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On the longevity and behaviour of microfilariae of Wuchereria bancrofti, Brugia pahangi and Dirofilaria immitis transfused to laboratory rodents.

Microfilariae of Wuchereria bancrofti and Brugia pahangi, which were inoculated into Meriones unguiculatus and Mastomys natalensis respectively, were found in the peripheral blood of the rodents until the ninth day after infection, but no microfilarial periodicity was observed. Microfilariae of W. bancrofti disappeared much faster from the peripheral blood of jirds after reinfection than after the first inoculation. Microfilariae of Dirofilaria immitis inoculated into M. natalensis and laboratory mice were recovered in the peripheral blood until the 17th day after infection and remained infective to mosquitoes. For the first few days the microfilarial periodicity observed in the rodents was similar to that observed in the donor dog, but then reversed.

Animals↗

Evaluation of the diethylcarbamazine provocative test in the diagnosis of Wuchereria bancrofti infections in the Nigerian savanna and the effects on Dipetalonema perstans.

Large scale filariasis surveys in rural areas for microfilaraemia, especially of periodic types such as Wuchereria bancrofti are known to cause considerable administrative, technical and social problems. The present investigation was carried out in the population of two villages in the Malumfashi district of the Northern Nigerian savanna. From the survey results, the sensitivity and specificity of two techniques-day-time diethylcarbamazine (DEC) provocative test by blood smear and concentration, and night-blood examination by smear and concentration especially for W. bancrofti-were assessed. Day-time DEC provocative test proved to be efficient in terms of sensitivity and specificity, compared with the night-blood method, for W. bancrofti detection but less so for Dipetalonema perstans, the other blood microfilaria found in this population during these studies. A regression line between night-blood survey results for W. bancrofti and the results from day-time DEC provocative test was calculated. With the help of this regression line it is possible to estimate W. bancrofti microfilarial prevalence for night surveys, using the DEC provocative test results of day-time surveys. This can be done with minimal, but known, loss of accuracy and incurs fewer administrative, technical and social difficulties.

Adult↗

Immune reactions to Wuchereria bancrofti infections in Tanzania. I. Serum-mediated adherence of leucocytes to microfilariae in vitro, using serum from different groups of patients.

Studies on serum-mediated adherence of leucocytes to microfilariae of Wuchereria bancrofti in vitro were carried out in an area of Tanzania endemic for filarial infections. Patients were divided into age-matched groups according to parasitological and clinical conditions. No adherence was seen with serum from microfilariae-positive patients (with or without clinical disease). A slightly, but not statistically significantly, higher prevalence of adherence-positive sera was found among hydrocele patients (27%) and lymphangitis/elephantiasis patients (33%) than among endemic control patients (20%). These three positive groups exhibited a marked difference in age distribution of prevalence of positivity, with very high prevalences found among young hydrocele patients (48%) and old lymphangitis/elephantiasis patients (63%). The hydrocele fluid from hydrocele patients with adherence-positive serum also mediated adherence.

Adolescent↗

Immune reactions to Wuchereria bancrofti infections in Tanzania. II. Characterization of the serum-mediated adherence reaction of leucocytes to microfilariae in vitro.

Investigations to characterize the in vitro reaction of serum-mediated leucocyte-adherence to microfilariae of Wuchereria bancrofti were carried out in Tanzania. The adherence reaction took place within one hour and at least two serum factors were involved: a heat-labile factor, present also in normal serum (probably complement), and a more heat-stable factor, present in positive serum only (probably an antibody). Neutrophils and eosinophils were involved in the reaction proportionately to Their numbers in the cell solutions used; the reaction killed significantly more microfilariae, than did adherence-negative tests. Microfilariae could be used for at least one week after their isolation from the donor, but a significant decrease in the percentage of reactive microfilariae occurred within 16 hours of isolation. A high degree of species specificity was observed when positive sera were tested against other nematodes. The involvement of complement and the speed with which the reaction took place is in contrast to the results of similar studies from India, and may indicate a difference in the parasite in the two continents.

Adolescent↗

Vectors of Wuchereria bancrofti in the Sepik Provinces of Papua New Guinea.

