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Based upon the statistical data during 1986-1990 from provincial, regional or municipal institutions involved in the control and research of filariasis, important achievement in filariasis control has been achieved since 1986. During the 5 years, 22,350,772 person were blood-examined, among them, 268,034 were found to be microfilaria positive; a total of 78,550,945 man/times of treatment with DEC were given (including administration of DEC-medicated salt). Till the end of 1990, filariasis has been basically eliminated in 823 counties/cities out of the 864 endemic counties/cities, and has been basically eliminated in 12 endemic provinces, one autonomous region and one municipality. Thus far, filariasis is still prevalent in 41 counties/cities of Anhui province. Parasitological, serological and entomological monitoring on filariasis is being executed according to the "Technical scheme for filariasis surveillance in areas where the disease has been basically eliminated" formulated by the Ministry of Public Health. The preliminary results of longitudinal surveillance indicated that the decline of microfilaremia rate and the absence of resurgence coincided with the decrease in antibody titre in the population by IFAT. The progress of research work dealing with the transmission potential in areas where filariasis had been under control, the methods of immunodiagnosis and the treatment of patients with clinical signs was also reviewed.
This paper reports on the incidence of advanced filariasis after basic elimination of bancroftian filariasis since 1983 in Shandong Province. Investigation was carried out in a population of 166,776 between 1984 and 1988 in 252 villages of Teng Xian and other 5 counties/cities, the erstwhile highly endemic areas. A total of 1,038 filariasis patients were found with an average incidence of 0.6%. Among them, 383 were with elephantiasis, 357 with chyluria and 298 with hydrocele. 902 cases (86.9%) who suffered the disease before the elimination of filariasis and 136 cases (13.1%) after it, 125 (91.9%) being chyluria cases. The oldest of the 1,038 cases was 86 years of age and the youngest, 6 years of age. The course of duration as 8-74 years in elephantiasis cases, 82.8% of them (317 cases) had previously lymphangitis and/or lymphadenitis. In the past three years 16.4% (52 cases) suffered from prolonged or intermittent acute lymphangitis and/or lymphadenitis. The results of this survey indicated that, after the basic elimination of filariasis in Shandong Province together with thorough clearance of infection source, elephantiasis and hydrocele persisted while new cases of chyluria continued to develop. Therefore, in such areas more emphasis should be put on the treatment of clinical patients. New patients should be surveyed and old patients be treated actively so as to reach the goal of eradicating filariasis.
Bancroftian filariasis can be detected by using the ICT Filariasis test kit which is composed of specific polyclonal and monoclonal antibodies to Wuchereria bancrofti antigen. Chromatographic reaction with serum or plasma shows a result within 5 minutes. When compared with 454 thick blood films (standard smear method) within the same study, the ICT Filariasis test had sensitivity = 100%, specificity = 96.37%, efficiency = 96.70%, predictive value positive (PVP) = 70.70%, predictive value negative (PVN) = 100%. Compared with 454 membrane filtration technic (MFT), the MFT had sensitivity = 95.10%, specificity = 99.50%, efficiency = 99.12%, PVP = 95.10%, PVN = 99.50%. When we compared capillary tube technic (CAP) with TBF, CAP showed sensitivity = 85.40%, specificity = 100%, efficiency = 98.68%, PVP = 100%, PVN = 98.60%. With the convenience, high sensitivity-efficiency, lack of cross-reactions, no night blood collection, single reagent and rapidity of the test, the ICT Filariasis test can be recommended for screening of Bancroftian filariasis, and is suitable for the confirmation of suspected cases in the field where microscopic diagnosis is not available.
Lymphatic filariasis control was first included in national program in 1956. Since then, a large scale anti-filariasis campaign has been carried out extensively throughout the endemic areas. From 1956-1994, a cumulative total of 707,421,736 person-time were comprised in nationwide blood examination, and a total of 260,041,645 person-time DEC chemotherapy were conducted (including selective treatment, mass chemotherapy and DEC-fortified salt). Up to 1994, all of the 864 endemic counties/cities in 15 provinces/autonomous regions/municipalities had achieved effective control of filariasis successively. Parasitological, entomological and serological surveillance during the past few years demonstrated that the transmission of both bancroftian and malayan filariasis have been virtually interrupted in most of the areas reaching the criterion for effective control of filariasis.
