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1242. No Abstract

1243. No Abstract


1244. Thanomsub BW.  Chansiri K.  Sarataphan N.  Phantana S.Differential diagnosis of human lymphatic filariasis using PCR-RFLP. Molecular & Cellular Probes.  14(1):41-6, 2000 Feb.


Filariasis is still a public health problem in tropical countries. The most common causative agents of human filariasis are Wuchereria bancrofti and Brugia malayi. Traditional methods used to detect filarial parasites in human, animal and vector populations are tedious, time consuming, and confer little guarantee of sensitivity and species specificity. We have developed a rapid and specific method to detect filarial parasite DNAs in blood and mosquito samples using the polymerase chain reaction (PCR) technique. The primers used are MF/F and MF/R which amplify a 1.5 kb glutathione peroxidase gene of filarial worms. Using the restriction fragment length polymorphism (RFLP) technique, these PCR products will be further digested with restriction enzymes either Hpa I, Pst I, Alu I or  Hinf I to differentiate the genus of filaria. This PCR-RFLP technique can be apply to use in diagnosis and to differentiate between species of filaria in humans the reservoir host and the mosquito vector in endemic areas Copyright 2000 Academic Press.


1668. Esterre P.  Plichart C.  Huin-Blondey MO.  Nguyen L. Role of streptococcal infection in the acute pathology of lymphatic filariasis. Parasite.  7(2):91-4, 2000 Jun.


Growing evidence suggest that secondary bacterial, mainly streptococcal, infections contribute significantly to recurrent episodes of acute   adenolymphangitis (ADL) of filarial origin. We examined the role of group A streptococci in the progression of lymphedema in Polynesian patients with filariasis-related ADL (22 cases) or chronic pathology (10 cases), or with erysipela (10 patients) and, as controls, in 20 healthy adults.  Antistreptolysin O (ASLO) and anti-streptodornase B (ASDB) titers were  systematically determined in parallel to parasitological and biochemical  tests. ASLO and ASDB assays were positive in 100% of erysipela, 75% of  filarial ADL as compared to 50% of chronic pathology and 39% of healthy  controls. Interestingly, by opposition to ASLO titers which were not significantly different between the four groups, ASDB titers were higher in ADL (p = 0.019) and erysipela (p = 0.002) than in controls. These results support the hypothesis that recurrent streptococcal infections may have an important role in the pathogenesis of ADL in lymphatic filariasis.


1669. Fontes G.  Rocha EM.  Brito AC.  Fireman FA.  Antunes CM. The microfilarial periodicity of Wuchereria bancrofti in north-eastern  Brazil.Annals of Tropical Medicine & Parasitology.  94(4):373-9, 2000 Jun.


The periodicity of Wuchereria bancrofti microfilariae (mff) in peripheral blood was analysed in 42 microfilaraemics living in Maceio, in Alagoas state, north-eastern Brazil. Nine blood samples were collected from each subject, over a 24-h period, and two quantitative (60-microliter) thick smears were prepared from each sample. Although all the subjects had detectable microfilaraemias from 23.00 hours to 06.00 hours, no mff could be detected in most (71.4%) of the smears prepared from samples collected at 15.00 hours. Samples collected during the day, at 15.00 hours, contained 170 times fewer mff/microliter than those collected at 01.00 hours, when microfilaraemias were generally most intense. For diagnosis of bancroftian filariasis in Maceio, blood samples should be collected  between 22.00 and 03.00 hours, when microfilarial counts will be at least  90% of the peak counts. The circadian variation observed was independent of the subject's gender and microfilarial density. Mathematical analysis, using a simple harmonic-wave model, indicated a periodicity index of 127.6 and that maximum microfilarial densities occurred at 00.51 hours, confirming the nocturnal pattern of microfilaraemia in the study area.


1670. Hoffmann W.  Petit G.  Schulz-Key H.  Taylor D.  Bain O.  Le Goff L.  Litomosoides sigmodontis in mice: reappraisal of an old model for filarial  research. [Review] [35 refs] Parasitology Today.  16(9):387-9, 2000 Sep.


Onchocerciasis and lymphatic filariasis (LF) are major causes of severe  morbidity and considerable socio-economic problems throughout the tropics.  Vector control and mass chemotherapy have helped to control these  infections in some regions, but the temporary success of such measures argues strongly for the development of vaccines. Success in such a venture will require detailed knowledge of protective immune responses in conjunction with the identification of target antigens. By comparison with other important parasitic infections, such as schistosomiasis and leishmaniasis, work on the development of vaccines for onchocerciasis and LF has been constrained because of the difficulties of producing cyclical and patent filarial infection in laboratory mice. Wolfgang Hoffmann and colleagues here outline the opportunities presented by the rodent filaria Litomosoides sigmodontis for filarial research. [References: 35]


1671.Norman RA.  Chan MS.  Srividya A.  Pani SP.  Ramaiah KD.  Vanamail P.   Michael E.  Das PK.  Bundy DA. EPIFIL: the development of an age-structured model for describing the transmission dynamics and control of lymphatic filariasis. Epidemiology & Infection.  124(3):529-41, 2000 Jun.