The vectors of Wuchereria bancrofti were investigated in two areas of the Sepik Provinces of Papua New Guinea. At the village of Yauatong, indoor-resting Anopheles punctulatus had an infection rate of 47.3% and an infective rate of 3.4%. No infections occurred in 382 Culex annulirostris obtained in night-landing catches. At the village of Yankok only An. koliensis contained infective larvae but An. punctulatus and Cx quinquefasciatus were infected. Probit values of the cumulative percentages of filariae-positive mosquitoes plotted against the logarithm of the corresponding filaria count are illustrated.

Anopheles↗

Natural infections of Wuchereria bancrofti in Aedes (Stegomyia) polynesiensis and Aedes (Finlaya) samoanus in Samoa.

Seven years after the 2nd mass treatment of the population with diethylcarbamazine, transmission of subperiodic Wuchereria bancrofti was studied in four villages in Samoa during one year by means of biting catches of Aedes polynesiensis and A. samoanus. 2 villages were coastal, one inland bush and the other an inland coconut plantation community. Overall infection and infective rates from 6702 Ae. polynesiensis were 0.84 and 0.27% respectively, and the infection rate from 2858 Ae. samoanus, collected in 10-minute catches from 24 sites, was 0.65%. No infective Ae. samoanus was found in these samples. 12-hour all-day catches in the 2 coastal villages confirmed active transmission by Ae. polynesiensis. 12-hour all-night catches in the same 2 villages recorded high transmission by Ae. samoanus although there was little evidence of local breeding. The annual transmission potential for Ae. polynesiensis and Ae. samoanus was high in one of the coastal villages and low in the other. A total of 221 infected Ae. polynesiensis and 40 Ae. samoanus were recorded. Of the 72 infective Ae. polynesiensis, 59.1% contained 1 to 2 larvae each (median density 1.4); 70% of the 40 infected Ae. samoanus had 1 to 2 larvae (median density 1.1). From the proportion of infective Ae. polynesiensis the mean probability of survival was estimated as 0.917.

Aedes↗

Distribution of vectors, transmission indices and microfilaria rates of subperiodic Wuchereria bancrofti in relation to village ecotypes in Samoa.

Aedes polynesiensis and Ae. samoanus biting densities and Wuchereria bancrofti infection and infective rates were studied in 47 villages throughout the islands of Samoa Upolu, Manono and Savaii during 1978-79, and microfilaria (mf) rates were surveyed in 28 of the villages. The mf rate was correlated with both infection and infective rates of Ae. polynesiensis in Upolu, but not of Ae. samoanus. In Upolu, Ae. polynesiensis was apparently the major vector. It was relatively more abundant in more cultivated and populated areas, along the northern coast of Upolu, except Apia town area. In Savaii, Ae. samoanus predominated over Ae. polynesiensis except in "plantation" villages. Relatively high biting densities and rates of infection and infectivity indicated that Ae. samoanus was not less important than Ae. polynesiensis as a vector in Savaii. Ae. samoanus preferred natural vegetation, in contrast to Ae. polynesiensis which was found near human habitations in cultivated land. There was no difference between the biting densities of Ae. polynesiensis in "coastal" and "inland" villages, indicating that crab holes (numerous only in some coastal villages) may not influence the density of Ae. polynesiensis. Higher mf rates were associated with villages where Ae. polynesiensis, rather than Ae. samoanus, was dominant, indicating that Ae. polynesiensis was generally a more efficient vector. In the former villages, the difference in mf rates between males and females was smaller than in the latter, probably reflecting a difference in biting habits of the vectors. Ae. polynesiensis infections were recorded in plantations over 2 km from any village, suggesting that both habitats were foci of transmission.

Adolescent↗

Epidemiology of Wuchereria bancrofti in Leogane, Haiti.

A survey for Wuchereria bancrofti in Leogane, Haiti, revealed that 140 of 421 individuals (33%) had a patent infection, of which 40% lived in the suburban outskirts of the city. The median microfilaria density was 19.1 per 20 mm3 of blood for suburban dwellers compared with only 8.8 for those living in the city. The vector, Culex quinquefasciatus (Say), breeds mostly in and around numerous rum distilleries, located exclusively around the periphery of the city, and this undoubtedly accounts for the higher prevalence and intensity of infection among suburban dwellers.

Adolescent↗

Factors affecting transmission of Wuchereria bancrofti by anopheline mosquitoes. 1. Uptake of microfilariae.

