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PubMed2004

[Present status of bancroftian filariasis in Maceió, State of Alagoas, Brazil].

Epidemiological and entomological surveys were carried out in the human and mosquito populations in Maceió, Alagoas, in order to assess the present status of bancroftian lymphatic filariasis. Examination of thick blood smears of 10,450 students from different areas of the city revealed 0.66% Wuchereria bancrofti microfilaria carriers. The distribution of filariasis is focal in the city, 80% of the individuals with patent infection living in two neighboring areas with 1.24% and 5.25% prevalence. Parallel studies performed with samples of all age groups in the human population showed similar microfilaria prevalence rates observed previously in the student survey. However, thick blood smears taken from members of families with at least one subject with patent infection gave a prevalence six times greater suggesting, increased transmission in households. The percentage of carriers was higher in the youngest age group (< 20 years). Culex quinquefasciatus mosquitos caught at the locations where the autochthonous cases were found presented natural infection rates ranging from 0.28% to 4.62%. The combination of all these findings indicates occurrence of active transmission of W. bancrofti in the urban area of Maceió, Alagoas State. Based on these data, measures for the potential control of filariasis were planned.

English Abstract↗
PubMed2004

Geographic distribution of lymphatic filariasis in Haiti.

Although lymphatic filariasis is known to have been endemic in Haiti since at least the mid 1700s, a national filariasis survey has never been conducted. As a first step in the national program to eliminate filariasis, we collected blood in January-April 2001 from 50-250 school children (6-11 years old) in all 133 communes of the country using an adaptation of the lot quality assurance sampling method. Of 22,365 children tested, 901 (4.0%) were positive for circulating Wuchereria bancrofti antigen. When weighted by commune population, the overall national antigen prevalence in this age group was 7.3%. Infected children were found in 117 (87.9%) communes, the most heavily affected areas being concentrated in the northern part of the country. In only 16 (12.1%) communes were all 250 children antigen negative. Thus, W. bancrofti infection in Haiti is much more widespread than previously realized; virtually the entire population of the country may be considered at risk of infection.

Animals↗
PubMed2005

Concomitant parasitism: bancroftian filariasis and intestinal helminths and response to albendazole.

Subjects in an disease-endemic area in Orissa, India concomitantly infected with filariasis and intestinal helminths had significantly lower intensity of filarial infection in comparison with those who were infected only with filariasis. Administration of albendazole resulted in a significant decrease in the prevalence of filarial antigenemia in subjects concomitantly infected with intestinal helminths, but produced little change in this infection measure in subjects infected only with Wuchereria bancrofti. These results indicate that intestinal helminths could play a role in the anti-filarial activity of albendazole, most probably by depressing filarial infection intensity in co-infected individuals. Confirmation of these findings in a larger cohort may yield important new insights regarding the role of using albendazole in the ongoing intervention programs for the control of lymphatic filariasis.

Adolescent↗
PubMedDate not supplied

Filariasis in a child from southern Turkey: a case report.

Filariasis is a parasitic condition in which the lymphatic system is invaded by filarial nematodes. The initial signs are those of lymphangitis and lymphadenitis. The manifestations include edema in the extremities and elephantiasis due to lymphatic obstruction. Filariasis is endemic to most parts of the world, but occurs only sporadically in Turkey. This report describes a case of filariasis in a child who presented with fever and extensive lower-extremity edema.

Albendazole↗
PubMed1990

A highly specific and sensitive monoclonal antibody-based ELISA for the detection of circulating antigen in bancroftian filariasis.

A monoclonal antibody, Og4C3, directed against antigens of Onchocerca gibsoni (but not phosphorylcholine) has been used in a sandwich ELISA to detect a circulating antigen of Wuchereria bancrofti in human serum. The interfering effect of host antibody was reduced by first boiling one part of serum for 5 min in the presence of three parts of 0.1 M Na2EDTA, pH 4.0. A total of 119 sera from individuals and 8 pooled sera from clinically and/or parasitologically defined cases of filariasis, plus 8 individual and 1 pooled endemic control sera, all from the filariasis serum bank of the World Health Organisation, as well as 20 non-endemic control sera, were screened with the assay. Circulating antigen was detected in serum from people infected with W. bancrofti but not Brugia malayi. B. timori, O. volvulus or Loa loa, and not in endemic or non-endemic controls. Of the 68 sera from W. bancrofti-infected subjects, 55/55 parasitologically confirmed and 12/13 clinically confirmed but amicrofilaraemic cases reacted in the assay. A weak but significant correlation (r2 = 0.4016) was found between numbers of microfilariae in blood and detectable levels of circulating antigen from patients with bancroftian filariasis.

