Evaluation of fuadin therapy in schistosomiasis japonica

Treatment with Fuadin was tried in 2,407 patients who were found positive for Schistosoma japonicum ova on stool examination. These patients represented both sexes of all ages ranging from 5 to 50 years. Only 1,135 were able to complete one course of 40 cc. given intramuscularly in nine injections. Of this number, 1,083 were followed-up during and after treatmentAt the end of one course, 847 or 78.21% ceased to pass viable ova; 236 or 21.79% were still positive on stool examination . Of these 236 patients, 62 continued to receive additional injections until all became negative. Taken together, 909 or 83.91% no longer passed ova in the stool at the end of treatmentOnly 334 out of 909 were followed-up one month after completing treatment, and 34 or 9.28% were again positive for eggs. These cases were considered relapses or treatment failures rather than re-infectionsToxic reactions appeared in 63.3% (718) of the 1,135 patients, the most common of which were nausea, vomiting, and anorexia, general body weakness, headache, joint pains, and fever. Despite these reactions, the whole course of nine injections was continued in the 1,135 patients by simply prolonging the interval of injection as long as the toxic reactions were still present. (Summary)

Serological studies in El tor cholera

Three test were utilized, namely agglutination, vibriocidal and the hemolysis-inhibition tests in determining the serological responses of 161 immunized individuals in this study. Three vaccines were given in different dosage regimen - El Tor, mixed El tor and cholera , and classical cholera vaccines. Higher agglutinative and vibriocidal antibody titers were obtained among those immunized with two or three doses of El Tor vaccine than with the other two types of vaccines. The agglutinating antibody response to classical Inaba and Ogawa challenge by those given the El tor vaccine was even higher than those that received classical cholera vaccine. Antibodies to both classical and El Tor strains of cholera vaccine but to a lesser degree than by either the pure El Tor or the mixed vaccine. These differences in percentage with rise in agglutinative titer were found significant by statistical analysisIt was further obseved that the reduction in vibriocidal antibody titer was not as marked as in the agglutinative antibody titer 6 months after primary immunization. It is of special interest and utmost importance to note that the usual single 1 cc. adult dose given as a booster 6 months after the primary immunization failed to produce sufficient agglutinative antibodies and on this basis it is felt that the double regimen should instead be preferred. (Summary)

The use of Nalidixic acid in public health

From the above study, it is quite evident that nalidixic acid has been successfully used for Salmonellosis other than S typhi, for Shigellosis and for gastroenteritis due to Edwardsiella tarda. The advantage is the shorter course of treatment which is of paramount importance in public health. While at the start of the trials we tried to follow the 2 tablets four times a day administration can be very effective and without untoward symptoms as dizziness. This was well demonstrated in the control of Shigellosis in Bataan. It has to be mentioned that the patients who complained of dizziness were all those with diarrhea. It is envisioned that in future trials, we will use the drug at 2 tablets four times a day during the first 24 hours then reduce the dose to 1 tablet four times a day for the rest of the course. This is the first time that nalidixic acid has been used in specific enteric infections in the Philippines. The practitioner has now an antimicrobial which he can use for enteric infections and effect a cure in a shorter time than other antimicrobials.(Summary)

AIDS in the Philippines: how much has it spread, what has been done, what lies ahead?

A total of 50 HIV carriers, 46 of them female prostitutes, have been detected through seroprevalence surveys of the Department of Health. Infection rate are highest in 2 cities near US military bases. Seven (7) frank AIDS cases who contracted the disease outside the country have been reported . Public information measures have heavily relied on mass media and there is anecdotal evidence that awareness of the disease among the urban population is increasing. The National AIDS Committee foresees that a large number of cases seen in the Philippines in the next few years will be in returning nationals who where infected abroad. (Auth)

The need for technical controls as an integral part in the management of medical diagnostic laboratories

For the first time a study was conducted to find out if there is actually a need to employ technical controls as an integral part in the management of diagnostic laboratories. The study involved biochemical, serological, parasitological and bacteriological units. While reproducibility was looked into in biochemical units, accuracy was studied in the other units. While it is presumed that internal controls exist in the units, the study brought out that they are not sensitive enough to detect changes which need appropriate remedial measures. It brought out variability of performance among workers and among laboratories. It showed also that an interlaboratory control can serve as an intralaboratory control. The acceptance of the need for controls will depend much on the inherent personal attitudes of the worker, the supervisor and the head of the laboratory. The proper attitude is necessary for its acceptance and implementation. Management of our diagnostic laboratories cannot be any different from management of a private firm where in the latter the manager controls the work for which he is accountable. (Summary)

Capillariasis philippinensis: a fish-borne parasitic zoonosis.