Mathematical models of transmission dynamics of infectious diseases provide a useful tool for investigating the impact of community based control measures. Previously, we used a dynamic (constant force-of-infection) model for lymphatic filariasis to describe observed patterns of infection and disease in endemic communities. In this paper, we expand the model to examine the effects of control options against filariasis by incorporating the impact of age structure of the human community and by addressing explicitly the dynamics of parasite  transmission from and to the vector population. This model is tested using  data for Wuchereria bancrofti transmitted by Culex quinquefasciatus in  Pondicherry, South India. The results show that chemotherapy has a larger  short-term impact than vector control but that the effects of vector  control can last beyond the treatment period. In addition we compare rates  of recrudescence for drugs with different macrofilaricidal effects.


1672. Plaisier AP.  Stolk WA.  van Oortmarssen GJ.  Habbema JD. Effectiveness of annual ivermectin treatment for Wuchereria bancrofti infection. [Review] [19 refs] Parasitology Today.  16(7):298-302, 2000 Jul.


Using estimates for the anthelmintic efficacy of a single dose of ivermectin in the treatment of lymphatic filariasis patients, Anton Plaisier, Wilma Stolk, Gerrit van Oortmarssen and Dik Habbema here present and discuss model predictions of the impact of a five-year programme of annual community treatment on the intensity of infection. They show that  the effectiveness of such programmes in terms of reductions in the microfilarial density depends critically on the treatment coverage and the pattern of attendance at repeated mass administrations. Improving these factors will possibly be more important than improving the efficacy of ivermectin by increasing its dosage or by adding other drugs. [References:  19]


1673.  Ramzy RM.  Helmy H.  el-Lethy AS.  Kandil AM.  Ahmed ES.  Weil GJ.  Faris

R.  Field evaluation of a rapid-format kit for the diagnosis of bancroftian  filariasis in Egypt. Eastern Mediterranean Health Journal.  5(5):880-7, 2000 Sep.


The AMRAD-ICT Filariasis Test (ICT-Fil) is a new, rapid-format card test for the detection of bancroftian antigenaemia in human blood. We evaluated the performance of the test under field conditions in Egypt by comparing 1813 endemic and 102 nonendemic participants. Endemic participants were tested for microfilaraemia (thick smear and membrane filtration) and serum antigenaemia (ELISA). The infection rates detected were 2.8% by thick smear, 3.5% by membrane filtration, 8.8% by ELISA and 9.0% by ICT-Fil. The card test detected antigenaemia in 98.0% and 95.3% of microfilaraemia carriers testing positive by thick smear and blood filtration respectively. Nonendemic participants were ICT-Fil negative. Identical results were obtained for 173 out of 184 (94%) endemic participants tested by the serum and whole blood ICT-Fil versions.




2174. Esterre P.  Plichart C.  Sechan Y.  Nguyen NL. The impact of 34 years of massive DEC chemotherapy on Wuchereria bancrofti infection and transmission: the Maupiti cohort. Tropical Medicine & International Health.  6(3):190-5, 2001 Mar.


  Semi-annual mass DEC chemotherapy combined with vector control at the beginning of the programme, has been administered on the remote island of Maupiti (French Polynesia) since 1955 (except two periods in 1960-67 and 1970-74). The results of two surveys in 1985 and 1989, reporting 0% microfilaraemia, led to the hope that the eradication of lymphatic filariasis had been achieved. We combined parasitological criteria (microfilaraemia by membrane filtration), immunological (antigenaemia and serum levels of specific IgG antibodies) and molecular (PCR-based evaluation of infection in mosquitoes) techniques and found only good control of the parasite: We found residual microfilaraemia in 0.4% of the sample (mean level in carriers: 101.2 mf/ml), antigenaemia in 4.6% (mean level in positive persons: 714.4 units/ml) and specific IgG in 21.6% (including in one very young child). In addition, an infection rate of 1.4% was calculated in the Aedes polynesiensis vector population. These data, obtained in 1997 just before a hurricane, were partially confirmed in 1999 (0.1% of infection rate in the vector). Together with the possibility of some resistance to DEC, various epidemiological factors critical for the eradication of lymphatic filariasis are discussed.


2175. Freedman DO.  Plier DA.  De Almeida AB.  De Oliveira AL.  Miranda J. Braga C. Effect of aggressive prolonged diethylcarbamazine therapy on circulating antigen levels in bancroftian filariasis. Tropical Medicine & International Health.  6(1):37-41, 2001 Jan.


