A longitudinal study on cutaneous larva migrans in an impoverished Brazilian township

The objective of this study was to describe the clinical pathology and seasonal variation of cutaneous larva migrans (CLM) in an impoverished community.

A representative sample of the population of a poor urban neighbourhood in Fortaleza, northeast Brazil, was examined for CLM four times during a period of eleven months.

In total, 4107 individuals were examined. Sixty-three individuals were diagnosed to have CLM with a total of 132 larval tracks. The prevalence varied from 3.1% (95% CI: 2.2-4.3) in the middle of the rainy season to 0.2% (95% CI: 0.0-0.9) in the peak of the dry season. This corresponds to an incidence of 1841 cases of CLM per 10,000 inhabitants per year. The male sex was significantly more often affected (P<0.01). Eighty-three percent of the lesions were located at the trunk, legs or feet. Moderate or severe itching was present in all patients; 31.2% complained of insomnia due to itching, and 21% of the lesions were superinfected.

CLM is a common parasitic skin disease in this deprived community, it is associated with significant morbidity, and its occurrence varies according to the rainfall.