Fish from lagoons in Northern Luzon, Philippines, have been shown experimentally to be intermediate hosts of Capillaria philippinensis. Eggs ingested by the fish hatch in the intestines and the larvae double in size in 3 weeks. When fed to monkeys, Mongolian gerbils and birds, the larvae develop into adults and reproduce. Fish from the lagoons or purchased from the market were fed to gerbils and the animals developed patent infections, demonstrating natural transmission of the parasite. Philippine and Thailand populations have the habit of eating uncooked freshwater and brackish water fish and some have been experimentally infected with C. philippinensis. These countries report the largest number of cases of intestinal capillariasis. Fish-eating birds are now considered natural hosts for the parasite, fish the intermediate hosts, and humans accidentally become infected by eating infected fish.

HIV-1 seropositive women in the Philippines: pregnancy outcome and perinatal transmission of HIV-1.

Annual surveillance studies were initiated in 1985 to determine the incidence and prevalence of HIV-1 infection in female prostitutes registered through the Social Hygiene Clinic System of the Philippine Department of Health. All of the confirmed HIV-1 seropositive women detected in the above surveys who could be contacted were followed up about every three months to monitor their clinical and immunological status. Since we regularly interviewed and examined these HIV-1 seropositive women, we were able to note the occurrence of pregnancies following HIV diagnosis. By September 1990, 54 HIV-1 seropositive women (aged 18-35) detected from the above surveys had been interviewed and examined. Twenty-six of these HIV-1 positive women had a total of 37 pregnancies. Eight were pregnant at the time of HIV diagnosis: three term deliveries, one premature delivery (PD) at eight months, three abortions, and one lost to follow-up while still pregnant. Five of these eight had repeat pregnancies: two term deliveries, two abortions, and one lost to follow-up while pregnant. Eighteen other women became pregnant one or more times after HIV diagnosis: seven term deliveries, 13 abortions, two PDs, one ectopic pregnancy terminated, one currently pregnant, and one lost to follow-up during pregnancy. There was no clear indication from clinical examinations and CD4+ cell counts that pregnancy exacerbated the course of HIV-1 related disease in these women. One of the 12 term infants has died and eight have developed non-specific findings that are suggestive but not diagnostic of HIV infection.2+ strongly seropositive by both ELISA and Western blot assay at 16 months.

Sexual behavior of Filipino female prostitutes after diagnosis of HIV infection.

A study of female prostitutes in Manila who tested positive for human immunodeficiency virus (HIV) antibody ascertained demographic and sexual behavior information following diagnosis. Counselling alone did not appear to have a major impact on the sexual behavior of the HIV positive women since most continued to work as prostitutes. Switching from high risk to low risk jobs in bars is not effective in preventing HIV positive women from engaging in prostitution. Revoking work permits is only effective if enforced with adequate follow up. Alternative job training programs may offer a viable approach.

Albendazole in the treatment of intestinal capillariasis.

Albendazole or Zentel a benzimidazole derivative, was used to treat intestinal capillariasis in hospitalized patients seen in Northern Luzon in the Philippines. In initial studies, four patients responded satisfactorily to the drug in dosages of 400 mg/day in divided doses for 20 days. This is the same dosage used for mebendazole, which has been the drug of choice in treating the parasitosis. In further studies, 16 patients with Capillaria philippinensis, were treated with 400 mg/day of the drug for 10 days, and 15 were completely cured. The one treatment failure was found to be passing eggs of the parasite three months later, and was retreated with the standard mebendazole regimen of 400 mg/day for 20 days. Side effects attributed to albendazole were not reported in any of the patients. Albendazole, 400 mg/day in two divided doses, is now the recommended drug of choice in Northern Luzon in the Philippines.

Prevalence of Trichomonas vaginalis in some Filipino women.

Vaginal specimens obtained from 1,284 hospitality girls and 87 expectant mothers were examined for Trichomonas vaginalis by first examining material collected from vaginal swabs and after incubation in Feinberg and Whittington culture medium. Twenty-four percent of the specimens examined, shortly after the cotton-tip swab was placed into 1 ml culture medium, were positive by direct microscopic examination and 37% positive following 3 to 5 days incubation at 37 degrees C. Only 3 of the specimens from mothers were positive after the first examination and 4 positive after culture. These high prevalence rates are expected among hospitality girls and are the highest rates thus far reported from the Philippines. These results provide convincing evidence of the value of using cultural methods in determining prevalence rates for Trichomonas vaginalis infections in females.

Studies on Echinostoma ilocanum in the Philippines.