OBJECTIVE: To explore the measures for continuing surveillance of filariasis. METHODS: Selecting some vulnerable spots for focal surveillance, double-slide biood sampling for microfilaria examination, dissecting vectors for detecting the mosquitoes infected with filarial larva, using IFAT for detecting antifilarial antibody. RESULTS: 27,938 persons were examined for microfilaria and 4,454 mosquitoes were dissected for filaria larva, all were negative. 3,606 serum samples were examined for antifilarial antibody average positive rate was 1.35%(0.39-4.97%). CONCLUSION: The results of surveillance showed that the achievement of filariasis control in Guangxi after filariasis elimination is consolidated.
Mebendazole (Vermox 500) in long duration treatment 2 g/day for 3 to 4 weeks, is sometimes indicated in therapy of Loa Loa filariasis but remains the only active therapy on M. perstans filariasis. The perfect product tolerance and efficacy allow large indication in treatment of this last filariasis, the most often found in Gabon (Central Africa).
During 1964 to 1967, a survey of 30,534 persons for filariasis was made on all over the country with the following results: 1. Among 24,816 draftees from all over the country in the army recruitment camp 155(0.63 %) were found infected with Brugia malayi. Cheju Do showed the highest microfilaria rate(3.5 %), North Kyongsang Do(1.4 %) the next and South Cholla Do(1.2 %) the third. 2. Blood films from 2,308 inhabitants were examined and 407(17.6 %) showed microfilaria in Cheju Do. 30(3.1 %) out of 974 inhabitants in North Kyongsang Do were found to be infected. The microfilaria rates were 2.0 per cent for 400 inhabitants of Chindo island in South Cholla Do. However, no positive case of microfilaria was found in the inhabitants of Kokumdo among 1,820 persons examined in South Cholla Do and of Namhae island(among 165 persons examined) in South Kyongsang Do. 3. The mean microfilarial density per 20 cu. mm of blood was 52.6 in the inhabitants of Cheju Do, 12.2 in North Kyongsang Do and 27.3 in Chindo island(South Cholla Do). 4. Any distinct relationship between the incidence of positive cases of microfilariae and age or sex of the cases was not observed in Cheju Do. However, in Norh Kyongsang Do and South Cholla Do the microfilaria rate of the male group is higher than the one of the female group of the inhabitants. 5. From the above survey results it turned out that filariasis was found throughout Southern Korea except Kyonggi Do and South Kyongsang Do. A total 30,534 persons examined, 601(2.0 %) were found to be infected by Brugia malayi. Therefore, it seems that there are some endemic foci of malayian filariasis in three main areas such as North Kyongsang Do, South Cholla Do and Cheju Do.
Filariasis control including a preparatory phase in the early 50s and two more extensive campaigns in the late 50s and 70s, has gained remarkable achievements. By the end of 1987, filariasis in 781 (90.4%) of 864 counties/cities was brought under control, i.e., the microfilariasis rate declined to less than 1% in the whole population in every village concerned. At present, there remain about 2,446,000 filariasis cases, accounting for 7.9% of 30,099,400 before nationwide campaigns. Microfilaria carriers among the remaining cases amounted to 1,473,000 and amicrofilaremic but symptomatic, to 973,000. The major experience comprises the integration of the control project into national health program, the mobilization of various sectors, including the community, the investigators and technical personnel in research institutions and control services all to participate and cooperate in problems and difficulties encountered.
A population of 202 residents in an area endemic for Brugia timori lymphatic filariasis was treated in a diethylcarbamazine control programme commencing in 1977. All individuals were treated twice with diethylcarbamazine on a mass basis with additional selected treatment for cases with manifestations of infection. Clinical features of lymphatic filariasis were recorded annually until 1982, and the population re-assessed in 1988, six years after the completion of chemotherapy. Microfilarial counts were made on each occasion, and circulating filarial antigen levels measured for 1982 and 1988. The results showed a dramatic and sustained reduction in the rate of elephantiasis and adenolymphangitic disease, and of circulating antigenaemia, and the prevalence of microfilaraemia was reduced to zero by the end of the study.
