ABSTRACT
Among helminthic infections of medical improtance; Mansonell perstans (M.perstans) hardly features; being generally considered a non-pathogen responsible for asymptomatic eosinophilia. However; during a screening exercise for trypanosomes in various villages of South-eastern Uganda in 1996; P.falciparum accounted for 35while M.persans was identified in 26of the 105 screened cases in Kirongo village; no case of trypanosomiasis was found in this village. Methods: In the process of screening; it was observed that two of the cases with M. persans had long standing symptoms of pains in the joints; bones and muscles; body weakness anfd vague headaches; some degree of anxiety was observed. One of the cases was bedridden by these symptoms. Physical assessment was generally unrevealing. However it was noted that these two cases had the highest numbers of microfilariae load; a course of oral levamesole 120mg twice daily for three days was tried and blood from a finger prick examined daily for microfilariae. Results: It was found that the microfilariae progressively became fewer and less motile during the course of therapy. By the fourth week blood was free from microfilariae and the cases were asymptomatic. A third case from another village was identified with similar symptoms and heavy microfilariae load and responded to a single oral dose of Ivermectin; 200 micrograms. kg body weight. Conclusion: Heavy loads of microfilaria M. perstans produce severe symptoms of muscle; joint and bone pains as well as headaches and anxiety; which respond to a course of Levamesole or Ivermectin