Ingestion of Wuchereria bancrofti microfilariae (mf) from humans by 639 Anopheles gambiae, 557 An. arabiensis, 117 An. melas and 9 An. funestus was investigated. The mf densities in blood fell into 3 groups; 0-32mf/ml, 107-122 mf/ml and 421-1140 mf/ml. In An. gambiae and An. arabiensis percentage of mosquitoes ingesting mf was strongly associated with mf density in host blood; in An. melas the association was much weaker. Mean number of mf ingested per mosquito was also strongly correlated to mf density in An. gambiae and An. arabiensis but not in An. melas. At low mf densities both An. gambiae and An. arabiensis concentrated mf, with concentration decreasing as density increased. From regression analysis, observed and expected uptake of mf would be equal at 622.9 mf/ml in An. gambiae and 391.6 mf/ml in An. arabiensis.

Adult↗

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↗

Effect of two successive annual treatments with single doses of ivermectin on microfilaraemia due to Wuchereria bancrofti var. pacifica.

Between 1986 and 1988 a single-blind, dose-ranging study was carried out in French Polynesia to determine the efficacy and tolerability of single 50, 100, 150 and 200 micrograms/kg doses of ivermectin in Wuchereria bancrofti carriers. Forty male microfilariae (mf) carriers between 18 and 50 years of age, in whom mf density was greater than or equal to 20 mf/ml, were treated twice at a one-year interval. Twelve months after the second treatment, in carriers who were given a dose greater than or equal to 100 micrograms/kg, mean mf density was 4-7% of the initial pretreatment mf density. Therefore, several successive annual treatments with single doses greater than or equal to 100 micrograms/kg of ivermectin should result in reducing mf densities to a very low level. Nevertheless, at 9 months after the second treatment, residual parasitaemia ranged from 1 to 2182 mf/ml (median 85) in 30 patients. Finally, in patients with pretreatment mf counts less than or equal to 150 mf/ml, mean mf density was 2.8 and 8.9 mf/ml, respectively, during the 2 six-month periods following treatment, while in patients with pretreatment mf densities greater than 150 mf/ml (median 1500) it was 92.3 and 334.1 mf/ml during the same periods. These results suggest that, when implementing filariasis control programmes, the best strategy might be administration of several treatments with a single dose of ivermectin every 6 months to the entire population, at least in French Polynesia. Afterwards, when mf densities had been reduced to a relatively low level (100-150 mf/ml), annual treatments could be considered.

Adolescent↗

The significance of low density microfilaraemia in the transmission of Wuchereria bancrofti by Culex (Culex) quinquefasciatus Say in Sri Lanka.

Laboratory-bred Culex quinquefasciatus were fed on carriers with low and moderate densities of microfilariae (mf) of Wuchereria bancrofti. In the first series of experiments, mosquitoes were dissected 12 d after feeding. The percentage of infected mosquitoes and the numbers of larvae per infected mosquito were directly proportional to the mf density at the time of feeding. There was an overall high infection rate and a wide distribution of larvae per individual mosquito at all levels, except for the 4 lowest counts. Of the 4 carriers with counts of 5 mf/ml and less, 3 were capable of infecting Cx quinquefasciatus, giving infection rates of 1.0%, 7.4% and 12.0% respectively. In the second series, some mosquitoes were dissected immediately after feeding and the remainder 12 d later. There was a good correlation between the number of mf ingested and the number of infective larvae per mosquito. The high infection rates in Cx quinquefasciatus when fed on low-density microfilaraemia carriers, and the varying number of larvae in individual mosquitoes, suggest that low-density carriers could be a source of infection. Field studies were also carried out in 3 different area with mf rates of 7.24%, 0.72% and 0.16%, respectively. In the 2 areas with low mf rates, infection rates in mosquitoes were 1.32% and 1.08% respectively. Cx quinquefasciatus fed on a carrier with a residual microfilaraemia of 19 mf/ml following treatment with diethylcarbamazine had an infection rate of 13.8%. These studies suggest that the examination of recently fed house-resting populations of Cx quinquefasciatus could be a sensitive method for measuring the prevalence of mf in the human population.

