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Gary J. Weil - One of the best experts on this subject based on the ideXlab platform.
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Long-term efficacy of single-dose combinations of albendazole, ivermectin and diethylcarbamazine for the treatment of Bancroftian Filariasis.
Transactions of the Royal Society of Tropical Medicine and Hygiene, 2001Co-Authors: M. M. Ismail, Gary J. Weil, R L Jayakody, Deepika Fernando, M S G De Silva, G A C De Silva, W K BalasooriyaAbstract:In a 'blinded' trial (in Sri Lanka, 1996-98) of 47 male asymptomatic microfilaraemic subjects with Wuchereria bancrofti infection, the safety, tolerability and filaricidal efficacy of 3 single-dose combination regimens were compared: albendazole 400 mg with ivermectin 200 micrograms/kg, albendazole 400 mg with diethylcarbamazine citrate (DEC) 6 mg/kg or albendazole 600 mg with ivermectin 400 micrograms/kg. Treated subjects were followed-up for 24 months. This represents the first long-term study using combinations of albendazole with DEC or ivermectin in the above doses against Bancroftian Filariasis. All subjects had pre-treatment microfilaria (mf) counts over 100/mL. All 3 treatments significantly reduced mf counts, with the albendazole-DEC-treated group showing the lowest mf levels at 18 and 24 months post-treatment. Filarial antigen tests suggested that all 3 treatments had significant activity against adult W. bancrofti; albendazole-DEC combination had the greatest activity according to this test, with antigen levels decreasing to 30.5% of pre-treatment antigen levels, 24 months after therapy. All 3 treatments were clinically safe and well tolerated. These results suggest that a single dose of albendazole 400 mg together with DEC 6 mg/kg is a safe and effective combination for suppression of microfilaraemia of Bancroftian Filariasis that could be considered for use in Filariasis control programmes based on mass treatment of endemic populations.
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Bancroftian Filariasis in Egypt: visualization of adult worms and subclinical lymphatic pathology by scrotal ultrasound.
The American journal of tropical medicine and hygiene, 1998Co-Authors: R. Faris, Reda M. R. Ramzy, Omar Hussain, Maged El Setouhy, Gary J. WeilAbstract:The purpose of this study was to explore the value of scrotal ultrasound as a means of evaluating Bancroftian Filariasis. Color Doppler ultrasound examinations were performed to look for subclinical hydroceles and motile adult filarial worms (dancing worms) in dilated lymphatics. Sixty-one male subjects from a Filariasis-endemic area in Egypt were studied including 19 clinically normal microfilaria (MF) carriers (seven with dancing worms and eight with subclinical hydroceles), 13 MF-negative subjects with positive filarial antigen test results (three with dancing worms and seven with subclinical hydroceles), 22 exposed subjects with no MF and negative antigen test results (no dancing worms, four subclinical hydroceles), and seven subjects with clinical Filariasis (no dancing worms, seven hydroceles). Thus, all men tested with clinical Filariasis and most clinically normal subjects with either microfilaremia or filarial antigenemia had abnormal ultrasound examination results. Ultrasound findings often changed after therapy with diethylcarbamazine, with disappearance of dancing worms and development of new scrotal calcifications or hydroceles. This study confirms the value of scrotal ultrasound as a means of noninvasively visualizing adult filarial worms and assessing subclinical lymphatic damage in Bancroftian Filariasis.