Animals↗
PubMed1990

[On the transmission role of residual microfilaremia cases in the area with filariasis virtually eradicated].

The transmission role of the residual microfilaremia cases was studied in Pingle Village, Liangqing Township, Yongning County where bancroftian filariasis had been virtually eradicated during 1984-1988. The results indicated that after the microfilarial rate of the human population met the criterion of elimination of filariasis, namely below 1% of the total population in all the administrative villages, and the average density of microfilaria being around 5 per 60 microliters peripheral blood, subsequent control measures might be no longer instituted while the microfilaria rate and its density could continue to decline. Some residual microfilaremiae cases having higher microfilarial density turned negative gradually, so did the natural infection rate of Culex quinquefasciatus with filaria larvae and its density year by year. No filaria larvae were found in vector mosquitoes in 1987-1988. The authors deemed that the filariasis transmission in this area has been interrupted.

Animals↗
PubMed1990

Diethylcarbamazine in the control of bancroftian filariasis in the highly endemic Ok Tedi area of Papua New Guinea: phase 1.

The effects of a well-spaced diethylcarbamazine (DEC) mass drug application in areas highly endemic for Wuchereria bancrofti in Papua New Guinea are not known. In 1986 a semi-annual single-dose 6 mg/kg body weight administration of DEC was initiated in the Ok Tedi area of Western Province, Papua New Guinea. The rate of bancroftian filariasis in the area was 39%. Within two years the rate of detectable microfilaraemia was reduced from 31% to 11% in the treated group. The mean blood density of the parasite was reduced from 79 to 19 microfilariae per 20 microliters. A survey of untreated villages in the immediate area (not surveyed before 1988) showed a filariasis rate of 39%. A 14-fold difference in the total microfilaraemia count was noted between the two groups when 1988 data were compared. A reduction in the annual rate of filariasis may be monitored through a well-established passive case detection program for malaria. The DEC treatment program was well accepted despite side-effects encountered in 20% of the treated population early on in the program. The success of the 2-year Phase 1 program has expanded into an annual single-dose administration of DEC over a larger area.

Adult↗
PubMed1986

[Lymphatic filariasis in Haiti: historical sequel or future public health problem in this geographic region?].

Wuchereria bancrofti persists in Haiti in localized foci, discontinuously distributed. The parasite, transmitted by Culex quinquefasciatus, develops in mesoendemic or hyperendemic fashion in urban and suburban areas, on the coastal plains sheltered from the prevailing winds, predominantly in the Nord department and around the gulf of La Gonave. Lymphatic filariasis is a major public health problem. Its impact is more evident in males on account of the genital repercussion of the disease. The acute lesions appear from early infancy and are related to microfilarial density. The chronic lesions begin with adolescence, and occur with high frequency in adults. Lymphatic filariasis has retreated in the countries where socioeconomic or sanitary conditions have improved: Puerto Rico, French West Indies, Cuba. In countries confronted by underdevelopment, overpopulation and uncontrolled urbanization, the disease is prevalent: Haiti, Dominican Republic, Trinidad. It is essential to carry out epidemiological investigations in order to identify the extend of the lymphatic filariasis problem in the Caribbean, particularly as population migration in both directions is becoming intensified: the native people looking for work in the industrialized countries, and tourists seeking the attractions of the tropics.

Adolescent↗
PubMed1993

Lymphatic filariasis in a recently described endemic area in Marinduque, Philippines.

Marinduque has never been considered endemic for filariasis. The disease was suspected when a high incidence of scrotal enlargement was noted in three villages. On April 25-26, 1991, a field survey was conducted in these villages. The objectives were: 1) to confirm the existence of filariasis, 2) to determine its age and sex distribution, 3) to gain insights on its prevalence and on the periodicity of the parasite. Daytime and nocturnal blood films were collected from both sexes aged 5 years and above. They were examined for microfilaria. Dried up smears were examined after staining. A total of 297 individuals comprising 23% of the area's population were studied. Microfilaremia was demonstrated in 47 individuals or 16% of those examined. Among the positive cases, 32 or 68% were males. Individuals 15-49 years old accounted for 28 or 60% of all the cases discovered. The prevalence rate for the study area was 37/1000 population. Out of 146 daytime smears, 18 or 12% demonstrated microfilariae. Of the 224 nocturnal smears, 37 or 17% were positive. Parasitologists at the Department of Health identified the parasite to be Wuchereria bancrofti. The study established the presence of filariasis in Marinduque. Males and young adults are predominantly afflicted. A non-periodic strain of parasite is possibly involved. Further investigations of the parasite and the vectors are recommended.

