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Biomedical subjects

D A Bundy

Publications and source records attributed to D A Bundy.

At least 145 records · Page 8Linked to original sources

Population distribution of Trichuris trichiura in a community of Jamaican children.

The Trichuris trichiura worm burdens of 23 children living in a Place-of-Safety in Kingston, Jamaica, were assessed by stool collection for more than five days after treatment with mebendazole. This procedure was repeated after a seven-month period of natural re-infection. For both collections the maximum rate of worm expulsion was achieved on the fourth day after starting treatment. The worm population distributions were overdispersed and well described by the negative binomial probability model (k = 0.29) in each case. For any one individual, the number of worms passed on the first expulsion was unrelated, absolutely or relatively, to the number passed on the second. These data suggest that: knowledge of the time dependency of helminth expulsion is essential for the accurate estimation of worm burdens by this method; populations of Trichuris are more highly aggregated than those of Ascaris and may thus be more susceptible to control by selective rather than random chemotherapy; and the inherent predisposition of hosts to infection may be of minor importance in determining the distribution of worms in the population-heavily infected hosts appear no more or less likely to acquire large worm burdens on subsequent exposures.

Child↗

Sodium azide preservation of faecal specimens for Kato analysis.

The modified Kato technique has the advantages of reproducibility, simplicity and economy: the disadvantage is that it cannot be used in conjunction with traditional faecal preservatives. Sodium azide has been evaluated as a preservative for human faeces for subsequent Kato analysis. More than 400 faecal samples (from normal and malnourished children, and from mixed-age participants in a field survey of the Turks and Caicos Islands) were each mixed with 2-5 mg of sodium azide powder and stored in 2 or 4 ml autoanalyser cups at ambient tropical temperature. At intervals up to 30 weeks, aliquots were prepared for Kato analysis. Trichuris trichiura, Ascaris lumbricoides and Necator americanus eggs were well preserved without degenerative or developmental changes in morphology. Quantitative analyses of 18 samples indicated that the mean egg count/sample did not change significantly after storage for 1, 2, 4, 8, 12 and 16 weeks in preservative. The use of azide preservative extends the applications of the Kato technique to field and clinical studies in which delays may occur between specimen collection and examination. The direct costs of azide preservation are substantially lower than for traditional methods and the preserved specimens are more compact and resistant to leakage.

Ascaris↗

Experimental investigations on the behaviour of the cercariae of an ectoparasitic digenean Transversotrema patialense: general activity patterns.

The activity patterns of the cercariae of Transversotrema patialense have been examined by monitoring the behaviour of individual larvae. Records of three different behavioural modes, namely active, tail-first swimming, passive dropping and resting periods were made separately. The age- and temperature-dependence of the activity patterns during the spontaneously active life of the cercariae were examined and estimates made of the absolute speeds of swimming and dropping. Through the temperature range 25--32 degrees C, the spontaneously active life of cercariae declined from about 18 h to about 6 h. Within this interval, after an initial period of high activity rates, a gradual decline in activity followed. The decline was a result of a decreasing frequency of swimming events rather than any change in the durations of such events. The neural control and energetic significance of the cercarial activity patterns are discussed.

Animals↗

Geohelminth infection of children from rural plantations and urban slums in Malaysia.

This study compares levels of geohelminth infection in children living in rural estates and urban slum areas of Malaysia. The statistical characteristics of geohelminth infection in 1499 children from birth up to 15 years of age, living in rural estates, were analysed according to age, sex and ethnic origin and compared with the same statistics for 1574 slum-dwelling children of similar age groups and ethnic origins. The prevalence and intensity of ascariasis and trichuriasis were significantly higher among children from the urban slums. Slum-dwelling ethnic Indians and Malays had higher levels of infection with Ascaris lumbricoides and Trichuris trichiura than their rural counterparts, but the infection status of the ethnic Chinese in the 2 areas was similar. Hookworm infection was similar in both areas, indicating that hookworm infection is neither necessarily nor solely a rural disease. These results suggest that urban slum children are at greater risk of ascariasis and trichuriasis than their rural counterparts.

Adolescent↗

Estimation of age-specific rates of acquisition and loss of Wuchereria bancrofti infection.

This study uses a reversible catalytic model to estimate the age-specific rates of gain and loss of Wuchereria bancrofti infection from data collected during a control programme in Pondicherry, South India. The data describe the infection status in 1981 and 1986 of two cohorts of individuals, one living in an area where vector reduction had been achieved, and the other in a comparable endemic area. The rate of loss of infection in the absence of reinfection is estimated for the cohort in the control area, and the rate of gain of infection by the cohort in the endemic area estimated by substitution in the model. The mean expected life span of patent infection is estimated to be 5.4 years. The instantaneous rate of loss of infection is independent of age, while the rate of gain of infection exhibits a convex age-profile, peaking in the 16-20 year age-class. The reduced rate of gain in adults is largely attributable to the increasing proportion of potentially resistant individuals with clinical disease. The results suggest that the age-distribution of bancroftian filariasis is primarily determined by age-dependency in the rate of acquisition of infection.

Adolescent↗

Quantitative assessment of contamination of soil by the eggs of Ascaris lumbricoides and Trichuris trichiura.