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efficacy of single dose combinations of albendazole ivermectin and diethylcarbamazine for the treatment of Bancroftian Filariasis
Transactions of The Royal Society of Tropical Medicine and Hygiene, 1998Co-Authors: M. M. Ismail, Gary J. Weil, R L Jayakody, Deepika Fernando, M S G De Silva, G A C De Silva, W K BalasooriyaAbstract:Abstract In a ‘blinded’ trial (in Sri Lanka, 1996–1998) of 47 male asymptomatic microfilaraemic subjects with Wuchereria bancrofti infection, the safety, tolerability and filaricidal efficacy of 3 single-dose combination regimens were compared: albendazole 400 mg with ivermectin 200 μg/kg, albendazole 400 mg with diethylcarbamazine citrate (DEC) 6 mg/kg or albendazole 600 mg with ivermectin 400 μg/kg. Treated subjects were followed-up for 24 months. This represents the first long-term study using combinations of albendazole with DEC or ivermectin in the above doses against Bancroftian Filariasis. All subjects had pretreatment microfilaria (mf) counts over 100/mL. All 3 treatments significantly reduced mf counts, with the albendazole-DEC-treated group showing the lowest mf levels at 18 and 24 months post-treatment, Filarial antigen tests suggested that all 3 treatments had significant activity against adult W. bancrofti; albendazole-DEC combination had the greatest activity according to this test, with antigen levels decreasing to 30·5% of pre-treatment antigen levels, 24 months after therapy. All 3 treatments were clinically safe and well tolerated. These results suggest that a single dose of albendazole 400 mg together with DEC 6 mg/kg is a safe and effective combination for suppression of microfilaraemia of Bancroftian Filariasis that could be considered for use in Filariasis control programmes based on mass treatment of endemic populations.
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Evaluation of a recombinant antigen-based antibody assay for diagnosis of Bancroftian Filariasis in Egypt.
Annals of tropical medicine and parasitology, 1995Co-Authors: Reda M. R. Ramzy, R. Faris, Abdel M. Gad, Hanan Helmy, Ramaswamy Chandrashekar, Gary J. WeilAbstract:(1995). Evaluation of a recombinant antigen-based antibody assay for diagnosis of Bancroftian Filariasis in Egypt. Annals of Tropical Medicine & Parasitology: Vol. 89, No. 4, pp. 443-446.
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Community diagnosis of Bancroftian Filariasis
Transactions of the Royal Society of Tropical Medicine and Hygiene, 1993Co-Authors: R. Faris, Gary J. Weil, Reda M. R. Ramzy, Abdel M. Gad, A. A. BuckAbstract:Abstract The objective of this study was to find the best tests for efficiently estimating the true prevalence of Bancroftian Filariasis in endemic areas. The study population comprised 427 people over 10 years of age in an endemic village in Egypt. Four tests were evaluated; a standardized clinical examination, night blood examinations for microfilariae (50 μL thick films and 1 mL membrane filtration), and a test for circulating filarial antigen. 191 subjects (44·75%) had at least one positive test and were considered to have Filariasis. The sensitivities of clinical examination, thick films, membrane filtration and antigen testing for Filariasis were 16%, 50%, 64%, and 88%, respectively. Relative to membrane filtration of night blood, the filarial antigen test had a sensitivity of 97·5%, a positive predictive power of 71%, and a negative predictive power of 99%. None of the blood tests was a sensitive indicator of clinical Filariasis; 69% of clinical cases were negative in all 3 blood tests and would have been missed if clinical examinations had not been done. Therefore, we recommend a combination of clinical examination and the filarial antigen test (with optional examination for microfilariae of those with positive antigen tests) for community diagnosis of Bancroftian Filariasis in endemic areas.
Paul E. Simonsen - One of the best experts on this subject based on the ideXlab platform.
