Urban Filariasis - Abstracts

Wuchereria bancrofti vespid, Immune response, Serum immune complexes diagnosis, Diethylcarbamazine (DEC), Wolbachia in filarial parasites, Interdigital skin lesions, Urban Filariasis, Doxycycline, mass drug administration program, Filarial Lymphedema Care, Detection of filarial parasites, Albendazole, research abstracts

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Urban Filariasis - Abstracts

Postby patoco » Fri Aug 04, 2006 2:36 pm

Urban Filariasis - Abstracts

Lymphedema People

http://www.lymphedemapeople

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When most people think of lymphatic filariasis, the images come to mind of rain forests, hot tropical jungles and sparlsey populated areas. The reality however, is that a significant number of those at risk for and that have filariasis live in densly populated areas stretching around the tropic climate band.

Here are some selected abstracts related to treeating and eliminating filariasis in urban centers.

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Situation analysis in a large urban area of India, prior to launching a programme of mass drug administrations to eliminate lymphatic filariasis.

Ann Trop Med Parasitol. 2005 Apr;99(3):243-52

Ramaiah KD, Vijay Kumar KN, Ravi R, Das PK.
Vector Control Research Centre (Indian Council of Medical Research), Medical Complex, Indira Nagar, Pondicherry - 605 006, India. ramaiahk@yahoo.com

The main strategy now adopted for the elimination of lymphatic filariasis (LF) is based on mass drug administrations (MDA). Annual administration of antifilarial drugs to 65%-80% of the population at risk of the disease is believed to be necessary if LF is to be eliminated, at least as a public-health problem, within a reasonable time-frame. To facilitate the development of drug-delivery strategies that are sufficient to ensure such high treatment coverages in large urban areas, a situation analysis was undertaken in the Indian city of Chennai. The subjects interviewed came from households with high, moderate, low or very low incomes. A lack of information on the prevalence and socio-economic impact of the disease meant that LF was not viewed as a major pubic-health problem in the study area, even though cases of elephantiasis and hydrocele were detected in 2%-8% and 7%-20% of the households investigated. Overall, 40% of the interviewees from very-low-income households and 78% of those from middle-income households knew that (the parasite causing) elephantiasis was transmitted by mosquitoes. Only 4% of the subjects from high-income areas and 1% of those from low-income areas were aware that filarial infection was a major cause of hydrocele. Most of the subjects (>55% of each of the four socio- economic groups considered) felt that they were not at risk of developing elephantiasis. When specifically asked, only 35% of the subjects from high-income households but 84% of those from low-income households said that they would be willing to consume tablets of an antifilarial drug (diethylcarbamazine) in MDA to eliminate LF. It is therefore unclear whether high-income households in urban areas should be included in MDA programmes.The interviewees felt that an intensive campaign of information, education, communication and advocacy would be necessary if an effective MDA-based programme were to be implemented. Drug distribution through the health services was the most preferred option.Clearly, factors such as a lack of appreciation of the socio-economic impact of LF, a general belief that the risk of elephantiasis is low, doubts about the need to include all sectors of the eligible population in MDA, and a common dependence on private practitioners make successful MDA against LF in urban areas a challenging task. On the positive side, however, an urban population is often covered by a huge network of colleges, private practitioners, non-governmental organizations and residents' associations, and such networks provide new opportunities in the development of effective drug-delivery strategies.

PMID: 15829134 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/entrez/quer ... s=15829134

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Situation analysis in a large urban area of India, prior to launching a programme of mass drug administrations to eliminate lymphatic filariasis.

Ramaiah KD, Vijay Kumar KN, Ravi R, Das PK.
Vector Control Research Centre (Indian Council of Medical Research), Medical Complex, Indira Nagar, Pondicherry - 605 006, India. ramaiahk@yahoo.com