Animals↗

A quantitative approach to the relationship between Wuchereria bancrofti microfilaria counts by venous blood filtration and finger-prick blood films.

Counts of nocturnally periodic Wuchereria bancrofti microfilariae (mf) in 20 mm3 finger-prick blood films were compared with membrane counts after filtration of 1 ml of venous blood for their efficacy in determining the prevalence of Bancroftian filariasis. The technique used for spreading and staining the blood films was critically important to the sensitivity of this screening procedure. There was good agreement between the 2 methods. Four statistical approaches were used to measure the correlation between the 2 sampling methods: 2 linear regression methods using untransformed and transformed data, and 2 non-parametric rank correlation methods. Based on the statistical analyses, this study strongly supports the general observation that finger-prick blood samples tend to contain more mf than equivalent volumes of venous blood, at mf densities high enough to be detectable by the finger-prick technique. It also demonstrates that finger-prick samples provide good estimates of mf densities and prevalence of infection except in areas of very low mf densities, where the membrane filtration method would provide a more accurate estimate of prevalence. Regression analyses using untransformed and transformed data, and the rank correlation tests, demonstrated a strong statistically significant correlation (P less than 0.001) between venous and finger-prick mf counts.

Adolescent↗

Factors affecting transmission of Wuchereria bancrofti by anopheline mosquitoes. 4. Facilitation, limitation, proportionality and their epidemiological significance.

Quantitative understanding of the transmission dynamics of lymphatic filarial parasites is essential for the rational planning of control strategies. One of the most important determinants of transmission dynamics is the relationship between parasite yield, the success rate of ingested microfilariae (mf) becoming infective larvae in a mosquito vector, and mf density in the source of the human blood meal. Three types of relationship have been recognized in human filaria/mosquito couples--limitation, facilitation and proportionality; facilitation has hitherto been observed only in the couple Wuchereria bancrofti/Anopheles gambiae in Burkina Faso, in experimental studies on a high density mf carrier. The present paper demonstrates facilitation in W. bancrofti/An. gambiae and W. bancrofti/An. arabiensis in lower mf density carriers in The Gambia and Tanzania, and in W. bancrofti/An. funestus in Tanzania. Facilitation was not found in An. melas in The Gambia nor in An. merus in Tanzania. Analysis of published data shows limitation at low level mf densities in W. bancrofti/Culex quinquefasciatus in Sri Lanka, and in the same couple in India. Limitation also occurs in Brugia malayi/Aedes togoi in experimental cats; proportionality occurs in B. malayi/Mansonia bonneae in Malaysia. The epidemiological significance of these host/parasite relationships is discussed, and supporting evidence for its validity is presented from the published results of large-scale control programmes.

Animals↗

Mass chemoprophylaxis of lymphatic filariasis with a single dose of ivermectin in a Polynesian community with a high Wuchereria bancrofti infection rate.

In April 1991 supervised mass prophylaxis of lymphatic filariasis with a single dose of ivermectin, 100 micrograms/kg, was carried out in a Polynesian village with a high infection rate of Wuchereria bancrofti in humans and active transmission by the vector mosquito, Aedes polynesiensis. Of 876 inhabitants aged 3 years or more (pregnant women excluded), 864 (98.6%) were treated. Simultaneously, venous blood samples were collected from 577 (97.5%) of the 595 inhabitants aged 15 years or more, of whom 122 (21.4%) were found to be microfilaria (mf) carriers (86 males and 36 females). The geometric mean microfilariae (GMM) count was 358.7 mf/ml for the whole group, 387 mf/ml for males (range 1-8160 mf/ml) and 280 mf/ml for females (range 1-7769 mf/ml). Following treatment, 33 (3.8%) of the 864 persons treated experienced some adverse reactions (21 with grade 1 and 12 with grade 2). Of the 33 with reactions, 29 were among the 122 (23.8%) mf carriers and 4 among the 831 (0.5%) non-microfilaraemic persons. Six months later, 123 (21.1%) of 584 inhabitants sampled were microfilaraemic: the GMM count for the whole group was 106 mf/ml (1-8177), with 29 mf/ml (1-3740) in 35 female and 177 mf/ml (1-8177) in 88 male carriers. Of these 123, 15 (whose GMM count was 4.5 mf/ml; range 1-204) were amicrofilaraemic 6 months before, and 19 had a microfilaraemia level higher than that 6 months earlier, before treatment. 117 of the 122 carriers identified in April were resampled: comparison of their GMM counts before and 6 months after mass treatment indicated that treatment with a single dose of 100 micrograms/kg ivermectin resulted in a reduction of microfilaraemia by 69%.