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FILARIAL-SPECIFIC ANTIBODY RESPONSE IN EAST AFRICAN Bancroftian Filariasis: EFFECTS OF HOST INFECTION, CLINICAL DISEASE, AND
2013Co-Authors: Filarial Endemicity, Dan W. Meyrowitsch, Paul E. Simonsen, Walter G. Jaoko, Benson B. A. Estambale, Mwele N. Malecela-lazaro, Edwin MichaelAbstract:Abstract. The effect of host infection, chronic clinical disease, and transmission intensity on the patterns of specific antibody responses in Bancroftian Filariasis was assessed by analyzing specific IgG1, IgG2, IgG3, IgG4, and IgE profiles among adults from two communities with high and low Wuchereria bancrofti endemicity. In the high endemicity community, intensities of the measured antibodies were significantly associated with infection status. IgG1, IgG2, and IgE were negatively associated with microfilaria (MF) status, IgG3 was negatively associated with circulating filarial antigen (CFA) status, and IgG4 was positively associated with CFA status. None of the associations were significantly influenced by chronic lymphatic disease status. In contrast, IgG1, IgG2, and IgG4 responses were less vigorous in the low endemicity community and, except for IgG4, did not show any significant associations with MF or CFA status. The IgG3 responses were considerably more vigorous in the low endemicity community than in the high endemicity one. Only IgG4 responses exhibited a rather similar pattern in the two communities, being significantly positively associated with CFA status in both communities. The IgG4:IgE ratios were higher in infection-positive individuals than in infectionnegative ones, and higher in the high endemicity community than in the low endemicity one. Overall, these results indicate that specific antibody responses in Bancroftian Filariasis are more related to infection status than to chroni
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filarial specific antibody response in east african Bancroftian Filariasis effects of host infection clinical disease and filarial endemicity
American Journal of Tropical Medicine and Hygiene, 2006Co-Authors: Walter G. Jaoko, Dan W. Meyrowitsch, Paul E. Simonsen, Benson B. Estambale, Mwele N Malecelalazaro, Edwin MichaelAbstract:The effect of host infection, chronic clinical disease, and transmission intensity on the patterns of specific antibody responses in Bancroftian Filariasis was assessed by analyzing specific IgG1, IgG2, IgG3, IgG4, and IgE profiles among adults from two communities with high and low Wuchereria bancrofti endemicity. In the high endemicity community, intensities of the measured antibodies were significantly associated with infection status. IgG1, IgG2, and IgE were negatively associated with microfilaria (MF) status, IgG3 was negatively associated with circulating filarial antigen (CFA) status, and IgG4 was positively associated with CFA status. None of the associations were significantly influenced by chronic lymphatic disease status. In contrast, IgG1, IgG2, and IgG4 responses were less vigorous in the low endemicity community and, except for IgG4, did not show any significant associations with MF or CFA status. The IgG3 responses were considerably more vigorous in the low endemicity community than in the high endemicity one. Only IgG4 responses exhibited a rather similar pattern in the two communities, being significantly positively associated with CFA status in both communities. The IgG4:IgE ratios were higher in infection-positive individuals than in infection-negative ones, and higher in the high endemicity community than in the low endemicity one. Overall, these results indicate that specific antibody responses in Bancroftian Filariasis are more related to infection status than to chronic lymphatic disease status. They also suggest that community transmission intensity play a dominant but subtle role in shaping the observed response patterns.
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Bancroftian Filariasis in an irrigation project community in southern Ghana
Tropical medicine & international health : TM & IH, 1999Co-Authors: Mawuli Dzodzomenyo, Paul E. SimonsenAbstract:Summary An epidemiological study to document the endemicity and transmission characteristics of Bancroftian Filariasis was conducted in an irrigation project community in southern Ghana. In a 50% random sample of the population, the prevalence of microfilaraemia was 26.4% and the geometric mean microfilarial intensity among positives was 819 microfilariae/ml of blood. Hydrocoele was found in 13.8% of the males aged >18 years, and 1.4% of the residents examined, all females, had lymphoedema/elephantiasis. Detailed monitoring of the microfilarial intensity in 8 individuals over a 24-h period confirmed its nocturnal periodicity with a peak at approximately 0100 hours. The most important vector was Anopheles gambiae s.l., followed by An. funestus. The abundance of these mosquitoes and their relative importance as vectors varied considerably between the wet and the dry season. Opening of the irrigation canals late in the dry season resulted in a remarkable increase in the population of An. gambiae (8.3% of which carried infective filarial larvae) to levels comparable to those seen during the wet season, suggesting that the irrigation project is responsible for increased transmission of lymphatic Filariasis in the community.
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Bancroftian Filariasis : analysis of infection and disease in five endemic communities of north-eastern Tanzania
Annals of tropical medicine and parasitology, 1995Co-Authors: Dan W. Meyrowitsch, Paul E. Simonsen, W.h. MakundeAbstract:Clinical and parasitological surveys for Bancroftian Filariasis were carried out in five endemic communities in north-eastern Tanzania, covering a population of 3086 individuals. High microfilarial...