Adolescent↗
PubMed1993

Recent advances in the chemotherapy of lymphatic filariasis.

Lymphatic filariasis is the most widespread of human filarial infections, a group of vector-borne infestations. After the discovery of diethylcarbamazine (DEC), little advance was made in the development of new chemotherapeutic agents for the treatment of lymphatic filariasis until 1985. Since then, several new initiatives have occurred as the result of a global effort by the World Bank/UNDP/WHO Special Programme on Tropical Diseases and the Onchocerciasis Control Programme. Some of these global research initiatives are reviewed in this paper. Recent observations throw a new light on the rational use of DEC including its deployment as a medicated salt. Ivermectin, an established drug for the treatment of river-blindness is examined for its potential use in the treatment of lymphatic filariasis. Experimental results from two novel compounds out of several being developed by the WHO/OCP Macrofil project are considered in respect to their potential macrofilaricidal activity, particularly in relation to lymphatic filarial infections.

Benzimidazoles↗
PubMed1993

[Long-term surveillance after basic elimination of bancroftian filariasis].

The longitudinal and cross-sectional systemic surveillance have been conducted for 9-11 consecutive years in six counties (cities) of Guangxi Zhuang Autonomous Region after basic elimination of bancroftian filariasis. The two different control regimens had been used with DEC selective treatment followed by mass treatment of all persons and selective treatment followed by taking DEC medicated salt. During the former 6 years, residual microfilaremia cases could still be detected; whereas during the latter 5 years, no microfilaremia cases could be detected at all. The natural infection of vector mosquitoes showed negative. The positive rate of antibody in the populations was reduced to 1.4-5.5% detected by IFAT, reaching to the level of local non-endemic areas. The result indicated that the transmission of filariasis in these areas has been blocked. The authors suggested that a period of 10 years might be appropriate for surveillance after basic elimination of bancroftian filariasis.

Animals↗
PubMed1993

The resurgence of lymphatic filariasis in the Nile delta.

A study of 325,000 residents of 314 villages in six governorates of the Nile delta area of Egypt revealed that the prevalence of lymphatic filariasis increased from < 1% in 1965 to > 20% in 1991, especially in the governorates of Qalyubiya, Monufiya, Dakhaliya, and Giza. The distribution of the communites with endemic filariasis is focal. Clusters of villages with high prevalences are surrounded by others in which the disease is absent, although their environmental, social, and agricultural features appear similar. The article analyses why the significant decline in filariasis between 1945 and 1965 in Egypt has been followed by a resurgence of the disease.

Animals↗
PubMed1993

A comparison of the Og4C3 antigen capture ELISA, the Knott test, an IgG4 assay and clinical signs, in the diagnosis of Bancroftian filariasis.

To compare methods for diagnosing Bancroftian filariasis, six hundred and seventy four people from rural areas of Papua New Guinea were screened using microfilaraemia, the Og4C3 antigen capture ELISA, an ELISA to detect IgG4 specific antibodies and clinical examination. Both ELISA tests detected around twice the number of positive cases than those detected by the presence of microfilariae alone. No correlation was found with clinical signs and laboratory tests. This study raises concern over the underestimation of the prevalence of filariasis due to ineffective diagnostic criteria. The two ELISA tests should be of value in epidemiological surveys and for monitoring filariasis control programs.

Adolescent↗
PubMed1995

Clinical manifestations of bancroftian filariasis with special reference to lymphoedema grading.

We report on some aspects of progression of chronic disease and its association with acute manifestations with special reference to grades of lymphoedema in bancroftian filariasis. These analyses were based on the clinical history and clinical findings of 1300 individuals at the time of their first visit to the filariasis clinic at a centre in south India. The mean number of adenolymphangitis (ADL) attacks in one year was 4.9 +/- 1.7, 5.5 +/- 0.9 and 10.4 +/- 3.2 in patients with grade I, grade II and grade III lymphoedema respectively. The mean duration of oedema was 47.4 +/- 5.9 days, 6.2 +/- 0.5 and 8.6 +/- 0.9 yr in patients with grade I, grade II and grade III lymphoedema respectively. These findings suggest that the progression of lymphoedema from one grade to the next in bancroftian filariasis is associated with increased frequency of ADL attacks.

Disease Progression↗
PubMed1996

Mattancherry urban agglomeration, a diminishing focus of lymphatic filariasis in Kerala.

