Therapy of Tungiasis: a Double-blinded Randomized Controlled Trial with Oral Ivermectin

• Published in: Memórias do Instituto Oswaldo Cruz Vol. 99; no. 8
• Main Authors: Jörg Heukelbach, Sabine Franck, Hermann Feldmeier
• Format: Journal Article
• Language: English
• Published: Fundação Oswaldo Cruz, Fiocruz 14-02-2005
• Subjects: tungiasis - Tunga penetrans - therapy - ivermectin - randomized controlled trial - Brazil
• ISSN: 1678-8060

Tungiasis is an ectoparasitosis causing considerable pathology in
endemic areas. Standard therapy consists of removing the embedded
parasite with a sterile needle. There is no effective chemotherapy at
hand. To fill this gap, a double-blinded randomized controlled trial
with oral ivermectin was conducted. A total of 54 individuals (27 in
the placebo group, 27 in the ivermectin group) was followed up for
seven days. They presented a total of 192 lesions. Patients received
either ivermectin (300 μg/kg body weight at a single dose,
repeated after 24 h) or placebo. Outcome measures included the clinical
stage of lesion, presence of erythema, pain, itching, signs of
viability of the parasite, and total lysis of flea. The ratio of fleas
with total lysis per total number of fleas was slightly higher in the
ivermectin group; however, this difference was not statistically
significant. There was no significant difference in any of the other
outcome measures between the treatment and the placebo group. The
results show that oral ivermectin is without any clinically significant
efficacy against embedded sand fleas at the dose given.