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Bancroftian Filariasis: the pattern of microfilaraemia and clinical manifestations in three endemic communities of Northeastern Tanzania.
Acta tropica, 1995Co-Authors: Paul E. Simonsen, Dan W. Meyrowitsch, W.h. Makunde, Pascal MagnussenAbstract:Individuals from three villages in northeastern Tanzania, located 40 km inland from the Indian Ocean coast, were surveyed for parasitological and clinical evidence of Bancroftian Filariasis. Microfilarial (mf) prevalences ranged from 22.2 to 37.6%, and mf geometric mean intensities (GMI) ranged from 546 to 735 mf/ml blood, in the three villages. Microfilaraemia was rare in children below five years. The mf prevalences increased with age, reaching from 35.9 to 49.2% in individuals aged 45 years and above. No association between mf GMI and age was observed in any of the villages. Hydrocele was the most common chronic clinical manifestation, with prevalences ranging from 14.5 to 21.3% for all males, and from 52.9 to 62.1% for males aged 45 years and above. From 0.6 to 3.3% of the inhabitants in the three villages had elephantiasis, which most often affected the legs. Microfilaraemia was common in males with hydrocele, and in males of 45 years and above there was no significant difference in mf prevalence between males with (42.5%) and without (55.2%) hydrocele. In contrast, microfilariae were only detected in the blood from one of 18 individuals with elephantiasis. With respect to hydrocele, the present results do not support recently forwarded hypotheses assuming a general negative relationship between microfilaraemia and chronic clinical manifestations in Bancroftian Filariasis.
Gerusa Dreyer - One of the best experts on this subject based on the ideXlab platform.
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Aspects of the social realities of children and adolescents seen at a reference service for Bancroftian Filariasis in Recife, state of Pernambuco
Revista da Sociedade Brasileira de Medicina Tropical, 2008Co-Authors: Denise Mattos, Solange Mota, Gerusa DreyerAbstract:The authors report on aspects of the social realities of children and adolescents living in Jaboatao dos Guararapes, State of Pernambuco, who were diagnosed with Bancroftian Filariasis infection and were treated at the Filariasis Teaching, Research and Care Center of the Federal University of Pernambuco (Health Sciences Center), which is a tertiary-level reference service for Filariasis. The patients housing conditions were quantified and classified as subhuman, with a direct relationship with the maintenance of Bancroftian Filariasis transmission, and the authors highlight the need for political decisions regarding the implementation of basic sanitation projects.
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Hope Clubs as adjunct therapeutic measure in Bancroftian Filariasis endemic areas
Revista da Sociedade Brasileira de Medicina Tropical, 2006Co-Authors: Gerusa Dreyer, Joaquim Noroes, Denise MattosAbstract:In 1997 the World Health Organization announced an ambitious project called the Global Program to Eliminate Lymphatic Filariasis, as a Public Health Problem. The program is based on two pillars: interruption of transmission and morbidity control. Experience in Recife, Brazil, an endemic area for Bancroftian Filariasis, showed that an innovative approach called Hope Clubs, can equip lymphedema patients with the skills, motivation, and enthusiasm to sustain effective, low-cost and convenient self-care to prevent acute skin bacterial episodes and milky urine in the case of chyluria carriers. They feel they are not alone, they regain their potential for productive work and are able to amplify these activities throughout Filariasis-endemic communities.