Adolescent↗

Microfilariae recurrence in Polynesian Wuchereria bancrofti carriers treated with repeated single doses of 100 micrograms/kg of ivermectin.

Forty-six Polynesian carriers of Wuchereria bancrofti were treated with 3 successive single doses of ivermectin, 100 micrograms/kg, given every 6 months. Immediate microfilaricidal activity of ivermectin was excellent in all carriers, since residual mean microfilaraemia levels, 2 d after each of the 3 treatments, were less than 1% of pretreatment levels. Before initial treatment, geometric mean microfilaraemia was 500 microfilaria (mf)/ml for the whole group (range 21-6398 mf/ml); 6 months after each successive treatment it was 197, 108 and 87 mg/ml, respectively, 39.4, 21.6 and 17.4% of the pre-initial treatment level. By considering the mean percentage recurrent level at 6 months after the 3rd treatment (36.8%) as a threshold, it was possible to classify the carriers into 2 groups: 17 in whom the percentage recurrent level was > 36.8% and who were considered as 'fast repopulating' individuals, and the remaining 29 who were considered as 'slow repopulating' individuals. In the latter group, 6 months after each of the 3 treatments, the recurrent microfilaremia levels were 22.7%, 8.0% and 4.9% of the pre-initial treatment level, respectively, while they were 95.1%, > 100% and > 100% in the former. The constant recurrence of mf suggests that ivermectin, at a dosage of 100 micrograms/kg, had no effect on adult worms in 'fast repopulating' individuals, whereas the progressive lessening in recurrence of mf suggests some activity (sterilizing or killing) of ivermectin on W. bancrofti macrofilariae in 'slow repopulating' individuals.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Low positive predictive value of anti-Brugia malayi IgG and IgG4 serology for the diagnosis of Wuchereria bancrofti.

Enzyme-linked immunosorbent assays (ELISAs) for anti-Brugia malayi immunoglobulin (Ig) G and IgG4 were evaluated on sera from 1561 subjects in French Polynesia for the serodiagnosis of Wuchereria bancrofti filariasis, compared with the test for Onchocerca gibsoni circulating antigen (Og4C3) as a 'gold standard'. The sensitivity of the ELISA-IgG and ELISA-IgG4 assays was 90.8% and 94.5%, and the specificity was 45.9% and 50.7%. The positive predictive values were 41% and 45% respectively for an antigen prevalence rate of 30%. Thus antibody prevalences exceeded by two-fold the antigen prevalence, which itself exceeded by two-fold the prevalence of microfilaraemia.

Adolescent↗

Lymphatic pathology in Wuchereria bancrofti microfilaraemic infections.

To determine the extent of lymphatic disease in persons infected with Wuchereria bancrofti who were microfilaraemic, we examined the superficial lymphatics of the legs by scintigraphy. In 4 endemic control subjects and in 10 of 14 clinically asymptomatic microfilaraemic individuals, lymphoscintigraphy revealed one major channel of lymphatic drainage in each leg. However, while trunk lymphatics were bilaterally symmetrical in the control, marked differences in the calibre of lymphatic vessels were observed in the microfilaraemic persons. Non-discrete lymphatics and a diffuse symmetrical distribution of collateral vessels in both legs were observed in all of 5 amicrofilaraemic patients with grade 2 lymphoedema. A similar diffuse drainage pattern was also seen in 3 previously microfilaraemic persons who had remained amicrofilaraemic and asymptomatic following treatment with diethylcarbamazine citrate (DEC). Thus, clearance of microfilaraemia by DEC therapy did not appear to reverse the type of lymphatic pathology observed in microfilaraemic subjects. The lymphoscintigraphy patterns did not correlate with serum levels of antibodies to 3 recombinant filarial antigens. Virtually all the asymptomatic microfilaraemic individuals infected with W. bancrofti examined had subclinical lymphatic disease detected by the non-invasive imaging technique of lymphoscintigraphy.

Adolescent↗