug? A Review of Common Infections, Infestations, Bites, and Stings Among Returning Travelers.
    Am J Clin Dermatol 2016 Oct;17(5):451-462
    Department of Dermatology, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH, USA.
    The popularity of international travel continues to increase among Americans, even though they often experience subsequent illness on return from their journey. The pathogens responsible are not necessarily endemic to the destination itself but are often the result of poor sanitary conditions or activities engaged in while away. Skin disease ranks third among all medical concerns in returning travelers. Read More

    Two Severe Cases of Tungiasis in Goat Kids in Uganda.
    J Insect Sci 2016 24;16. Epub 2016 Mar 24.
    College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, P.O. Box 7062, Kampala, Uganda
    Tungiasis ensues from the penetration and burrowing of female sand fleas (Tunga spp.; Siphonaptera: Tungidae) in the skin of mammals. There are few case reports of severe tungiasis in goats and in these cases the Tunga species were not in most cases clearly identified. Read More

    Tungiasis in Italy: An imported case of Tunga penetrans and review of the literature.
    Pathol Res Pract 2016 May 2;212(5):475-83. Epub 2016 Feb 2.
    Department of Diagnostic Medicine and Public Health, University of Modena and Reggio Emilia, Via del Pozzo 71, Modena 41124, Italy.
    Tungiasis is an animal and human parasitic disease caused by fleas of the genus Tunga (Siphonaptera, Tungidae), endemic in equatorial and subtropical regions and rarely described in European countries, where clinicians and general pathologists could be not aware of this parasitic disease. To our knowledge, only 75 cases of human tungiasis (not all described in detail) were previously reported in Italy. We described a new case in a 34-year-old Italian flight attendant who developed a granuloma-like, ulcerated nodule in the subungual region of his left 5th toe, partially detaching the nail, about 20-30 days after his return from Brazil. Read More

    Tungiasis-associated morbidity in pigs and dogs in endemic villages of Uganda.
    Parasit Vectors 2016 Jan 27;9:44. Epub 2016 Jan 27.
    Institute for Parasitology and Tropical Veterinary Medicine, Freie Universität Berlin, 14163, Berlin, Germany.
    Background: Tunga penetrans (Insecta, Siphonaptera, Tungidae) causes severe morbidity among heavily infected humans and animals in Latin America and sub-Saharan Africa. The clinical pathology of tungiasis in animals has never been studied systematically.

    Methods: This was a cross-sectional study conducted between January to March 2015, aimed at describing tungiasis-associated clinical pathology in 121 and 20 T. Read More

    Epidemiology of infestation in selected areas in Kiharu constituency, Murang'a County, Kenya.
    Trop Dis Travel Med Vaccines 2015 5;1:13. Epub 2015 Dec 5.
    Department of Zoological sciences, Kenyatta University, P. O. Box 43844-00100, Nairobi, Kenya.
    Background: Tungiasis is a parasitic skin disease brought about by female when they burrow into the skin of their hosts. It is a disease that has largely been ignored. Epidemiology of tungiasis has not been widely studied in Kenya which could negatively affect effective intervention strategies. Read More

    Animal Reservoirs of Zoonotic Tungiasis in Endemic Rural Villages of Uganda.
    PLoS Negl Trop Dis 2015 16;9(10):e0004126. Epub 2015 Oct 16.
    Institute for Parasitology and Tropical Veterinary Medicine, Freie Universität Berlin, Berlin, Germany.
    Background: Animal tungiasis is believed to increase the prevalence and parasite burden in humans. Animal reservoirs of Tunga penetrans differ among endemic areas and their role in the epidemiology of tungiasis had never been investigated in Uganda.

