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Introduction: Tungiasis is a parasitic skin disease due to the permanent penetration of the female sand flea T. penetrans (Linnaeus, 1758) into the skin of its host., Case Report: A 39-year-old male patient was observed in May 2005 at the Outpatient Department of Dermato-Venerology Szent Rókus Hospital in Budapest because he felt the sensation of a foreign body growing under the skin of his left big toe. When the lesion occurred he was at Brazilian seaside, where he often walked barefooted. 6-7 days after, at the left big toe he saw on the margin oedematous, at the centre brownish punctuated lesion, 6-7 mm in diameter. Dermatological examination showed at the medial surface of the left big toe 6 mm in diameter, prominent, pustule-like lesion with approximately 2 mm rim of hyperemia. Surgically 4 mm in diameter whitish softish sheath was extracted. At the Department of Parasitology National Center for Epidemiology, Budapest, the parasite-like form was identified as Tunga penetrans., Conclusion: With this case report the authors would like to call Hungarian physicians attention to this exotic disease imported into Hungary. To the best of the authors' knowledge, this is the first imported human case of tungiasis in Hungary.

Introduction: The mortality of the Hungarian population is very unfavourable in relation to other European countries. Mortality from malignant diseases is the second most frequent cause of death in both sexes. The most frequent localisation of cancer is that of the bronchi and the lungs, followed by colorectal, breast and oral cavity cancers., Aim: Of the publication was to demonstrate the spatial distribution of mortality from malignant diseases of all sites, bronchi and the lungs, as well as mortality from cancer of the thyroid gland and leukaemias, and to evaluate the possible impact of the Chernobyl nuclear accident on the frequency of cancer mortality., Method: The spatial distribution of mortality in the country is evaluated by computing standardized mortality ratio on settlement level, using geographical information system. In case of frequent mortality events a region analysis was carried out, in the opposite case--a cluster analysis., Results: Regarding the spatial distribution of mortality from all malignant diseases of 0-64 year-old males there are regions with excess mortality in almost each county. In case of women of this age group, there is a significantly higher mortality in Budapest, in three counties in the Eastern part of the country, and in some settlements in Transdanubia. Mortality from the cancer of the bronchi and the lungs significantly accumulates in both sexes in four counties in Eastern Hungary. Mortality from cancer of the thyroid gland and leukaemias does not show typical spatial accumulation as well., Conclusions: The premature mortality from all malignant diseases and of cancer of the bronchi and lungs of the Hungarian male and female population shows an increasing tendency. Mortality from the latter cause shows a typical spatial accumulation, which causes should be investigated in analytical epidemiological studies. The potential causative role of the Chernobyl accident could not be proven in any case.

The authors examined the spatial accumulation of mortality and morbidity of cancer of the prostate of the total as well as age stratified male population of Hungary. Using GIS, a descriptive epidemiological study was carried out examining the spatial differences of mortality on settlement level with 2000 inhabitants by calculating standardized mortality and morbidity ratios. The significance of the difference of mortality and morbidity from the national mean was tested by chi square probe. On the basis of the results a significant excess in mortality was detected in 11 regions of the country. The unfavourable regions cover 11.6% of the territory of the country where 25.6% of the male population live. A significant excess morbidity can be observed in 8 counties. A significant correlation was found between the unfavourable regions of mortality and morbidity (r=0.443, p<0.05). The age-specific analysis of morbidity revealed the highest excess in morbidity in the age group over 70 years accumulating in 3 counties of Transdanubia and in 6 counties of the Great Plain. On the basis of the results of mortality and morbidity analysis according to age and areas the unfavourable regions can be identified where mortality and morbidity from cancer of the prostate accumulates. These studies serve as a basis for intervention strategies.

In evaluating the health state of the population one of the most reliable parameter is mortality. The development of statistical and spatial analytical methods gave a tool for evaluating mortality and morbidity in small areas. GIS mapping helps in the assessment of health state of small areas, to investigate causal relationship and create plans of intervention. Within the frames of the National Environmental Health Action Programme (NEHAP, 1996) a spatial statistical information system was elaborated. By the help of this system, mortality from cancer of the lip, oral cavity and pharynx (ICD-X.: C00-C14) was analysed for 1986-1997 and morbidity for 1997-1999 by computing standardised mortality and morbidity ratio. Regions with unfavourable mortality and morbidity were defined, statistical significance was tested. After age and gender stratification, a cluster analysis was also carried out. An international comparison of mortality was done as well. According to our data, mortality - most frequent in both sexes according to the international comparison - as well as morbidity showed a typical spatial distribution. An excess in mortality and morbidity is observable in the central part of the country, as well as in the Northern part and in traditional wine producing areas. The spatial accumulation of mortality is very similar to that of mortality from chronic liver diseases (ICD-X.: K70). In the primary prevention of oral cancer smoking cessation and the decrease of alcohol consumption is of great importance. Screening activity of GPs and dental doctors is of major importance in secondary prevention.