Efficacy of a single dose treatment of Wuchereria bancrofti microfilaria carriers with diethylcarbamazine in Matara, Sri Lanka.

OBJECTIVE: To test the efficacy of diethylcarbamazine DEC single dose regimen of 6 mg/kg body weight (bw) on a sample of Wuchereria bancrofti microfilaria (mf) carriers in Matara. DESIGN: 6 mg/kg bw DEC dose in 50 mg tablets given under direct observation to the subjects at 23.00 hours after pre-treatment blood collection for mf counts. Post-treatment mf counts were at 1, 2 weeks and 1, 3, 6, 12 months. SUBJECTS: 31 asymptomatic mf carriers, 14 males, age range 6 to 62 years. RESULTS: Treatment resulted in 89 to 97% success rate, 19 to 28% cure rates and 74 to 80% reduction in mf density. There was no difference statistically in the success rate and cure rate at 6 and 12 months. The effect of DEC treatment at 6 and 12 months compared by sex, age group and pre-treatment mf level showed no difference. 64.5% of the carriers treated had at least one mild adverse reaction. Rates of the common reactions were 41.9% fever, 22.6% headache and 16.1% joint pains. CONCLUSION: A new mass treatment program has been initiated by the national Antifilariasis Campaign using the single dose DEC 6 mg/kg bw regimen. The satisfactory reduction in mf density at 6 and 12 months following DEC single dose treatment we observed provides support for this program.

Sperm preparation and in utero insemination in the management of subfertility.

OBJECTIVE: To study the place of sperm preparation and in utero insemination in subfertile couples in whom ovulatory and tubal aetiological factors have been excluded or treated. DESIGN: A retrospective cohort study. SETTING: Diagnostic Seminology Laboratory, Galle. SUBJECTS AND METHODS: Patients (n = 325) who had in utero insemination (IUI) from September 1990 to June 1994 were studied retrospectively. All had stimulation of ovaries with clomiphene and the Insler score was used to confirm ovulation before IUI. Swim up, spin down and glass wool filtration techniques, and the Earl's balanced salt solution with human serum albumin were used for sperm preparation. MAIN OUTCOME MEASURES: Association between variables. RESULTS: Of the subjects 97(30%) had male factor, 79(24%) abnormal sperm-cervical mucous interaction and 41(13%) idiopathic subfertility. In 114(35%) the cause was not documented. The number of IUI attempts per subject ranged from 1 to 19 with a mean of 4.2 and SD 3.2. There were no significant difference in conception rates in relation to the different methods of sperm preparation or the underlying aetiological factor. CONCLUSION: Sperm preparation and in utero insemination are feasible in Galle and should be considered as an option in the treatment of subfertility.