Parasitological survey conducted recently in Mattancherry, Kerala showed a low prevalence of microfilariae (mf), with a mf rate of 1.81%, compared to that of 1956 when the mf rate was 14.7%. No brugian infection was encountered in the present investigation, though both bancroftian and brugian infections were reported earlier. Culex quinquefasciatus, the vector of bancroftian filariasis was the most predominant (93.3%) mosquito species, and its infection and infectivity rates were 0.76% and 0.54% respectively. Mansonioides spp., the vectors of brugian filariasis constituted only 0.2% of the total mosquitoes and with no infection. The overall reduction in the prevalence of mf cases and vector infection rates over the years is attributed to the continued activities of the National Filaria Control Programme. The disappearance of brugian filariasis could mainly be due to the drastic reduction in the Mansonioides breeding habitats, as a result of rapid urbanization coupled with improved socio economic conditions.

Animals↗
PubMed1998

Spatial analysis of lymphatic filariasis distribution in the Nile Delta in relation to some environmental variables using geographic information system technology.

Geographic information system (GIS) was used to analyze the spatial distribution of filariasis in the Nile Delta. The study involved 201 villages belonging to Giza, Qalubiya, Monoufiya, Gharbiya, and Dakahliya governorates. Villages with similar microfilarial (mf) prevalence rates were observed to cluster within 1-2 km distance, then, clustering started to decrease significantly with distance up to 5 km (Pearson correlation coefficient = -0.98). the likelihood of negative and high prevalence villages being contiguous was very low (approximately 1.8%, n = 612 village-pairs) indicating homogeneity in disease processes within the defined spatial scales. Of the villages located within 2 km from the main Nile branches (n = 46), 95% exhibited low prevalence. In addition, the spatial pattern of mf prevalence was shown to be negatively associated with annual rainfall and relative humidity, while it was positively associated with annual daily temperature. Average mf prevalence in warmer, relatively drier areas receiving 25 mm of rain was significantly higher (3.9%) than that in less warmer but more humid areas receiving 50 mm of rain (1.6%) (P < 0.0001). Based on the results of the present study, GIS was used to generate a "filariasis risk map" that could be used by health authorities to efficiently direct surveillance and control efforts. This investigation identified some of the factors underlying filariasis spatial pattern, quantified clustering and demonstrated the potential of GIS application in vector-borne disease epidemiology.

Animals↗
PubMed1997

Estimation of ASO titer as an indicator of streptococcal infection precipitating acute adenolymphangitis in brugian lymphatic filariasis.

Recurrent episodes of acute adenolymphangitis (ADL) are important clinical manifestations of lymphatic filariasis which contribute significantly to the progression of lymphedema. It is increasingly being recognized that secondary bacterial infections play an important role in the etiology of ADL. We examined the role of streptococcal infection as a precipitating factor of ADL in brugian filariasis, by determining the anti-streptolysin O (ASO) titers and by isolating the causative organism wherever possible. The study population consisted of 30 patients with filariasis related ADL (Group A), 30 patients with chronic filarial edema (Group B) and 60 age and sex matched healthy adults (Group C). ASO titer was estimated by the latex agglutination method at the time of entry into the study, at the 15th day and at 3, 6 and 12 months. ASO titers were persistently elevated in 90% of patients in Group A and a portal of entry for bacterial infection was detected in all of these patients. In Group B only six patients had persistently elevated ASO titers. These patients had grade III lymphedema and three of them had monilial infections in the affected limb. In the control group none had persistently elevated ASO titers. The elevated ASO titers and the detection of a site of entry for bacteria in patients with ADL supports a streptococcal etiology for this condition.

Acute Disease↗
PubMed1999

Can vector control play a useful supplementary role against bancroftian filariasis?

A single campaign of mass treatment for bancroftian filariasis with diethylcarbamazine (DEC) in Makunduchi, a town in Zanzibar, United Republic of Tanzania, combined with elimination of mosquito breeding in pit latrines with polystyrene beads was followed by a progressive decline over a 5-year period in the microfilarial rate from 49% to 3%. Evidence that vector control had contributed to this long-term decline was obtained by comparison with another town, Moga, where a DEC campaign was used without vector control and where resurgence of microfilariae could be observed 3-6 years after the campaign. In Zanzibar town, treatment of 3844 wet pit latrines and cesspits with polystyrene beads reduced the adult mosquito population in houses by about 65%. Supplementary treatment of open drains and marshes with Bacillus sphaericus produced little or no additional reduction compared to a sector of the town where only pit treatment with polystyrene was carried out. The cost and effort of achieving the 65% reduction in mosquito population could hardly be justified for its impact on filariasis alone, but its noticeable impact on biting nuisance might help to gain community support for an integrated programme.

Animals↗