RESUMO
The effects of a mass chemotherapy programme using spaced doses of diethylcarbamazine citrate on Wuchereria bancrofti microfilaraemias and vector infection rates were studied in an isolated rural community of 650 people in north Trinidad where a microfilaria rate of 15% had previously been recorded. A single oral dose of 6 mg/kg body weight was given at monthly intervals for one year. After 6 months, 79% (52/66) of persons previously microfilaraemic had become negative. After 12 months the negative proportion had increased to 90% (63/70). The geometric mean microfilaria density of those still microfilaraemic was reduced from 19.7 to 4.6 per 100 mm3 of blood. Of 147 initially negative persons, none had become positive following treatment. Filarial infection rates in Culex quinquefasciatus from randomly sampled houses fell from 6.4% to zero; in houses where occupants with microfilaraemia had been identified before treatment, the rate was reduced from 15.8% to zero. In a supplementary study, however, weekly collections from one initially positive house showed a rapid decline in the vector infection rate from 43% to 2% after three months but an additional 3 months elapsed before the index reached zero. There was negligible microfilarial uptake by the vectors from residual low-density microfilaraemias (less than 10 microfilariae per 100 mm3 of blood) after chemotherapy.
Assuntos
Dietilcarbamazina/administração & dosagem , Filariose Linfática/tratamento farmacológico , Filariose/tratamento farmacológico , Animais , Culex/parasitologia , Dietilcarbamazina/uso terapêutico , Humanos , Controle de Insetos , Insetos Vetores , Microfilárias/isolamento & purificação , Trinidad e Tobago , Wuchereria bancrofti/isolamento & purificaçãoRESUMO
PIP: A parasitological and clinical survey of Wuchereria bancrofti and Mansonella ozzardi was conducted in Blanchisseuse, an isolated rural community of 650 people in coastal north Trinidad. W. bancrofti microfilariae were found in 15% of the resident population and the prevalence was higher in males (19%) than in females (12%). Microfilaraemias were undetected in children under 5 years of age but 12% of children and adolescents between 5 and 19 years of age were positive. Microfilaraemias were most common in males aged 40-59 years (34%) and in females in the same age group (21%). Whereas geometric mean microfilaria densities were generally higher in females than in males under 40 years old, in the older age groups the pattern was reversed, the difference being especially pronounced in the over 60s. There were more than 2 times as many males with M. ozzardi microfilariae (35%) than there were females (15%). The prevalence was low in children and young adults but increased with age thereafter. In the older age groups microfilaria densities followed a similar trend. Genital signs compatible with lymphatic filarial disease were seen in 29% of males; these included hydrocoele (15%) and elephantiasis of the scrotum (1%). Most signs were seen in persons over 50 years of age. 6% of females had lymphoedema of the leg(s), and in 4 cases (2.3%) this had progressed to elephantiasis. A positive association was found between M. ozzardi microfilaraemia and clinical history of articular pain. The findings suggest that both filarial species are of some public health significance in at least 1 rural area of Trinidad, and they provide a basis for the development of a lymphatic filariasis control strategy in the community.^ieng
Assuntos
Filariose/epidemiologia , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Mansonella , Mansonelose/epidemiologia , Pessoa de Meia-Idade , Trinidad e Tobago , Wuchereria bancroftiAssuntos
Humanos , Masculino , Feminino , Wuchereria bancrofti , Mansonella , Índias Ocidentais , População RuralAssuntos
Negro ou Afro-Americano , Neoplasias/epidemiologia , Feminino , Humanos , Masculino , Fatores Sexuais , Fatores de Tempo , Índias OcidentaisAssuntos
Humanos , Masculino , Feminino , Negro ou Afro-Americano , Neoplasias , Fatores Sexuais , Fatores de Tempo , Índias OcidentaisRESUMO
An outbreak of Plasmodium malariae malaria occurred in Grenada some 16 years after the end of a malaria eradication campaign, probably due to renewal of transmission from recrudescent cases. Serological studies were used in addition to blood film surveys in defining the outbreak, and their value in such surveillance situations is emphasized.