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Bancroftian Filariasis in children and adolescents clinical pathological observations in 22 cases from an endemic area
Annals of Tropical Medicine and Parasitology, 2005Co-Authors: Jose Figueredosilva, Gerusa DreyerAbstract:In areas where Bancroftian Filariasis is endemic, the clinical manifestations of the disease, which are often very varied, appear most frequently during early adulthood or later. In consequence, very little attention, if any, has been given to the signs and symptoms of the disease in childhood. In an attempt to fill this gap, clinical and pathological observations were made, in Brazil, on 22 children (aged 2-15 years) who were infected with Wuchereria bancrofti. There was a predominance of lymph-node involvement. In all but three (14%) of the children (who had adult parasites in their intrascrotal lymphatic vessels), the adult worms were located in the afferent or efferent vessels of draining lymph nodes, predominantly in the inguinal region. None of the patients presented with distal lymphoedema, and the adenopathy was characterized by painless, localized, lymph-node enlargement, without signs of inflammation in the overlying skin. Histologically, the alterations in the lymphatic vessels and surrounding structures were similar to those described in adult patients, and depended essentially on adult-parasite viability. The localization of the adult worms in the paediatric cases was peculiar and distinct from that observed in adult patients, in whom the adult parasites are usually found in extra-nodal lymphatic vessels. In areas endemic for Bancroftian Filariasis, therefore, filarial infection should be considered as a possible cause of adenopathy. For the differential diagnosis of adenopathy in young patients from endemic areas, the authors recommend the use of ultrasound and other non-invasive diagnostic tools, as alternatives to excisional biopsies, which are often unnecessary in Bancroftian Filariasis.
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Bancroftian Filariasis in children and adolescents: clinical–pathological observations in 22 cases from an endemic area
Annals of tropical medicine and parasitology, 2005Co-Authors: José Figueredo-silva, Gerusa DreyerAbstract:In areas where Bancroftian Filariasis is endemic, the clinical manifestations of the disease, which are often very varied, appear most frequently during early adulthood or later. In consequence, very little attention, if any, has been given to the signs and symptoms of the disease in childhood. In an attempt to fill this gap, clinical and pathological observations were made, in Brazil, on 22 children (aged 2-15 years) who were infected with Wuchereria bancrofti. There was a predominance of lymph-node involvement. In all but three (14%) of the children (who had adult parasites in their intrascrotal lymphatic vessels), the adult worms were located in the afferent or efferent vessels of draining lymph nodes, predominantly in the inguinal region. None of the patients presented with distal lymphoedema, and the adenopathy was characterized by painless, localized, lymph-node enlargement, without signs of inflammation in the overlying skin. Histologically, the alterations in the lymphatic vessels and surrounding structures were similar to those described in adult patients, and depended essentially on adult-parasite viability. The localization of the adult worms in the paediatric cases was peculiar and distinct from that observed in adult patients, in whom the adult parasites are usually found in extra-nodal lymphatic vessels. In areas endemic for Bancroftian Filariasis, therefore, filarial infection should be considered as a possible cause of adenopathy. For the differential diagnosis of adenopathy in young patients from endemic areas, the authors recommend the use of ultrasound and other non-invasive diagnostic tools, as alternatives to excisional biopsies, which are often unnecessary in Bancroftian Filariasis.
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The histopathology of Bancroftian Filariasis revisited: the role of the adult worm in the lymphatic-vessel disease
Annals of tropical medicine and parasitology, 2002Co-Authors: José Figueredo-silva, Joaquim Noroes, Agnaldo Pereira Cedenho, Gerusa DreyerAbstract:Although morphology is generally limited to static images, the histopathological features of Bancroftian lymphatic disease are presented here in a way that is as dynamic as possible and closely associated with the clinical, ultrasonographic and surgical characteristics. The protean spectrum of alterations seen in the host's lymphatic vessels is discussed, and the changes caused by the live and dead worms are highlighted, as independent events. Evidence of a remodelling process, in which the lymphatic endothelial cells appear to have a key role, is provided for the first time. Despite many new pieces of information, there remain many 'blank pages' in the natural history of Bancroftian Filariasis.
P.k. Das - One of the best experts on this subject based on the ideXlab platform.
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Non-involvement of nulliparous females in the transmission of Bancroftian Filariasis
Acta tropica, 1992Co-Authors: K.d. Ramaiah, P.k. DasAbstract:The possible involvement of nulliparous females of Culex quinquefasciatus in the transmission of Bancroftian Filariasis under field conditions was examined in Pondicherry, South India. Biting nulliparous females that had previously ingested partial blood meals were found infected with microfilariae/L1 stage larvae. None of them harboured infective-stage larvae. These findings suggest that nulliparous females are not involved in the transmission of Filariasis. Therefore, their inclusion for estimating the transmission parameters is questionable. However, nulliparous females should also be dissected in order to determine the vector infection rates accurately. Infective larvae were encountered in females of all other age groups.