The main strategy now adopted for the elimination of lymphatic filariasis (LF) is based on mass drug administrations (MDA). Annual administration of antifilarial drugs to 65%-80% of the population at risk of the disease is believed to be necessary if LF is to be eliminated, at least as a public-health problem, within a reasonable time-frame. To facilitate the development of drug-delivery strategies that are sufficient to ensure such high treatment coverages in large urban areas, a situation analysis was undertaken in the Indian city of Chennai. The subjects interviewed came from households with high, moderate, low or very low incomes. A lack of information on the prevalence and socio-economic impact of the disease meant that LF was not viewed as a major pubic-health problem in the study area, even though cases of elephantiasis and hydrocele were detected in 2%-8% and 7%-20% of the households investigated. Overall, 40% of the interviewees from very-low-income households and 78% of those from middle-income households knew that (the parasite causing) elephantiasis was transmitted by mosquitoes. Only 4% of the subjects from high-income areas and 1% of those from low-income areas were aware that filarial infection was a major cause of hydrocele. Most of the subjects (>55% of each of the four socio- economic groups considered) felt that they were not at risk of developing elephantiasis. When specifically asked, only 35% of the subjects from high-income households but 84% of those from low-income households said that they would be willing to consume tablets of an antifilarial drug (diethylcarbamazine) in MDA to eliminate LF. It is therefore unclear whether high-income households in urban areas should be included in MDA programmes.The interviewees felt that an intensive campaign of information, education, communication and advocacy would be necessary if an effective MDA-based programme were to be implemented. Drug distribution through the health services was the most preferred option.Clearly, factors such as a lack of appreciation of the socio-economic impact of LF, a general belief that the risk of elephantiasis is low, doubts about the need to include all sectors of the eligible population in MDA, and a common dependence on private practitioners make successful MDA against LF in urban areas a challenging task. On the positive side, however, an urban population is often covered by a huge network of colleges, private practitioners, non-governmental organizations and residents' associations, and such networks provide new opportunities in the development of effective drug-delivery strategies.

PMID: 15829134 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/entrez/quer ... med_docsum

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Relative abundance of Culex quinquefasciatus (Diptera: Culicidae) with reference to infection and infectivity rate from the rural and urban areas of East and West Godavari districts of Andhra Pradesh, India.

Dec 2002

Murty US, Sai KS, Kumar DV, Sriram K, Rao KM, Krishna D, Murty BS.
Bioinformatics Group (Biology Division), Indian Institute of Chemical Technology, Hyderabad, Andhra Pradesh, India. usnmurty@iict.ap.nic.in

This paper describes the seasonal abundance of Culex quinquefasciatus in the rural and urban areas of the East and West Godavari districts (EGDT and WGDT) of Andhra Pradesh, India. The per man-hour density (PMHD) was collected from seven units in EGDT and two units in WGDT, which comprised rural and urban areas. The highest infection and infectivity rates were found in the rural areas of Rajahmundry (43.6%) and Amalapuram (13.2%) respectively. In urban areas, the highest infection and infectivity rates were found in Rajahmundry: 7.5% and 3.6% respectively. There was considerable difference in the infection rate and infectivity rates between the rural areas and urban areas in each unit.

PMID: 12757213 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/entrez/quer ... med_docsum

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Urban lymphatic filariasis in central Nigeria.

Terranella A, Eigiege A, Gontor I, Dagwa P, Damishi S, Miri E, Blackburn B, McFarland D, Zingeser J, Jinadu MY, Richards FO.
Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322, USA. ajterra10@hotmail.com

Wuchereria bancrofti and the other mosquito-borne parasites that cause human lymphatic filariasis (LF) infect over 120 million people world-wide. Global efforts are underway to stop transmission of the parasites, using annual, single-dose mass drug administrations (MDA) to all at-risk populations. Although most MDA to date have been in rural settings, they are also recommended in urban areas of transmission. It remains unclear whether there is significant urban transmission in West Africa, however, and the need for urban MDA in this region therefore remains a matter of debate.Clinic-based surveillance, for the clinical manifestations of LF, has now been used to identify areas of urban transmission of W. bancrofti in Jos, the major urban population centre of Plateau state, Nigeria. The eight clinics investigated were all located in slum areas, close to vector breeding sites, and were therefore considered to serve at-risk populations. Over a 1-month period, selected providers in these clinics sought hydrocele, lymphoedema, elephantiasis, or acute adenolymphangitis among the patients seeking treatment. The consenting patients who were suspected clinical cases of LF, and a cohort of patients suspected to be cases of onchocerciasis, were tested for W. bancrofti antigenaemia. All the patients were asked a series of questions in an attempt to determine if those found antigenaemic could only have been infected in an urban area. During the study, 30 suspected clinical cases of LF were detected and 18 of these (including two patients who were found to be antigenaemic) lived in urban areas. Of the 98 patients with exclusively urban exposure who were tested for filarial antigenaemia, six (6.1%) were found antigenaemic. Clinic-based surveillance appears to be a useful tool for determining if there is W. bancrofti transmission in an urban setting.

