Parasitic skin diseases: health care‐seeking in a slum in north‐east Brazil

Abstract

SummaryEctoparasitic diseases are endemic in many poor communities in north-east Brazil, and heavy infestation is frequent. We conducted two studies to assess disease perception and health care seeking behaviour in relation to parasitic skin diseases and to determine their public health importance. The first study comprised a representative cross-sectional survey of the population of a slum in north-east Brazil. Inhabitants were examined for the presence of scabies, tungiasis, pediculosis and cutaneous larva migrans (CLM). The second study assessed health care seeking behaviour related to these ectoparasitoses of patients attending a Primary Health Care Centre (PHCC) adjacent to the slum. Point prevalence rates in the community were: head lice 43.3% (95% CI: 40. Only 28 of 54 patients with scabies, three of 55 patients with tungiasis, four of six patients with CLM and zero of 110 patients with head lice sought medical assistance. The physicians of the PHCC only diagnosed a parasitic skin disease when it was pointed out by the patient himself. In all cases patients were correctly informed about the ectoparasitosis they carried. The results show that tungiasis and pediculosis, and to a lesser extent scabies and CLM, are hyperendemic but neglected by both population and physicians, and that prevalence rates of tungiasis and scabies at the PHCC do not reflect the true prevalence of these diseases in the community.

Knowledge, attitudes and practices regarding head lice infestations in rural Nigeria

“…The majority of these had applied any treatment, which shows the effectiveness of individual therapeutic measures (mainly grooming and combing) in this resource-poor setting. In a Brazilian slum, people did not present to a primary health care centre serving an urban slum due to pediculosis, which points to a similar perception of the disease in the affected population [16]. Head lice have even been described to have positive social functions in different societies, due to the social n (%) bonding during grooming [12,23].…”

“…In high-income settings, stigma and disgust are very common, whereas in low-and middle-income settings, head lice infestations are rather seen as a nuisance, or form part of normal life [12,16].…”

Neglected diseases of neglected populations: Thinking to reshape the determinants of health in Latin America and the Caribbean

“…Malnutrition [35], diarrhea, anemia and other complications of soil-transmitted helminth infections will often lead to growth stunting [36], school absenteeism [37] and also affect a child's ability to learn [38], reducing his or her chances of a better-paid and safer job later in life. Untreated parasitic skin infestations or infections (e.g., tungiasis and scabies often with secondary bacterial infection; and cutaneous larva migrans) [39] can lead to school absenteeism and lost work days. Poverty, poor housing, high population densities and unsafe or inadequate living conditions, combined with environmental conditions favoring vector breeding will readily promote the spread of some communicable diseases and trigger outbreaks in poor communities [40].…”

Ex Vivo Development of Eggs from Head Lice (Pediculus humanus capitis)

“…In this community, head lice are hyperendemic [18]. Children had not been treated for head lice infestations nor received antiparasitic or antibiotic drugs during the previous four weeks.…”