We conducted longitudinal studies on filariasis control in Villupuram district of Tamil Nadu, south India, between 1995 and 2000. Overall, 23 entomological (yearly) data sets were available from seven villages, on indoor resting collections [per man hour (PMH) density and transmission intensity index (TII)] and landing collections on human volunteers [PMH and annual transmission potential (ATP)]. All four indices decreased or increased hand-in-hand with interventions or withdrawal of inputs and remained at high levels without interventions under varied circumstances of experimental design. The correlation coefficients between parameters [PMH: resting vs. landing (r = 0.77); and TII vs. ATP (r = 0.81)] were highly significant (P < 0.001). The former indices from resting collections stand a chance of replacing the latter from landing collections in the evaluation of global filariasis elimination efforts. The TII would appear to serve the purpose of a parameter that can measure infection pressure per unit time in the immediate household surroundings of human beings and can reflect the success or otherwise of control/elimination efforts along with human infection parameters. Moreover, it will not pose any additional risk of new infection(s) and avoids infringement of human rights concerns by the experimental procedures of investigators, unlike ATP that poses such a risk to volunteers.
This report summarizes the available information on the immunology of filariasis, and discusses immunodiagnosis and the immunological factors influencing the host-parasite relationship in lymphatic filariasis and onchocerciasis. Several areas that require further research are identified, particularly concerning the development of new serological techniques, and the fractionation of specific antigens. The problems associated with vaccine development are considered and the importance of finding better animal models for research is stressed.
The seroprevalence of antibodies against human T-cell leukemia virus was determined by ELISA in 68 patients with filarial infestation living in an endemic area. The total seropositivity was 2.9% and the HTLV-1-positive cases were detected in 2 microfilaremic patients 12 and 40 years old. This value is very close to that obtained for healthy individuals in the same region and age groups. This result suggests that there is no relationship between filariasis and HTLV-1 infection as previously proposed.
A blood survey for filariasis was carried out in the Kepu District of Jakarta. Examination of stained 20 c.mm finger-prick blood thick films and membrane filter concentration (MFC) of 1 ml venous blood. The youngest age group examined, 5-9 years old revealed a mf rate of 17% of which 71% were of a low density character detected by MFC only. The mf rate appears to remain relatively constant from the 10-14 year old group onward, approximately 35%, but at all age groups at least half the infections were of low density. The highest mf rate and density was observed present in the 15-20 year old group.
A blood survey employing membrane filter concentration (MFC) and examination of stained 20 c.mm thick blood films as diagnostic methods was carried out in Banjar Regency of South Borneo, an area of endemic B. malayi filariasis. In untreated populations the mf rate, as revealed by MFC, ranged from 23.2% for the 5-9 year old group to 43.7% for the greater than 50 year old group. For all age groups approximately one half of the microfilaraemias were of a low grade nature, diagnosed by MFC only. In a population that had been subjected to mass DEC administration 1 1/2 years prior to this survey, the MFC-diagnosed rate was 15%. Approximately two thirds of these infections were of very low density, the average density being 2.2 mf/ml.
Surveys for human bancroftian filariasis infections were conducted in the Lower Rufiji Basin, Tanzania, before and after the long rains in 1981. A multipurpose water resources development project has been planned in the area. A microfilarial rate of 18.1%, a mean microfilarial count of 80 microfilariae per 100 microliters blood were observed. Generally, males showed higher microfilarial rates than their female counterparts. All microfilariae were identified as Wuchereria bancrofti. A prevalence rate of 0.4% was recorded for leg elephantiasis. None of the cases were seen in individuals below 20 years of age. Only two cases of elephantiasis of the breasts were seen and no cases of elephantiasis of the arms were encountered. Rates for scrotal elephantiasis and hydrocoeles in males were 8.7% and 11.5% respectively, and enlargement of the inguinal and/or femoral lymph glands was common and the onset of this manifestation is early.
In a Bancroftian filariasis survey on the coast of Tanzania microfilaria rates rose with age reaching 53% in the 60-69 year group followed by a slight fall above this age. The most important clinical manifestations were hydrocoele, funiculitis and elephantiasis, with hydrocoele presenting the most serious public health problem. Hydrocoele rates increased with age reaching 90% above the age of 70. The highest proportion of large hydrocoeles were also in the older age groups. A satisfactory methodology was established for the planning of future surveys leading to control.