PMID: 16492364 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/entrez/quer ... med_DocSum

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Determination of the prevalence of lymphatic filariasis among migrant workers in Kuwait by detecting circulating filarial antigen.

April 2006

Iqbal J, Sher A.
Department of Microbiology, Faculty of Medicine, Kuwait University, PO Box 24923, Safat 13110, Kuwait. iqbal@hsc.edu.kw

The main objective of this study was to determine the prevalence of filarial infection among migrant workers in Kuwait. The study was conducted from April 2000 to November 2003. A total of 1050 migrant workers (>90 % from the Indian subcontinent) from filarial endemic countries and 260 individuals residing in Kuwait as controls (50 healthy Kuwaiti blood donors, 50 microfilaria-negative individuals from endemic areas and 160 patients with other parasitic infections) were screened for filarial infection. All specimens were tested for microfilaraemia by microscopy of nucleopore-filtered blood (NFB) and detection of circulating filarial antigen (CFA) by an immunochromatographic test (ICT) and the TropBio assay. The overall prevalence of filarial antigenaemia was 18.3 % (192 individuals) using the ICT and 20.3 % (213 individuals) using the TropBio assay. Thirty-two cases (3 %) of Wuchereria bancrofti were detected by microscopy and the mean microfilaria count in these cases was 816 microfilariae ml(-1). CFA was detected only in two of the 260 control subjects. Statistical analysis to calculate the sensitivity, specificity and prevalence of infection was carried out using maximum-likelihood statistical methods. The overall sensitivity and specificity of the ICT and TropBio assay to detect CFA were comparable. Compared with NFB microscopy, the sensitivity of the ICT was 93.8 % and specificity ranged from 84 to 100 %. The sensitivity and specificity of the TropBio assay were 90.1 and 100 %, respectively. However, the ICT failed to detect CFA in two cases with a microfilarial load of <20 microfilariae ml(-1). In conclusion, the prevalence of filarial infection among the migrant workers in Kuwait was 18.3 % as determined by the ICT.

PMID: 16533987 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/entrez/quer ... med_DocSum

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Natural vectors of dirofilariasis in rural and urban areas of the Tuscan region, central Italy.

May 2006

Cancrini G, Magi M, Gabrielli S, Arispici M, Tolari F, Dell'Omodarme M, Prati MC.

Dipartimento di Scienze di Sanita Pubblica, Universita La Sapienza di Roma, Italy.

Entomological investigations by means of dog- and human-baited traps were carried out in summers 2000-2002 in urban and rural areas of the Tuscan region in central Italy. The aim of the study was to define the mosquito species involved in the transmission of Dirofilaria nematodes and to assess the risk that their presence might represent for animal and human health. Nocturnal fieldwork on host-seeking activity and feeding preferences was followed by microscopic identification of the mosquito species attracted and by molecular identification of Dirofilaria parasites in mosquitoes. In total, 3,611 mosquito females belonging to 12 species, largely represented by Culex pipiens L. and Aedes caspius (Pallas), were caught. Some females of each species collected fed on the dogs, indicating their possible role as an intermediate host, but filarial DNA was found only in Cx. pipiens, Anopheles maculipennis s.l. (Meigen), and Coquillettidia richiardii (Ficalbi). In rural environments, the DNA evidence indicated the presence of infective larvae of Dirofilaria immitis, whereas in urban areas, infective larvae of Dirofilaria repens were present. The role of Cx. pipiens as a vector for heartworm disease and subcutaneous infections in natural and artificial environments was confirmed, whereas Ae. caspius seemed refractory to the infection. The different role of the collected species is discussed. The vector competence of An. maculipennis and Cq. richiardii needs further investigation, because the importance of these species poorly represented, and the role of species such as Aedes albopictus (Skuse), characterized by a dominant diurnal activity pattern, has to be evaluated.

PMID: 16739418 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/entrez/quer ... med_docsum

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Aedes albopictus is a natural vector of Dirofilaria immitis in Italy.