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Seasonality of adult Culex quinquefasciatus and transmission of Bancroftian Filariasis in Pondicherry, South India.
Acta tropica, 1992Co-Authors: K.d. Ramaiah, P.k. DasAbstract:Seasonal variations in biting Culex quinquefasciatus and transmission of Bancroftian Filariasis were investigated in Pondicherry, South India. The biting density of C. quinquefasciatus, the principal vector species, was lowest in the summer months and higher during the monsoon and winter months. The survival of the vectors as indicated by the proportion of parous mosquitoes was found to be less in the summer season. Biting mosquitoes with infective stage larvae were not encountered during the hottest months of May, June and July and the early monsoon month of August indicating seasonality of transmission. Maximum transmission took place between November and March. These findings suggest that vector control measures according to the season of transmission may produce more cost-effective results than year round control operations.
Abraham Rocha - One of the best experts on this subject based on the ideXlab platform.
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Elimination of Bancroftian Filariasis (Wuchereria bancrofti) in Santa Catarina state, Brazil.
Tropical medicine & international health : TM & IH, 2000Co-Authors: B. R. Schlemper, Mário Steindel, Edmundo C. Grisard, Carlos J Carvalho-pinto, O. J. Bernardini, C. V. De Castilho, G. Rosa, S. Kilian, Alessandra A. Guarneri, Abraham RochaAbstract:During the 1950s, three foci of Wuchereria bancrofti transmission were identified in the State of Santa Catarina, Brazil. In Florianopolis, Sao Jose da Ponta Grossa and Barra da Laguna community treatment of Bancroftian Filariasis with diethylcarbamazine (DEC) was performed using two distinct approaches, without vector control or improvements in sanitation. In two of the three communities only microfilaraemic individuals were treated, while in Barra da Laguna the entire population received DEC treatment regardless of their infection status. In both cases, transmission of the parasite was blocked and no new cases were detected in all localities for up to 10 years. Recently, a new survey in Sao Jose da Ponta Grossa and Barra communities revealed no microfilaria-positive individuals, including residents that were positive in the 1950s. These data confirm that transmission of W. bancrofti was interrupted in Santa Catarina, and mass treatment appears to be more effective than treatment of microfilaraemic individuals only.
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treatment of Bancroftian Filariasis in recife brazil a two year comparative study of the efficacy of single treatments with ivermectin or diethylcarbamazine
Transactions of The Royal Society of Tropical Medicine and Hygiene, 1995Co-Authors: Gerusa Dreyer, Joaquim Noroes, Zulma Medeiros, Amaury Coutinho, Abraham Rocha, Democrito Miranda, Jose Angelo Rizzo, Eliane Galdino, Luiz Dias De Andrade, Abiel SantosAbstract:The effectiveness of single oral doses of ivermectin (200 or 400 micrograms/kg) and diethylcarbamazine (DEC, 6 mg/kg), preceded 4 d earlier by either placebo or very small doses of these drugs, was compared, over a 2-year period, in a double-blind trial in 67 microfilaraemic Brazilian men with Bancroftian Filariasis. Regimens containing ivermectin alone decreased the number of microfilariae significantly faster and more effectively for the first month after treatment than regimens containing DEC alone, but the latter were significantly more effective throughout the second year after treatment (1.7-8.2% of pretreatment levels with DEC vs. 12.6-30.8% with ivermectin during that period); the higher ivermectin dose showed a tendency towards more effectiveness than the lower dose. Most effective was the combination of ivermectin (20 micrograms/kg) followed 4 d later by DEC (6 mg/kg), with reduction of microfilaraemia to 2.4% of pretreatment levels at 2 years. Adverse reactions were well tolerated with all regimens, the reactions being significantly more generalized (i.e., fever) following ivermectin and localized (i.e., scrotal inflammatory nodules around dying adult worms) following DEC. Further trials of single-dose combination therapy vs. single high doses of ivermectin or DEC should determine the ideal regimen for treatment and control of Bancroftian Filariasis.
