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OPINIÃO OPINION

1535

Ectoparasitoses e saúde pública no Brasil: desafios para controle Ecoparasitoses and public health in Brazil: challenges for control

Jörg Heukelbach 1 Fabíola Araújo Sales de Oliveira Hermann Feldmeier 2

1

1 Fundação Mandacaru. Rua José Vilar de Andrade 257, Fortaleza, CE 60833-830, Brasil. [e-mail] 2 Institute of International Health, Center for Humanities and Health Sciences, Faculty of Medicine, Free University of Berlin. Fabeckstrasse 60-62, 12203, Berlin, Germany. [e-mail]

Abstract Parasitic skin diseases such as scabies, pediculosis, tungiasis, and cutaneous larva migrans are hyperendemic in the numerous poor communities in Brazil and are commonly associated with considerable morbidity. However, programs to control ectoparasites are non-existent in the country’s public health system. Due to neglect of these diseases by the population itself and health care professionals, the diseases’ highly contagious characteristics, and lack of effective treatment and/or presence of animal reservoirs together with a complex life cycle, effective control of ectoparasites is an enormous public health challenge. This article discusses potential measures to control parasitic skin diseases in affected communities, based on mass treatment, health education, and (when applicable) eradication of animal reservoirs. Key words Ectoparasitic Infestations; Vulnerable Group; Urban Health; Health Surveillance

Resumo Doenças ectoparasitárias como a escabiose, a pediculose, a tungíase e a larva migrans cutânea são hiperendêmicas em inúmeras comunidades carentes no Brasil, e não raramente associadas à severidade considerável. Entretanto, programas que priorizem o controle de ectoparasitas não existem em nível de saúde pública no país. Como conseqüência da alta contagiosidade, de manejo inadequado, de negligência tanto da população como dos profissionais de saúde e/ou da presença de reservatórios animais, além de