A Rapid Assessment Method to Estimate the Prevalence of Ectoparasitoses in Brazil: Tungiasis and Scabies As Case Studies

The epidemiologies of the ectoparasitoses tungiasis and scabies are unknown, and their distribution has not been described systematically in Brazil. We developed a rapid assessment method (RAM) based on an online questionnaire as a new tool to assess the prevalence of tungiasis and scabies and severe disease at the municipality level in the state of Ceará in northeast Brazil. As a first step, online records of tungiasis and scabies were collected from scientific publications, lay media, and the gray literature. Then, an image-based RAM with questions about the prevalence of these diseases, severe diseases, and animal reservoirs was developed as an online open questionnaire. Valid responses were obtained from 1265 respondents, primarily health professionals, from all 184 municipalities in the state. The literature review returned results for only two municipalities. The number of responses from the online questionnaires differed considerably between municipalities (one to 104 responses/municipality). Active contact with municipality health secretariats increased the number of respondents, especially community health agents. The RAM obtained consistent results regarding the prevalence and other epidemiological information. Our approach rapidly obtained primary data on the occurrence of these two important but neglected ectoparasitoses at the municipality level without considerable cost. This approach provides information for planning evidence-based control measures and identifying high-risk areas for focused studies. The RAM can easily be adapted and extended to other settings, countries, and diseases.