Echinostoma ilocanum is widespread among the Philippine Islands but only 3% of over 30,000 stools were found to be positive for eggs. The prevalence rates were highest in Ilocana populations of northern Luzon; 11% of over 7,000 stools examined, however, rates as high as 44% were found. Pila luzonica is eaten uncooked by some people and metacercariae from these snails developed into adults in a number of laboratory animals. Rats, mice and hamsters were the most susceptible with patent infections developing as early as 7 days and lasting for 328 days. There seems to be little disease in humans and animals infected with this parasite.

Leptospirosis in the Philippines.

Leptospirosis was first isolated in the Philippines from one of the human cases of Weil's Disease in 1932 and from then up to 1970 a total of 65 cases were studied sporadically. From 1971 up to 1973 a total of 390 cases were studied out of which 82 (21.02%) were found positive by isolation and serological examination. An outbreak of leptospirosis was followed up from 1976 to 1983 in a penal farm in Sablayan, Mindoro. At the time of the outbreak, 31% of the sera from patients and those with complaints reacted to one or more antigen pools with 40% of these reactors reacting to only one antigen pool. Only one percent of prisoners and residents without complaints reacted to one or more antigen pools, with 80% of these reactors reacting to pool 3 alone. Three and half years later, a first follow-up was done in which 9.07% reacted to one or more pools. Of these, 42% reacted to pool 2 and 82% to pool 3 alone or in combination with other pool. Ninety five percent of those reacting to Pool 2 reacted to L. pyrogenes and 88% of those that reacted to Pool 3 reacted to L. autumnalis. More than three years later after the first follow-up, a second follow up was done. This time 2.29% reacted to one or more pools. Most reacted specifically to L. autumnalis. The residents outside the penal farm were all non-reactive. Sampling from another penal colony and in four agricultural areas revealed no significant reactivity.(ABSTRACT TRUNCATED AT 250 WORDS)

Attempts to modify treatment of intestinal capillariasis.

Attempts to reduce the standard treatment of intestinal capillariasis of 200 mg mebendazole twice daily for 20 days were not successful. Two of 13 patients given mebendazole at single daily dosages of 500 mg per day for 16 days relapsed 3 to 6 months after treatment. Attempts to reduce the treatment to 14 days were even less satisfactory in that 4 of 8 patients treated experienced relapses 2 to 9 months later. Since intestinal capillariasis can be fatal it is recommended to continue the use of the standard schedule of 400 mg mebendazole daily for 20 days for new cases and 30 days for relapsed cases until a more effective drug is available.

Additional isolations of Japanese encephalitis virus from the Philippines.

Japanese encephalitis virus was isolated from Culex tritaeniorhynchus, Culex bitaenorhynchus and Anopheles annularis mosquitoes collected from San Jose, Nueva Ecija, South Central Luzon in the Philippines. This is the second report of the isolation of the virus from mosquitoes in the Philippine Islands.

Biomedical survey in North Samar Province, Philippine Islands.

A biomedical survey was carried out in North Samar Province, Philipines to update information on the prevalence of parasitic and other infectious diseases. A total of 1,394 stool specimens, 1,859 blood smears and 1,274 sera were collected from persons living in 8 barrios. Stools were examined for intestinal parasites, bloods smears for malaria and filariasis and sera tested for antibodies to Schistosoma japonicum, Entamoeba histolytica, Toxoplasma gondii, influenza A and B, and Japanese encephalitis virus. The prevalence rates for intestinal parasites were: Trichuris trichiura 90%, Ascaris lumbricoides 78%, hookworm 65%, Schistosoma japonicum 15%, Strongyloides stercoralis 1%, Entamoeba coli 16%, Endolimax nana 6%, entamoeba histolytica 5%, Giardia lamblia 3%, Entaemoeba hartmanii 1%, Chilomastix mesnili 1%. No malaria was found but microfilariae of Wuchereria bancrofti were detected in 4% of the blood smears; the MfD50 was 12.9. The circumoval precipitin test (COPT) was used to detect antibodies to Schistosoma japonicum and 65% of 994 sera was considered positive. The indirect hemagglutination test (IHA) was used for detecting antibodies to Entamoeba histolytica and Toxoplasma gondii and 5% and 3% of 1,274 sera tested were positive at titers equal to or greater than 1:128 and 1:256, respectively. Hemagglutination inhibition tests (HI) were used to detect antibodies to Influenza A2HK68, Influenza A2HK68, Influenza B2T62 and Japanese encephalitis virus and 72%, 12% and 78%, respectively, of 1201 sera were considered positive at titers equal to or greater than 1:20.