ABSTRACT
Dans les pays intertropicaux; les filarioses posent de sante publique; touchant environ150 millions de sujets dans le monde. La Republique Centrafricaine; a l'instar des autres pays tropicaux; n'est pas epargnee par ce fleau. Deux types de filarioses font l'objet de preoccupation a cause de leurs consequences socio-economiques et medicales; la dracunculose et l'onchocercose .Deux programmes de lutte sont en cours d'execution mais toutes les regions ne sont pas entierement couvertes.les objectifs specifiques de ce travail prospectif qui a dure 5 mois etaient de determiner la prevalence des filarioses dans la capitale et etudier les profils epidemiologiques et les aspects cliniques des personnes atteintes dans les Arrondissements et quartiers de Bangui choisis au hasard. Les sujets jeunes de 15 a 44 ans etaient 266 sur les 323 sujets de l'etude; soit 82 ; 4. Le sexe masculin representaient 44.Le prurit etait present dans 87;6des cas ; la gale 31;4;les nodules 8; 7et les depigmentations des jambes ; 15 ;5des cas .La gale etaient surtout observee dans le septiemea arrondissement .Les microfilaires dermiques etaient retrouvees dans 36; 84des cas avec une predominance masculine (57 ;5) et le septieme Arrondissement etaient plus touche que les autres .Les microfilaires sanguine etaient retrouvees dans 15 ; 79des cas .Pour ces filarioses ; Bangui est une ville mesoendemique avec cependant une forte prevalence dans les quartiers proches du Fleuve
Subject(s)
Academic Medical Centers , Filariasis/epidemiology , Signs and SymptomsABSTRACT
Lymphatic filariasis is one of the most debilitating and stigmatizing tropical diseases and yet the most neglected and least catered for. However; of recent; the World Health Organisation (WHO) has obtained cooperation from leading drug-manufacturing companies to provide drugs to infected communities free of charge for purposes of mass treatment. The WHO strategy for elimination of this disease has two components; one of which involves mass treatment of the entire population at risk using once-yearly administration of single doses of two drugs given together. These are albendazole and diethylcarbamazine or ivermectin. Uganda is one of the beneficiary countries; and the treatment is intended to be carried out in the districts of katakwi and Lira. It would take 4-6 years of treatment to eradicate the disease
Subject(s)
Albendazole , Diethylcarbamazine , Filariasis , Health ServicesABSTRACT
"Clinical epidemiology is going to be the Discipline par excellence of the next century; if not the millennium. Coming as it does from one who has spent decades in clinical medicine and therapeutics; this is a bold statement. Clinical epidemiology answers the questions what? Where? How? When? Who? Why? And Which? In matters of health and disease. It is because these questions have come to be answered effectively with respect to bancroftian Filariasis that it has been included in the world's six ""potentially eradicable"" diseases. In his impressive Review Article on page (); Dr. Gyapong takes us through answers to these epidemiology questions [1]. Filariasis occurs in 38 African countries where the mere presence of a hydrocele affords ""a rapid diagnostic index"" for infection [2]; while the so-called ""filarial dance sign"" is known to be present in intrascrotal lymphatics of microfilaraemic patients [3]. That the social and economic consequences of filarial morbidity are enormous on community preventive measures. People must be told that the mosquito; not juju or other ""supernatural factors: [1] is the culprit. I am old enough to remember the ""Town council Man"" in colonial Gold Coast. He would visit every house assigned to him; enforcing environmental sanitation and destroying pools of water and mosquito breeding places. If but one cocoanut shell was found in the compound with water in it;whether or not it contained a mosquito larva; the head of the household was given summons to go to court and pay a fine. Came independence and the community also became independent of the ""Town Council Man"" with the result that there are infinitely more mosquitoes now in independent Ghana than there were in the colonial Gold Coast. ""The WHO""; it is widely held; ""will do it for us"". Today; a vaccine is awaited for most things while the insects flourish. Deal with mosquito; and both malaria and Filariasis will be dealt a death blow. Fortunately; ivermectin will reduce the parasitic reservoir from which transmission occurs; and diagnosis of subclinical cases no longer has