TY - JOUR
T1 - Clinical interventions for tungiasis (sand flea disease)
T2 - a systematic review
AU - Abrha, Solomon
AU - Heukelbach, Jorg
AU - Peterson, Gregory M
AU - Christenson, Julia K
AU - Carroll, Simon
AU - Kosari, Sam
AU - Bartholomeus, Andrew
AU - Feldmeier, Hermann
AU - Thomas, Jackson
N1 - Funding Information:
We thank Wubshet Tesfaye of Faculty of Health, University of Canberra (Canberra, ACT, Australia) for assisting us with the screening of retrieved records.
Publisher Copyright:
© 2021 Elsevier Ltd
PY - 2021/8
Y1 - 2021/8
N2 - Tungiasis (sand flea disease) is an epidermal parasitic skin disease occurring in resource-limited communities. There is no standard treatment for tungiasis, and available treatment options are scarce. To our knowledge, this is the first systematic review aimed to assess randomised controlled trials (RCTs) investigating interventions for tungiasis. We systematically 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 Cochrane Collaboration's risk of bias tool to assess the risk of bias and Jadad scale to quantify the methodological quality of the RCTs. Of the 1839 identified records, only eight RCTs involving 808 participants were included, and several methodological deficiencies were identified in most of the trials. Trial interventions included: oral drugs niridazole and ivermectin and topical interventions of ivermectin lotion, metrifonate lotion, thiabendazole lotion, thiabendazole ointment, dimeticones (NYDA), and a neem seed and coconut oils-based mixture for treatment and coconut oil-based lotion (Zanzarin) for prevention. The coconut oil-based lotion for prevention and dimeticones for treatment of tungiasis 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 alternatives of tungiasis in endemic settings.
AB - Tungiasis (sand flea disease) is an epidermal parasitic skin disease occurring in resource-limited communities. There is no standard treatment for tungiasis, and available treatment options are scarce. To our knowledge, this is the first systematic review aimed to assess randomised controlled trials (RCTs) investigating interventions for tungiasis. We systematically 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 Cochrane Collaboration's risk of bias tool to assess the risk of bias and Jadad scale to quantify the methodological quality of the RCTs. Of the 1839 identified records, only eight RCTs involving 808 participants were included, and several methodological deficiencies were identified in most of the trials. Trial interventions included: oral drugs niridazole and ivermectin and topical interventions of ivermectin lotion, metrifonate lotion, thiabendazole lotion, thiabendazole ointment, dimeticones (NYDA), and a neem seed and coconut oils-based mixture for treatment and coconut oil-based lotion (Zanzarin) for prevention. The coconut oil-based lotion for prevention and dimeticones for treatment of tungiasis 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 alternatives of tungiasis in endemic settings.
KW - Administration, Oral
KW - Administration, Topical
KW - Animals
KW - Antiparasitic Agents/administration & dosage
KW - Humans
KW - Ivermectin/administration & dosage
KW - Niridazole/administration & dosage
KW - Ointments
KW - Randomized Controlled Trials as Topic
KW - Thiabendazole/administration & dosage
KW - Treatment Outcome
KW - Tunga
KW - Tungiasis/drug therapy
UR - http://www.scopus.com/inward/record.url?scp=85111317196&partnerID=8YFLogxK
U2 - 10.1016/S1473-3099(20)30853-7
DO - 10.1016/S1473-3099(20)30853-7
M3 - Article
C2 - 34237261
SN - 1473-3099
VL - 21
SP - 234
EP - 245
JO - The Lancet Infectious Diseases
JF - The Lancet Infectious Diseases
IS - 8
ER -