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Control comunitario de la sarna: un modelo basado en el uso de crema de permetrina
D Taplin1, S L Porcelain, T L Meinking
1Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, Florida.
Lancet (London, England)
|April 27, 1991
Resumen
Los brotes de sarna en las islas de Panamá fueron controlados de manera efectiva utilizando crema de permetrina al 5%, lo que demuestra su eficacia cuando los tratamientos anteriores fallaron. El control sostenido requirió vigilancia y tratamiento continuos para mantener una baja prevalencia de sarna.
Área de la Ciencia:
- Epidemiología La epidemiología.
- Dermatología Dermatología dermatología.
- La Medicina Tropical es una medicina tropical.
Sus antecedentes:
- Los brotes de sarna persistieron durante 18 años entre los indios Kuna en Panamá a pesar de los tratamientos con lindano y crotamitona.
- Los tratamientos anteriores no lograron controlar las epidemias de sarna en las islas de San Blas.
Objetivo del estudio:
- Para evaluar la eficacia de la crema de permetrina al 5% en el control de una epidemia de sarna.
- Evaluar el impacto a largo plazo del tratamiento con permetrina en la prevalencia de la sarna y las infecciones bacterianas secundarias.
Principales métodos:
- Un programa de tratamiento en toda la comunidad utilizando crema de permetrina al 5% se implementó en una isla con 756 habitantes.
- La prevalencia de la sarna se monitoreó antes, durante y después de la intervención, incluidos los períodos de tratamiento interrumpido y pérdida de control.
- También se monitorearon las infecciones bacterianas de la piel.
Principales resultados:
- La prevalencia de sarna disminuyó del 33% a menos del 1% después del tratamiento masivo con crema de permetrina al 5%.
- La baja prevalencia sostenida (<1,5%) se mantuvo durante más de 3 años con vigilancia y tratamiento continuos.
- La prevalencia aumentó al 3,6% durante una interrupción de suministro de medicamentos de 3 semanas y al 12% después de perder el control.
- Las infecciones bacterianas de la piel disminuyeron significativamente con el control de la sarna.
Conclusiones:
- La crema de permetrina al 5% es un tratamiento seguro y altamente efectivo para la sarna, incluso en regiones con resistencia al lindano.
- La vigilancia continua y el tratamiento inmediato son cruciales para mantener el control de la sarna a largo plazo.
- El manejo eficaz de la sarna puede conducir a una reducción de las infecciones cutáneas bacterianas secundarias.
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