    Methods And Findings: To identify the major animal reservoirs of Tunga penetrans and their relative importance in the transmission of tungiasis in Uganda, a cross sectional study was conducted in animal rearing households in 10 endemic villages in Bugiri District. Read More

    [Two travellers returning from the tropics with persistent wounds on their feet].
    Ned Tijdschr Geneeskd 2015 ;159:A9278
    Koninklijk Instituut voor de Tropen, Amsterdam.
    Two young tropical medicine residents returned from Zanzibar with multiple aching wounds on their toes that did not heal within 6 weeks. The clinical picture fit 'tungiasis', which is caused by Tunga penetrans, also known as jigger or sandflea. The ectoparasites were surgically removed and the status of tetanus vaccination was checked. Read More

    Skin lesions in returning travellers.
    Int Marit Health 2015 ;66(3):173-80
    Department of Epidemiology and Tropical Medicine, Military Institute of Medicine, Warsaw, Poland.
    Skin lesions, apart from diarrhoeas, fever of unknown origin, and respiratory tract infections belong to the most frequent medical problems in travellers returned from tropical and subtropical destinations, accounting more than 10% of reported cases. Most dermatoses have their clinical onset during travel, although some of them can occur after return. Travel-related dermatological problems can have a wide spectrum of clinical picture, from macular, popular or nodular rash, linear and migratory lesions, to plaques, vesicles, bullae, erosions or ulcers. Read More

    Dermatoscopy in inflammatory and infectious skin disorders.
    G Ital Dermatol Venereol 2015 Oct;150(5):521-31
    Dermatology Clinic, University of Catania, A.O.U. Policlinico Vittorio Emanuele, Catania, Italy -
    Dermatoscopy is a non-invasive technique that allows a rapid and magnified in vivo observation of the skin surface. By definition, it is performed with handheld devices (dermatoscopes) allowing X10 magnification. More expensive, computer-assisted digital systems (videodermatoscopes) may be equipped with lenses that ensure magnifications up to X1000; in this case the term videodermatoscopy is generally used. Read More

    Tungiasis Outbreak in Travelers From Madagascar.
    J Travel Med 2015 Jul-Aug;22(4):263-6. Epub 2015 Jun 2.
    Laboratoire de Parasitologie et Zoologie appliquée, Faculté de Médecine, et Institut de Parasitologie de l'Ouest, Rennes, France.
    Seven patients from a group of 16 travelers were diagnosed at our institution with one or more sand fleas on their toes, 1 day to 3 weeks after returning from Madagascar. A questionnaire was sent to the whole group to collect clinical and epidemiological information, which showed that 9 of 13 (69%) had received pre-travel medical advice, but none were aware of sand flea; thus prevention measures were rarely applied. Five of seven (71%) patients wore open sandals throughout the trip. Read More

    Skin infections in returned travelers: an update.
    Curr Infect Dis Rep 2015 Mar;17(3):467
    Department of Medicine, Oregon Health & Science University, Portland, OR, USA.
    Dermatologic manifestations of travel-related illness are particularly vexing due to the broad differential diagnosis and clinicians' unfamiliarity with uncommonly seen diseases. This paper aims to educate and update the reader on selected infectious diseases in the returned traveler whose disease manifestations are primarily dermatologic. First, the evolving epidemiology of these infections is examined; understanding the geographic distribution of infectious etiologies helps refine and narrow the differential diagnosis. Read More

    Characterization of Tunga penetrans antigens in selected epidemic areas in Murang'a county in Kenya.
    PLoS Negl Trop Dis 2015 Mar 20;9(3):e0003517. Epub 2015 Mar 20.
    Department of Zoological sciences, Kenyatta University, Nairobi, Kenya.
    Tunga penetrans are fleas that cause tungiasis, a condition characterized by high transmission rate due to poor housing conditions, social neglect and inadequate health care in economically disadvantaged communities in developing countries. This study therefore aimed at characterizing jiggers antigens to identify immunodominant ones to help understand immunological behavior of the parasite that would otherwise be important in future control of the parasite. Samples were gravid fleas and blood samples from infested individuals in Kahuro and Murang'a East district in Murang'a County. Read More