  BACKGROUND: Single dose diethylcarbamazine (DEC) as used in control programmes is effectively microfilaricidal for periods of up to a year or more but has incomplete ability to kill Wuchereria bancrofti adult parasites. These regimens can be effective in breaking transmission by suppression of circulating microfilariae available to mosquito vectors. Whether prolonged or aggressive therapy with DEC has a significant effect on adult worms, which may live up to 12 years or more, and is important in the context of the treatment of individual patients, is still incompletely understood. METHODS: In order to investigate the adulticidal effect of aggressive therapy, DEC was given at 6 mg/kg/day for 12-day courses at 0, 6, 12, and 18 months and Og4C3 antigenaemia followed over two years in 38 CAg + Brazilians in a W. bancrofti endemic area. RESULTS: At two year follow-up, the median level of antigenaemia was 21% of the pre-treatment value. 92% of individuals had antigen levels < 50% of pretreatment values, but only 26% had completely cleared antigenaemia. The clearance rate at 24 months was only 12% (3/26) in the asymptomatic CAg + patients but 58% (7/12) in those with clinical manifestations of filariasis. The latter individuals cleared significantly more antigen (median of 0% pretreatment antigenaemia vs. 26%; P=0.02) than asymptomatic but infected individuals. CONCLUSION: Aggressive repeated therapy with DEC alone is ineffective in consistently eradicating adult W. bancrofti, especially in infected but asymptomatic individuals. Prolonged courses of combination therapy with other antifilarial drugs should be investigated for treatment of individual patients with the means to pursue aggressive personal medical care.


2176. Gyapong M.  Gyapong JO.  Owusu-Banahene G. Community-directed treatment: the way forward to eliminating lymphatic filariasis as a public-health problem in Ghana. Annals of Tropical Medicine & Parasitology.  95(1):77-86, 2001 Jan.


  The elimination of lymphatic filariasis as a public-health problem is currently dependent on the delivery of annual drug treatments to at least 80% of the eligible members of endemic populations for at least 5 years. However, for various reasons, this goal may not be achievable by the health systems of most endemic countries in sub-Saharan Africa, particularly if treatment is not community-directed. In Ghana, community-directed ivermectin treatment involving the regular public-health services at the implementation level (ComDT/HS) has recently been compared with mass-treatment in which only the health services participated (HST). Health staff and the target communities appreciated the ComDT/HS approach more than the HST approach and were more willing to participate in the community-directed scheme. The treatment coverage achieved by ComDT/HS (74.5%) was not only much higher than that of HST (43.5%) but also probably adequate for filariasis elimination. HST coverage was particularly poor in villages located > 5 km from a health facility, but distance from such a facility had no significant effect on treatment coverage in the ComDT/HS arm. As virtually all the subjects who received drugs swallowed them, compliance with treatment was not a problem. The ComDT/HS approach is therefore recommended, especially for areas where access to health facilities is poor and the health workers are over-stretched. The implications of these findings for the global programme for filariasis elimination are discussed.


2177. Jain S.  Sodhani P.  Gupta S.  Sakhuja P.  Kumar N. Cytomorphology of filariasis revisited. Expansion of the morphologic spectrum and coexistence with other lesions. Acta Cytologica.  45(2):186-91, 2001 Mar-Apr.


  OBJECTIVE: To review the cytomorphologic spectrum of the filarial worm and associated tissue response in 33 cases. STUDY DESIGN: Retrospective analysis was carried out in clinically unsuspected cases of filariasis diagnosed on cytology over a period of 10 years. Twenty-nine aspirate smears from 28 patients were air dried and stained with May-Grunwald-Giemsa stain. Four routine cervical smears and one centrifuged smear of urine were stained with Papanicolaou stain. RESULTS: Microfilariae alone and along with adult gravid females were present in 25 and 4 cases, respectively. In one case both adult male and female worms with microfilariae and eggs were seen. The diagnosis was based on the presence of eggs alone in one case and fragments of female worms in two. Four of these cases were neoplastic lesions, and microfilariae were found incidentally. In one case of splenomegaly microfilariae were seen along with Leishman-Donovan bodies. CONCLUSION: Filariasis can be diagnosed on cytology by demonstrating microfilariae, a male or female worm, or eggs alone. It can be seen in association with neoplastic lesions and rarely with other parasitic infections.


2735.    Jain S.  Sodhani P.  Gupta S.  Sakhuja P.  Kumar N. Cytomorphology of filariasis revisited. Expansion of the morphologic spectrum and coexistence with other lesions. Acta Cytologica.  45(2):186-91, 2001 Mar-Apr.

2736.    Mohanty MC.  Satapathy AK.  Sahoo PK.  Ravindran B.  Human bancroftian filariasis - a role for antibodies to parasite carbohydrates. Clinical & Experimental Immunology.  124(1):54-61, 2001 Apr.

2737.    Rathaur S.  Sharma S.  Singh RN.  Henkle K.  Selkirk ME. Antibody responses of Wuchereria bancrofti patients to recombinant Brugia pahangi superoxide dismutase. Indian Journal of Experimental Biology.  39(1):35-40, 2001 Jan.



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