Assuntos
Oncocercose/patologia , Adolescente , Adulto , Equador , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Oncocercose/cirurgiaRESUMO
An open clinical trial of amocarzine was carried out in onchocerciasis patients in Ecuador and Guatemala. Administration after food was more effective than that during fasting. The most effective and best tolerated regimen, 3 mg/kg twice daily after food for 3 days (in 312 patients), killed 73% of 1477 female worms at nodulectomy 4 months after treatment. The mean microfilarial skin count was greatly reduced within a week (6-11% Of day 0 value on day 8) and it remained low at least 6 months (14-18% on day 180). Follow-up of a higher dose 3 day regimen taken while fasting showed microfilaridermia of 7-9% of the day 0 value 2 years after treatment.
Assuntos
Filaricidas/uso terapêutico , Onchocerca/efeitos dos fármacos , Oncocercose/tratamento farmacológico , Piperazinas/uso terapêutico , Adulto , Animais , Estudos de Coortes , Terapia Combinada , Esquema de Medicação , Avaliação de Medicamentos , Equador , Feminino , Filaricidas/administração & dosagem , Filaricidas/efeitos adversos , Seguimentos , Guatemala , Humanos , Oncocercose/cirurgia , Projetos Piloto , Piperazinas/administração & dosagem , Piperazinas/efeitos adversos , Pele/parasitologiaRESUMO
Nodulectomies were performed in a hypoendemic area on the Rio Santiago and in a hyperendemic area on the River Cayapas. All palpable nodules were removed. In the hypoendemic area the nodulectomies had a positive effect in reducing the intensity of infections and they contributed in the control of the advancement of the disease. In the hyperendemic area also a positive effect was observed but new nodules developed rapidly.
Assuntos
Oncocercose/cirurgia , Animais , Criança , Equador , Humanos , MasculinoRESUMO
This study is concerned with the relationship between palpable onchocercal nodules and Onchocerca volvulus microfilarial loads in the skin. The number of microfilariae in clinically normal skin decreases as the distance from the nodule increases. Surgical removal of nodules reduces the microfilarial loads in 40 of 46 patients studied over a period of five months, with an average reduction of 65.4% of the prenodulectomy microfilarial load at the iliac crest. Complete elimination of detectable parasites was seen in some patients. Five individuals had increased microfilarial loads, all of which had developed new palpable nodules. Also, nodulectomy had a significant effect on ocular tissue, reducing the levels of parasites in the cornea and anterior chamber in 10 of 15 patients observed with no new nodules developing during the observation period. Both dermal and ocular clinical manifestations of onchocerciasis were reduced in a proportion of the patients. These parasitological and clinical findings provide evidence that nodulectomy is a beneficial procedure to O. volvulus infected patients in Ecuador by reducing both microfilarial loads and the degree of pathology.
Assuntos
Olho/parasitologia , Onchocerca/crescimento & desenvolvimento , Oncocercose/cirurgia , Pele/parasitologia , Animais , Procedimentos Cirúrgicos Dermatológicos , Equador , Humanos , Microfilárias/crescimento & desenvolvimento , Oncocercose/parasitologiaRESUMO
In Guatemala a national nodulectomy campaign has been carried out since 1935 in three operational areas, namely the Eastern, Central and Western endemic zones. The prevalence of nodules was calculated in each 1 km grid square in these zones in each decade and plotted on mesh maps. A total of nine foci of high endemicity, three in each operational area, was found in the decade 1940-49. Nodule prevalence was concentric in each endemic focus; high in the centre and gradually falling towards periphery. The foci were found mainly on Tertiary or Quaternary-Tertiary volcanic rocks in the Eastern and Central zones, or on non-carbonate sedimentary rocks in the Western zone. Nodule carriers were found at altitudes from 220 to 2200 m above sea level. The altitude of the foci of high endemicity varied, being low in the Eastern zone, medium in the Central zone and high in the Western zone. The nodule prevalence declined from the decade 1940-49 to the decade 1970-79 in most of the grid squares. The Santa Rosa focus in the Eastern zone virtually disappeared before 1970. The extent of endemic area having a nodule prevalence of 1% or higher decreased from 2384 km2 in the decade 1940-49 to 1424 km2 in the decade 1970-79. The area recommended for vector control operation against Simulium ochraceum was estimated at 803 km2.
Assuntos
Oncocercose/epidemiologia , Altitude , Animais , Métodos Epidemiológicos , Fenômenos Geológicos , Geologia , Guatemala , Humanos , Insetos Vetores/parasitologia , Inseticidas , Oncocercose/prevenção & controle , Oncocercose/cirurgia , Simuliidae/parasitologia , Fatores de TempoRESUMO
The surface ultrastructure of male and female adult worms of Onchocerca volvulus obtained from human nodules by the technique of collagenase digestion has been compared with that of worms excised manually without the aid of enzyme treatment. No topographical differences have been identified.