    Pathology and diagnosis of proliferative and ulcerative dermatitis associated with Tunga penetrans infestation in cattle.
    J Vet Diagn Invest 2015 Jan;27(1):80-5
    private practice, Jujuy, Argentina (Marin)Veterinary Medical Teaching Hospital (Houston), School of Veterinary Medicine, University of California-Davis, Davis, CADepartment of Medicine and Epidemiology (Omanska-Klusek), School of Veterinary Medicine, University of California-Davis, Davis, CACalifornia Animal Health & Food Safety Laboratory, San Bernardino branch (Garcia, Uzal), School of Veterinary Medicine, University of California-Davis, Davis, CACollege of Veterinary Medicine, Western University of Health Sciences, Pomona, CA (Alcaraz)
    Tunga penetrans is the smallest biting flea known. In cattle, infestation by T. penetrans (tungiasis) typically affects the skin of the distal legs, udder, prepuce, and perianal area. Read More

    Notes on the genus Tunga (Siphonaptera: Tungidae) II--neosomes, morphology, classification, and other taxonomic notes.
    Parasite 2014 17;21:68. Epub 2014 Dec 17.
    Laboratoire de Parasitologie et Zoologie appliquée, Faculté de Médecine 2, avenue du Professeur Léon Bernard, 35043 Rennes Cedex, France - Laboratoire de Parasitologie, Mycologie et Immunologie parasitaire, Centre Hospitalier Régional Universitaire, 2 rue Henri Le Guilloux, 32033 Rennes Cedex, France.
    This review focuses on the neosomes, morphology, and taxonomy of adult species of the genus Tunga, complementing the previously published data on the phylogeny, ecology, and pathogenic role. Neosomes are structures formed after penetration of adult females into the skin of hosts resulting in significant enlargement, being the most characteristic and most frequently observed form in hosts. Neosomes can be differentiated by shape, measurements, and sites of attachment to principal hosts. Read More

    Treatment of parasitic skin diseases with dimeticones a new family of compounds with a purely physical mode of action.
    Trop Med Health 2014 Jun;42(2 Suppl):15-20
    Institute of Microbiology and Hygiene, Charité University Medicine , Berlin Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin, Germany.
    Epidermal parasitic skin diseases (EPSD) are common in the tropics and sub-tropics. They are caused by mites, lice and other blood-sucking insects. In resource-poor countries they are associated with considerable morbidity. Read More

    Association between footwear use and neglected tropical diseases: a systematic review and meta-analysis.
    PLoS Negl Trop Dis 2014 13;8(11):e3285. Epub 2014 Nov 13.
    Brighton & Sussex Medical School, Brighton, United Kingdom.
    Background: The control of neglected tropical diseases (NTDs) has primarily focused on preventive chemotherapy and case management. Less attention has been placed on the role of ensuring access to adequate water, sanitation, and hygiene and personal preventive measures in reducing exposure to infection. Our aim was to assess whether footwear use was associated with a lower risk of selected NTDs. Read More

    Tungiasis in Northern Tanzania: a clinical report from Qameyu village, Babati District, Manyara Region.
    J Infect Dev Ctries 2014 Nov 13;8(11):1456-60. Epub 2014 Nov 13.
    University of Milan, I.R.C.C.S. Foundation, Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.
    Introduction: Tungiasis is an infestation caused by the penetration in the skin of the gravid female of the flea Tunga penetrans (T. penetrans). The current epidemiological situation of tungiasis in Eastern Africa is poorly known. Read More

    Tungiasis presenting as a soft tissue oral lesion.
    BMC Oral Health 2014 Sep 3;14:112. Epub 2014 Sep 3.
    Department of Medical Microbiology, School of Biomedical Sciences, College of Health Sciences Makerere University, P, O, Box 7072, Kampala, Uganda.
    Background: The sand flea Tunga penetrans usually infects the feet and affects primary school-age children and elderly persons in rural Uganda. Tungiasis occurs nationwide but disease outbreaks have been reported in the Busoga sub-Region of eastern Uganda, associated with poor sanitation and proximity between humans and domestic animals. Ectopic tungiasis, usually seen with extensive infection and at weight-bearing body surfaces often follows exposure in highly infested environments. Read More

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