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J Prod'hon

Publications and source records attributed to J Prod'hon.

26 records · Page 2Linked to original sources
PubMedDate not supplied

[Onchocerciasis chemotherapy. II. Evaluation of two therapeutic schemes on microfilarial density, utilising the association diethylcarbamazine and levamisole (author's transl)].

As the study of the association diethylcarbamazine-levamisole gave encouraging results on the dermal microfilarial density of Onchocerca volvulus (Leuckart, 1893), the authors followed it up in order to determine the optimum regimen for mass treatment. Two therapeutic schemes have been tested: A--Initial treatment: 14 days with the dayly dosis of respectively 200 mg of diethylcarbamazine and 120 mg of levamisole progressively reached in four days. After one year: a single dayly dosis of respectively 200 mg and 60 mg for five days. B--Initial treatment: 7 days with the same dosis as above. After one year: dayly dosis of respectively 200 mg and 60 mg for seven days. It appears that scheme A may be considered as the best baseline to achieve the optimum regimen for the mass treatment of onchocerciasis. The aim of such a treatment is to decrease the dermal microfilarial density to a level compatible with the patient good condition.

Adolescent↗
PubMedDate not supplied

[An attempt to normalize the methodology of clinico parasitologic surveys of onchocerciasis in West-Africa (author's transl)].

In order to be able to compare in time and space the results of onchocerciasis surveys in West Africa, the authors suggest to standardize the methodology of these surveys. The following points are defined : criteria to choose the villages, selection of population specimen, registration of socio-demographic data, clinical examination, assessment of visual acuity, parasitological examination founded on two quantitative bloodless cutaneous biopsies, definition of epidemiologic indices, adjustement of these indices to a standard population, synthesis of results by age-group and sex on the one hand by the presentation of frequency distribution of cutaneous microfilarial densities, on the other hand by calculation of geometric means of these densities.

Africa, Western↗
PubMedDate not supplied

[Evaluation of regimens for mass-treatment of onchocerciasis by diethylcarbamazine (author's transl)].

We tested three regimens to find the most effective, best tolerated and most practical therapeutic scheme for the mass treatment of onchocerciasis by diethylcarbamazine. The schemes with a short induction cure followed by a single dose of medication every two months were better than a long and only curative course of medication without maintenance doses. The schemes with induction cure and maintenance doses given every two months were more effective and practical than weekly maintenance doses with or without induction cures tried by other authors. The preferred treatment protocol is the following: an induction cure of ten days with a starter dose of 25 mg the first day, 50 mg the second, 100 mg the third, 200 mg for each of the remaining seven days. This induction procedure is extremely effective and is well maintained by a single dose of 200 mg every two months. After one year, the dermal microfilarial density was found to increase slightly. The study must be continued to determine whether a second course of induction therapy is necessary.

Diethylcarbamazine↗
PubMedDate not supplied

[Parasitological diagnosis of onchocerciasis. A critical review of present methods (author's transl)].

The different methods used for the parasitological diagnosis of onchocerciasis are compared to test their reliability, sensitivity and practicability under field conditions in the Sudan-Savanna area. Two skin snips taken from both iliac crests with a sclerocorneal punch give the best results during large scale field surveys. The incubation of biopsies in normal saline solution is the most sensitive technique and the results may be further improved by filtration on millipore filter-paper and collagenase digestion. However, counting microfilariae emerged after 30 minutes in distilled water is the easiest method and gives a reasonably good reliability for comparison of the results in space and time. The lack of sensitivity can be compensated for by incubation of the negative specimen during 24 hours in saline solution.

Biopsy↗
PubMedDate not supplied

[The use of ivermectin in the control of onchocerciasis].

Onchocerciasis is an infection with the nematode Onchocerca volvulus. The main clinical symptoms are caused by the microfilariae. They include ocular lesions leading to blindness. Onchocerciasis is widely distributed in Africa from the Sahara to the southern tip, and is also found in some areas of South and Central America. Ivermectin was shown to be an effective treatment in the early 1980's, and is safe and better tolerated than diethylcarbamazine. We report the results of ivermectin treatment of onchocerciasis, and various features of the control obtained by large-scale ivermectin treatment programs. In large-scale programs, ivermectin (150 micrograms/kg) is administered once a year. This dose paralyses the microfilariae, such that they are carried away by the lymph to the lymph nodes where they are destroyed. This dose thereby reduces the load of microfilaria by 90%. The effects of a dose of ivermectin last about two or three years, and the lesions in the anterior segment of the eye can be cured or substantially reduced. Regular treatment prevents severe lesions of the posterior segment of the eye. The effects of repeated treatment on lesions of the retina are currently under investigation. Frequent doses of ivermectin prevent the development of embryo parasites in the females, and reduces the number of adults by attrition. Large-scale treatment programs reduce the transmission of the parasite by its vectors. There are several problems impeding large-scale treatment programs. Choosing patients for priority treatment requires expensive and sometimes aggressive methods of diagnosis. Thus new techniques for the identification of communities in which onchocerciasis is a serious public health problem are required. The choice of strategies for distribution, to optimize the cost, benefit ratio and feasibility, remain controversial. Wide distribution by mobile teams is effective, but expensive. Active distribution by trained community distributors is a cheaper potential alternative. Clinic-based or passive distribution requires the population to present to be able to obtain ivermectin. Thus, although cheap, this approach is generally poorly effective. A further complication is the clearly defined criteria on which these methods should be evaluated.

Africa↗