Dec 2003

Cancrini G, Frangipane di Regalbono A, Ricci I, Tessarin C, Gabrielli S, Pietrobelli M.
Dipartimento di Scienze di Sanita Pubblica, Sez. Parassitologia, Universita "La Sapienza", P. le Aldo Moro 2, 00185 Rome, Italy. gabriella.cancrini@uniromal.it

Investigations were carried out in Padova town (Veneto region, NE Italy) to define the actual role of Aedes albopictus in the natural transmission of Dirofilaria nematodes, and to assess the risk that its presence might represent for veterinary and medical health. During summer 2000-2002 daytime captures of human-attracted mosquitoes were carried out in three areas of the town. The presence of filarial parasites in mosquitoes was evaluated by PCR, and sequencing confirmed species assessment. DNA extraction was performed separately on pools of the insect abdomen and thorax-head, to discriminate between Dirofilaria infected/infective specimens. A total of 2721 mosquitoes were caught and A. albopictus was the most abundant species (2534). Filarial DNA was found in 27.5% (19/69) of the abdomen pools formed with mosquitoes collected in summer 2000, and in 11.1% (16/144) and 4.9% (6/123) thorax-head pools coming from samplings 2001 and 2002, respectively. Filarial DNA was belonging to D. immitis and all studied areas harboured infective specimens. These results prove A. albopictus as natural vector of D. immitis in Italy. Moreover, they support the hypothesis that the presence of the mosquito could affect the transmission pattern of canine heartworm disease in urban environment and, considering the aggressive anthropophylic behaviour of the species (30-48 bites/h) proven in Padova town, could enhance the circulation of filarial nematodes from animals to humans.

PMID: 14729167 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/entrez/quer ... med_docsum

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Bancroftian filariasis in urban areas of Alagoas State, Northeast Brazil: study in the general population

da Rocha EM, Fontes G, Brito AC, Silva TR, Medeiros Z, Antunes CM.
Departamento de Patologia, Centro de Ciencias Biologicas, Universidade Federal de Alagoas, Maceio, AL, Brazil. emmr@fapeal.br

In order to assess the present status of lymphatic filariasis in Alagoas State, Brazil, hemoscopic surveys were carried out in the human population of the three different physiographic regions of the State. Blood samples were collected by thick smear technique taken after 10:00 p.m. From a total of 101 cities of the State, 10 were randomly selected, Bancroftian filariasis was only found in Maceio, the capital of Alagoas State. In a cross-sectional survey conducted among the general population of 4 neighborhoods in the city, 10,973 individuals were examined, 226 were microfilaraemic with prevalence in the city neighborhoods ranging from 0 to 5.4%. Prevalence rates and microfilariae density were significantly higher in males. Among the examined inhabitants born out of Maceio, microfilariae carriers had lived a significantly longer time in endemic areas than the amicrofilaraemic subjects. Based on the data obtained in the present study, measures to avoid expansion of bancroftian filariasis in the region were established.

Full Text Article

http://www.scielo.br/scielo.php?script= ... en&nrm=iso

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Bancroftian filariasis in two urban areas of Recife, Brazil: pre-control observations on infection and disease.

Albuquerque MF, Marzochi MC, Sabroza PC, Braga MC, Padilha T, Silva MC, Silva MR, Schindler HC, Maciel MA, Souza W, et al.
Centro de Pesquisas Aggeu Magalhaes, Fundacao Oswaldo Cruz, Universidade Federal de Pernambuco, Recife, Brazil.

Bancroftian filariasis is a major public health problem in the city of Recife in north-eastern Brazil. In some of its urban areas microfilaraemia prevalence reaches 14%. This study describes epidemiological characteristics, infection and disease, in 2 urban areas, Coque and Mustardinha, before control measures were applied. The parasitological survey was performed by a 'door-to-door' census covering 5563 subjects, aged between 5 and 65 years. Microfilaraemia was detected by the thick drop technique, using 45 microL of peripheral blood collected between 20:00 and 24:00. In both areas the prevalence of microfilaraemia was 10%, and males had higher prevalences of infection and disease than females. The prevalence of microfilaraemia was higher in the 15-24 and 25-34 years age groups in both sexes. Most microfilaria (mf) carriers (72.1% in Coque and 79.7% in Mustadrinha) had mf densities < 100/60 microL of blood. Females of reproductive age had significantly lower mf densities than males. The overall disease prevalence in both areas was 6.3%. Amongst the subjects who presented with chronic disease 15.7% were microfilaraemic. Chronic disease prevalence increased from 1.4% in the 5-14 years age group to 11.3% in the oldest age group. The most frequent clinical manifestation was hydrocele (5.4%), followed by lymphoedema (1.8%). The epidemiological pattern of filariasis in the populations studied was marked by high prevalence of microfilaraemia, low mf density, and relatively low prevalence of filarial disease considering the level of endemicity.

PMID: 7570866 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/entrez/quer ... ds=7570866
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