Epidemiology and clinical aspects of tungiasis (sand flea infestation) in Alagoas State, Brazil

Background: Tungiasis (infestation with the sand flea Tunga penetrans) is common in resource-poor populations throughout Brazil. However, the epidemiological situation and the clinical aspects are not fully understood.Methodology: To describe the prevalence and severity of tungiasis, associated pathology, as well as the seasonal variation in rural northeast Brazil, we performed two cross-sectional surveys: one in the rainy season, another in the dry season. Individuals were examined for the presence of tungiasis, number of lesions, symptoms and signs. In the rainy season, 88.6% (1,015/1,146), and in the dry season 91.1% (990/1,087) of the respective target populations were examined.Results: The prevalence of tungiasis was 21.6% (95% confidence interval: 19.0-24.1) in the rainy season and 29.5% (26.6-32.3) in the dry season (p