to rely on blood sampling at night or on Diethyl Carbamazine provocation tests [4]; but is reliably achieved using finger prick to detect Og4C3 circulating antigens day or night [5;6]. Mosquito nets reduce nocturnal bites and hence incidence of both malaria and Filariasis. Doctors should keep long-term records and ascertain whether insecticide impregnanted nets lead to pesticide resistance or not. Spraying should never be abandoned as it had often been on the rumour that ""it does no good; and produces insecticide resistance"". These preventive measures are best supervised through decentralised programmes [1;7] and are most effectively conducted in the mother tongue of the community at the grassroots [8]. Local businessmen and market women should be encouraged to assist chiefs and community leaders in giving monthly prizes in environmental sanitation while public health experts chart the effect of such sanitation on morbidity of Filariasis and mortality from malaria. We should go back to the ""Sanitary Branch"" institutions of the colonial days[9] when clinical epidemiology did much to protect the health of the community. Central government should fund trips to Japan; Taiwan; Solomon Islands; South Korea and some parts of China [1] for African health workers to learn first hand how those communities managed to eradicate lymphatic Filariasis. Even with the current AIDS problem; I remain convinced that clinical epidemiology is the answer [10]. Vaccines have achieved much this century; but to ""wait for WHO to give us vaccines"" while we neglect ourselves and our environment is wholly irresponsible."
Subject(s)
Elephantiasis , Filariasis/epidemiologyABSTRACT
Les auteurs ont teste sur 150 adultes volontaires une mini-colonne echangeuse d'ions comparativement a la goutte epaisse dans le diagnostic des filarioses a microfilaires sanguicoles. L'analyse des 143 dossiers exploitables montre une sensibilite identique des deux techniques; mais que l'association des deux offre un gain de sensibilite de 60;5
Subject(s)
Filariasis/diagnosis , IonsABSTRACT
L'etude des filarioses est realisee dans trois villages proche du site prevu pour la construction d'un barrage sur la riviere Kadei (Cameroun oriental). La presence des microfilaires d'onchocerca volvulus est determinee par l'examen des biopsies cutanees. La prevalence parasitologique (37;9 pour cent) et les caracteristiques lesionnelles observees indiquent que l'onchocercose sevit dans la region au niveau de mesoendemie et se presente un facies de foret. Compte tenu de l'ecologie des vecteurs; cette etude d'impact montre que le barrage prevu ne devrait pas modifier d'une facon notable l'ecologie regionale et la transmission des filarioses dans la region
Subject(s)
Filariasis/epidemiology , Loiasis/epidemiology , Onchocerciasis/epidemiologyABSTRACT
Estudaram-se 342 pessoas internadas no Hospital Provincial de Pemba (HPP); Cabo delgado; sendo 41 positivos (12) para Wuchereria bancrofti; dos quais 4 tinham uma infeccao mista com mansonella perstans. Houve mais individuos do sexo masculino parasitados do que femininos; sendo as maiores prevalencias nos homens de 21 a 31 anos e nas mulheres de mais de 41 anos. Encontraram-se criancas de 1; 3 e 7 anos com microfilaremia. Das enfermarias; a Cirurgia foi onde se encontrou maior numero de individuos parasitados. As adenopatias foram significativamente mais frecuentes nos casos com microfilarias do que nos casos negativos; no entanto nao houve diferenca significativa para os hidroceles e pele espessada entre casos negativos e positivos. Foi maior a prevalencia de filaria em doentes provenientes de outras localidades do que naqueles que moravam na cidade de Pemba. / A filarial survey was carried out at the Provincial Hospital of Pemba; Cabo Delgado. Of 342 people studied; 41 (12) were microfilaria positive for Wuchereria bancrofti; and 4 of these had a mixed infection with Mansonella perstans. More men than women had parasites; the highest prevalence in men being among those between 21 and 30 years old; and in women among those over 41 years. Children as young as 1; 3 and 7 years old were also infected. The highest frequency of microfilaremia was found in patients interned in the Surgery ward. Adenopathy was more frequent in positive cases than in negative cases; but no statistical differences were found between positive and negative patients with hydrocoele and skin thickening. The prevalence of microfilaremic cases among persons who lived outside Pemba City was higher than among those living in the city