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Effects of high doses of diethylcarbamazine on adult Onchocerca volvulus examined by the collagenase technique and by histology.

Thirty adult male nodule carriers from a hyperendemic onchocerciasis area in the Liberian rain forest were treated with high doses of diethylcarbamazine (30 mg/kg/d) over one week. Another ten patients received placebo tablets and served as a control. All detectable nodules were removed from half of the patients at two months and from the remaining patients at ten months after chemotherapy. The adult worms in the nodules were examined for pathological alterations by the collagenase technique including embryogram, and by histology. No macrofilaricidal effect was observed at either time, and no significant reduction of microfilariae in the uteri of the female worms or in the tissue of the nodules was seen. Two months after the therapy there was a significant increase of degenerated stretched intrauterine microfilariae but this effect was no longer observed after ten months. No pathological effect was seen on the intrauterine coiled microfilariae. On the contrary, their number had significantly increased after ten months which could mean a stimulation of the embryogenesis. No effect on spermatogenesis was observed. Both techniques, the collagenase digestion and the histological examination of the nodules, provided similar results to demonstrate that there was no marked long lasting effect on O. volvulus after a treatment with high doses of diethylcarbamazine.

Animals↗

Missionary dentistry.

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Community Dentistry↗

Electron microscopical studies on onchocerciasis. II. Skin and microfilariae after treatment with metrifonate.

Skin snips of six patients with manifest onchocerciasis treated with a single dose of metrifonate (10 mg/kg) were examined by electron microscopy one, three, five and ten days after application of the drug. Compared to untreated cases 24 hours after treatment there is a marked increase in the extend of perivascular infiltrates which are composed not only of macrophages, lymphocytes and plasma cells, but also of eosinophils. Infiltrates directly around dead microfilariae are seen infrequently. This pattern of cellular reaction remains constant for the first ten days after treatment. Metrifonate obviously kills the microfilariae rapidly, already 24 hours after its application totally disintegrated parasites are to be found. On the other hand always a few intact microfilariae are seen, possibly they just hatched after treatment.

Adult↗

Malaria control by chlorproguanil. I. Clinical effects and susceptibility of Plasmodium falciparum in vivo after seven years of monthly chlorproguanil administration to children in a Liberian village.

For seven years, chlorproguanil (1.0 to 2.0 mg kg-1) was administered monthly to the children below 15 years of age in a village with holoendemic malaria. Malariometric indices were recorded every six months. Susceptibility in vivo was monitored by the clearance of Plasmodium falciparum parasitaemia after drug intake. Three parasite species were found initially: P. falciparum (52%), P. malariae (8%) and P. ovale (4%). The parasites found during the study were mainly P. falciparum, and parasite rates ranged from 37 to 87% at the different surveys one month after respective drug intake. A fifty-fold decrease of mean parasite density was generally observed seven days after drug intake. Splenomegaly was initially recorded in all two to nine year old children, with a mean size of 2.64 according to Hackett's index. From 18 months onwards as the mean spleen index was 1.15 in the same age group. Chlorproguanil may represent an important alternative drug to groups at risk in malaria control schemes.

Adolescent↗

Attempts to infect Meriones unguiculatus and Mastomys natalensis with Wuchereria bancrofti from West Africa.

44 male and female Meriones unguiculatus and 13 male Mastomys natalensis were inoculated with infective stage larvae of Wuchereria bancrofti from West Africa and dissected between 16 and 360 days after inoculation. Fourth stage larvae of W. bancrofti were recovered in Meriones until the 90th day p.i. and in Mastomys until the 175th day p.i. The longest larva obtained from Meriones measured 9.5 mm and from Mastomys 6.5 mm.

Animals↗

Effects of a single complete nodulectomy on nodule burden and microfilarial density two years later.

In hyperendemic onchocerciasis areas of the Liberian rain-forest it was possible to re-examine 210 microfilaria carriers two years after a first examination. At the first examination of these patients 143 had presented with palpable nodules, and 110 nodule carriers had been completely nodulectomized. Two-thirds of the operated patients had an average of one newly detected nodule two years later, and their microfilarial densities were slightly increased. In the remaining third of the operated patients no nodules could be palpated two years later, and the average microfilarial densities were slightly decreased. The 33 nodule carriers who had not undergone nodulectomy had, however, significantly higher numbers of nodules and microfilariae in the skin two years after the first examination. The possible benefit of a single, complete nodulectomy is discussed.

Adolescent↗

Influence of dietary cyanide on immunoglobulin and thiocyanate levels in the serum of Liberian adults.

Serum thiocyanate, antibody titers to thiocyanates, and serum immunoglobulins (IgM, IgG, IgA) were measured in 73 Liberian adults normally consuming diets of low, moderate, high, or no (control) cassava-derived cyanide (CN(-)). When control and low groups (n = 40; daily intake less than 0.60 mg CN(-) per kg body weight) were contrasted with moderate and high groups (n = 33; daily intake greater than or equal to 0.60 mg CN(-) per kg body weight), the authors observed that (1) one-time serum thiocyanate measurements were not sensitive to long-term cyanide intake; however, (2) antibody titers to thiocyanates were positively correlated with cassava-based cyanide intakes (r = .22, P = 0.05); and (3) serum IgM, IgG, and IgA levels were elevated in individuals regularly consuming moderate and high levels of dietary cyanide. Possible responsible mechanisms and health implications are discussed.

Adolescent↗

Calcification in adult Onchocerca volvulus.

Calcified worm fragments of adult Onchocerca volvulus from patients in West Africa were collected for a chemical analysis. The material contained predominantly calcium carbonate. Some results of investigations on the occurrence of calcified worms in untreated populations are reported on. Relations between the numbers of old parasites and those of calcified worms are discussed. The significance of possible resorption of calcified worm fragments for the interpretation of the effects of drug trials or other control measures are mentioned.

Animals↗

Electron microscopical studies on onchocerciasis. III. The onchocerca-nodule.

Six onchocerca-nodules from five Liberian patients were examined by electron microscopy. The bulk of cells in the centre of the nodules consists of lymphocytes and macrophages. The lymphocytes can be observed in various stages of differentiation. A major part of the macrophages shows degenerative changes with decrease of lysosomes and increase of fatty vacuoles. Near the worms epithelioid cells and giant cells can be found. Other cells in the nodule include polymorphonuclear neutrophils, eosinophils, plasma cells, and mast cells. Adult Onchocerca volvulus show the basic nematode body plan. The cuticle is subdivided into cortex and two layers with differently arranged fibrillar structures. The characteristics of the hypodermal cells are best seen in the lateral chords, in the interchordal regions the hypodermis is flattened by a muscle layer. The intestine typically contains pigment granules, the cells of the epithelium have folds of their cell membranes forming a basal labyrinth. The uterus consists of two tubes in which the development of the microfilariae from the early embryonic forms to the mature stages is examined.

Adult↗