{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T22:22:14Z","timestamp":1790461334271,"version":"4.1.0"},"reference-count":21,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,11,6]]},"abstract":"<jats:p>Tungiasis (sand flea disease) is a neglected tropical disease. Heavy infestation results in mutilation of the feet and difficulty in walking. We identified eight individuals with extremely severe tungiasis in rural Madagascar. To prevent reinfestation, four individuals received solid shoes and four received a daily application of an herbal repellent effective against <jats:italic>Tunga penetrans<\/jats:italic>. Over a period of 10 weeks the feet were examined and the severity of tungiasis-associated morbidity was measured. Within this period, the severity score for acute tungiasis decreased 41% in the shoe group and 89% in the repellent group. The four major inflammation-related symptoms disappeared in the four patients of the repellent group, but only in two patients of the shoe group. Those observations indicate that cases with extremely severe tungiasis, associated morbidity almost totally disappears within 10 weeks if the feet are protected by a repellent. Wearing shoes reduced acute morbidity only marginally.<\/jats:p>","DOI":"10.4269\/ajtmh.13-0244","type":"journal-article","created":{"date-parts":[[2013,9,17]],"date-time":"2013-09-17T04:35:59Z","timestamp":1379392559000},"page":"932-936","source":"Crossref","is-referenced-by-count":17,"title":["Regression of Severe Tungiasis-Associated Morbidity after Prevention of Re-Infestation: A Case Series from Rural Madagascar"],"prefix":"10.4269","volume":"89","author":[{"given":"Marlene","family":"Thielecke","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaomalala","family":"Raharimanga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Stauss-Grabo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Rogier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Richard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hermann","family":"Feldmeier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"R1","series-title":"Trop Med Int Health","first-page":"267","article-title":"Tungiasis: a neglected health problem of poor communities","volume":"6","author":"Heukelbach","year":"2001"},{"key":"R2","series-title":"Bull World Health Organ","first-page":"152","article-title":"Epidermal parasitic skin diseases: a neglected category of poverty-associated plagues","volume":"87","author":"Feldmeier","year":"2009"},{"key":"R3","series-title":"Emerg Infect Dis","first-page":"949","article-title":"Severe tungiasis in underprivileged communities: case series from Brazil","volume":"9","author":"Feldmeier","year":"2003"},{"key":"R4","series-title":"Ann Trop Med Parasitol","first-page":"471","article-title":"Prevalence of tungiasis in Oto-Ijanikin village, Badagry, Lagos State, Nigeria","volume":"75","author":"Ade-Serrano","year":"1981"},{"key":"R5","series-title":"Rev Soc Bras Med Trop","first-page":"63","article-title":"Tungiasis: a neglected disease causing severe morbidity in a shantytown in Fortaleza, State of Cear\u00e1","volume":"40","author":"Ariza","year":"2007"},{"key":"R6","series-title":"Mem Inst Oswaldo Cruz","first-page":"31","article-title":"The patterns o tungiasis in Araruama township, State of Rio de Janeiro, Brazil","volume":"96","author":"de Carvalho","year":"2003"},{"key":"R7","series-title":"Trans R Soc Trop Med Hyg","first-page":"371","article-title":"Identifying risk factor for tungiasis and heavy infestation in a resource-poor community in northeast Brazil","volume":"100","author":"Muehlen","year":"2006"},{"key":"R8","series-title":"Revue M\u00e9dicine V\u00e9terinaire","first-page":"551","article-title":"Tunga penetrans (Insecta, Siphonaptera, Tungidae) \u00e0 Madagascar: une nuisance n\u00e9glig\u00e9e","volume":"11","author":"Ratovonjato","year":"2008"},{"key":"R9","series-title":"Acta Trop","first-page":"255","article-title":"High prevalence of tungiasis in a poor neighborhood in Fortaleza, northeast Brazil","volume":"83","author":"Wilcke","year":"2002"},{"key":"R10","series-title":"Med Vet Entomol","first-page":"329","article-title":"The animal reservoir of Tunga penetrans in severely affected communities in Northeast Brazil","volume":"18","author":"Heukelbach","year":"2003"},{"key":"R11","series-title":"Nigerian J Parasitol","first-page":"1","article-title":"Tungiasis in the past and present: a dire need for intervention","volume":"28","author":"Heukelbach","year":"2007"},{"key":"R12","series-title":"Am J Trop Med Hyg","first-page":"216","article-title":"Ectopic localization of tungiasis","volume":"67","author":"Heukelbach","year":"2002"},{"key":"R13","series-title":"Parasitol Res","first-page":"449","article-title":"Investigations on the biology, epidemiology, pathology and control of Tunga penetrans in Brazil: II. Prevalence, parasite load and topographic distribution of lesions in the population of a traditional fishing village","volume":"90","author":"Muehlen","year":"2003"},{"key":"R14","series-title":"Mem Inst Oswaldo Cruz","first-page":"873","article-title":"Therapy of tungiasis: a double-blinded randomized controlled trial with oral ivermectin","volume":"99","author":"Heukelbach","year":"2005"},{"key":"R15","series-title":"Eur J Clin Microbiol Infect Dis","first-page":"19","article-title":"Tungiasis (sand flea disease): a parasitic disease with intriguing challenges for public health","volume":"32","author":"Feldmeier","year":"2012"},{"key":"R16","series-title":"PLoS Negl Trop Dis","first-page":"e2426","article-title":"Prevention of tungiasis and tungiasis-associated morbidity: a randomized, controlled field study in rural Madagascar","volume":"7","author":"Thielecke","year":"2013"},{"key":"R17","series-title":"PLoS Negl Trop Dis","first-page":"e879","article-title":"Control of tungiasis through intermittent application of a plant-based repellent: an intervention study in a resource-poor community in Brazil","volume":"4","author":"Buckendahl","year":"2010"},{"key":"R18","series-title":"Acta Trop","first-page":"126","article-title":"A plant-based repellent protects against Tunga penetrans infestation and sand flea disease","volume":"99","author":"Feldmeier","year":"2006"},{"key":"R19","series-title":"Ann Trop Med Parasitol","first-page":"89","article-title":"Prevention of tungiasis using a biological repellent: a small case series","volume":"98","author":"Schwalfenberg","year":"2004"},{"key":"R20","series-title":"Parasitol Res","first-page":"413","article-title":"Morbidity assessment in sand flea disease (tungiasis)","volume":"100","author":"Kehr","year":"2007"},{"key":"R21","series-title":"Pr\u00e9cis de M\u00e9decine Coloniale","first-page":"441","author":"Joyeux","year":"1937"}],"container-title":["The American Society of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/89\/5\/article-p932.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/89\/5\/article-p932.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/89\/5\/article-p932.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T18:17:00Z","timestamp":1723054620000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/89\/5\/article-p932.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,11,6]]},"references-count":21,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.13-0244","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,11,6]]}}}