This study used a method of retrieving eggs from soil to examine the spatial and temporal dynamics of soil contamination with geohelminth eggs. The level of soil contamination in two children's homes in Jamaica was determined before and after further soil contamination was prevented by chemotherapy. The home which had higher human infection levels also had a higher prevalence and density of eggs in soil. The spatial distribution of the eggs in soil was overdispersed in the home with higher levels of infection, and underdispersed in the other, perhaps due to the low density of eggs. At both localities, the proportion of soil samples containing eggs and the density of eggs in soil declined over a two-month period. The results suggest that geohelminth eggs are rapidly depleted from the surface of tropical soils in the absence of continuing sources of contamination.

Animals↗

Control of intestinal nematode infections by chemotherapy: mass treatment versus diagnostic screening.

There is increasing interest in the implementation of programmes to control nematodiases by chemotherapy, but no consensus on whether diagnostic screening before treatment is an essential component of such programmes. It is estimated that a screening component increases costs by a factor of 2-6 and may be beyond the economic and skill resources of endemic areas, but accords with accepted medical practice since only infected individuals are treated. In an attempt to examine this issue quantitatively, the relative risks of mass treatment and morbidity due to helminthiasis are compared. Age- and locality-targeting of mass treatment at populations at high risk of morbidity are proposed as procedures for further enhancing this risk differential. It is suggested that resolving the question of screening versus mass treatment requires more quantitative information than is currently available on the risk of side effects with treatment and the risk of morbidity with variable intensities of infection.

Humans↗

Predisposition of individuals and families in Mexico to heavy infection with Ascaris lumbricoides and Trichuris trichiura.

Stool specimens from 90% of the population of 2 marginal communities in Coatzacoalcos, Mexico, were examined by the Kato-Katz technique for the estimation of eggs per gram of faeces (epg). Average epg values for Ascaris lumbricoides and Trichuris trichiura were calculated for each family in the community, based on the arithmetic mean epg of family members for each parasite. 39 families were classified as either lightly or heavily infected with A. lumbricoides and infected members were treated with mebendazole. A. lumbricoides expelled following treatment were collected from the children 2-10 years of age, and reinfection was monitored monthly for 6 months. At the end of the reinfection interval, a final stool specimen was collected from all family members and those infected were treated. Again, A. lumbricoides expelled by the children 2-10 years of age were collected. There was a significant correlation between the number of A. lumbricoides expelled by the children at the first and second treatments as well as in epg values before the first and second treatments for both A. lumbricoides and T. trichiura in children (2-10 years) and adults (greater than 19 years). At the family level, there were significant correlations between the values of family mean epg before each treatment for both A. lumbricoides and T. trichiura.

Animals↗

Control of geohelminths by delivery of targeted chemotherapy through schools.

This study describes the age-targeted chemotherapeutic control of geohelminthiasis in the total population (n = 11,500) of the island of Montserrat, West Indies. The intervention programme involved the treatment with single dose albendazole of all children aged 2-15 years (approximately 2500) in 4 sequential cycles at intervals of 4 months. Infection status was monitored by an initial coprological survey of an age-stratified sample (11.5%) of the population, and by surveys of smaller samples (4-5%) after 2 and 4 cycles of treatment (7 and 15 months respectively). The programme delivered treatment to greater than 90% of the target population in each cycle, and reduced the prevalence and intensity of Ascaris lumbricoides and Trichuris trichiura infection in the target age-class. A decline in infection was also observed in the 16-25 year age-class, even though less than 4% of adults received treatment. The study demonstrates that chemotherapy targeted only at children can be implemented within an existing health infrastructure, and can achieve an overall reduction in the prevalence and intensity of geohelminth infection.

Adolescent↗

The dynamics of infection and disease in bancroftian filariasis.

This study examines the relationship between the dynamic of Wuchereria bancrofti infection and the development of chronic lymphatic disease. Data sets from Pondicherry, south India, and Calcutta are used to estimate the age-specific proportion of the endemic population which has converted from microfilaria positive to amicrofilaraemia, and is assumed to be at risk of disease. For men, but not women, the age-prevalence profile of the estimated population 'at risk' is shown to correspond closely to the observed age-prevalence of chronic lymphatic disease in the same community. For both sexes, and independent of age, approximately 11% of the population at risk eventually develop lymphoedema. These observations suggest that filariasis endemic populations consist of those individuals who remain amicrofilaraemic and asymptomatic, and those who progress through the sequence: uninfected, microfilaraemic, amicrofilaraemic, to develop irreversible obstructive lymphatic pathology.

Age Factors↗

Clinical epidemiology of bancroftian filariasis: effect of age and gender.

A cross-sectional survey was used to determine the prevalence of disease (n = 6493) and microfilaraemia (n = 24,946) due to Wuchereria bancrofti in Pondicherry, south India. The total disease attributable to filariasis was significantly higher in males (13.67%) than females (2.26%), due to the occurrence of hydrocele in males. While the prevalence of chronic signs was clearly age-dependent in both sexes, that of acute signs was independent of age. Thus the age and gender structure of the survey sample will crucially influence apparent prevalence. Examination of the gender differences in the point prevalence of disease in 12 areas of India showed a significant relationship between occurrence of disease and gender, but this relationship did not significantly differ between northern and southern Indian populations. The study suggested that the failure to appreciate the importance of age and gender in disease prevalence has led to misconception about disease patterns in India.

Age Factors↗