High prevalence of tungiasis in a poor neighbourhood in Fortaleza, Northeast Brazil

Tungiasis has been reported to occur in many Latin American, Caribbean and African countries. However, epidemiological data are still very scanty and do not exist at all for Brazil. To fill this gap, a cross-sectional study has been undertaken in a shantytown (favela) in Fortaleza, Ceará State, northeast Brazil. All 327 households of a circumscribed sub-area were visited, and 1185 out of the 1460 household members were thoroughly examined for the presence of tungiasis. Thirty-four% (95% CI: 30.9-36.4) were found to be infected with Tunga penetrans with a significant preponderance of the male sex (p<0.0001). In the children five to nine years old, the age group most heavily affected, the prevalence rate was 65.4% (95% CI: 54.0-75.7) in boys and in 48.3% (95% CI: 37.4-59.2) in girls. The data show that tungiasis is hyper-endemic in the study area. As the favela is typical for the many poor communities in northeast Brazil, it can be assumed that tungiasis is a frequent infection in the underprivileged in this part of the country.