One Health Initiative: Delusional Parasitosis Needs Assessment, Tennessee 2022

Delusional parasitosis (DP) is a false, persistent belief that an individual is infested with organisms, especially arthropods, of a parasitic nature. It is a complex and challenging problem that impacts healthcare, the pest management industry, state-led agriculture and health agencies, Extension professionals, and academia because of time burdens and frustration associated with interactions. To address the handling of suspected DP cases, we assembled a University of Tennessee One Health Initiative Working Group with individuals representing diverse disciplines and professions. The Working Group developed and conducted an online needs assessment of pest management, Extension, and health professionals to (i) understand their interactions with suspected DP cases and (ii) determine the educational resources used and needed. Of the pest management professionals and Extension personnel, 72.7% (n = 112) of the respondents indicated they had encountered someone with suspected DP within the last year. Those responding to suspected DP cases spent significantly more time and interactions than what was required for general inquiries. Seventy-three percent of respondents received specimens of which more were human derived (54.4%) than nonhuman derived (41.5%), potentially putting these nonhealthcare professionals at risk of potential contagion. We confirmed a lack of available resources, including protocols, training materials, and resources for expert medical referrals. Additionally, the staff responsible for handling these cases were concerned for their safety. After identifying the most pressing needs, the One Health Working Group members collaborated to produce comprehensive resources to assist professionals in identifying DP cases more quickly and efficiently routing them to essential care.