Atividade locomotora de Culex quinquefasciatus (Diptera: Culicidae) em condições de laboratório / Locomotor activity of Culex quinquefasciatus (Diptera: Culicidae) under laboratory conditions

Ritmos biológicos de insetos vetores têm sido estudados com o objetivo de melhor compreender seus comportamentos e traçar estratégias de controle mais eficientes para reduzir a disseminação de patógenos. Culex quinquefasciatus possui competência vetorial para diversos patógenos de importância médica, como a filária causadora da Filariose Bancroftiana e o arbovírus West Nile (WNV). O presente trabalho tem como objetivo estudar a atividade locomotora de Cx. quinquefasciatus em diferentes condições fisiológicas, comparando machos, fêmeas virgens, fêmeas inseminadas, fêmeas alimentadas com sangue e fêmeas inseminadas e alimentadas com sangue. Além disso, comparamos a atividade locomotora de fêmeas inseminadas por cópula com machos com a de fêmeas inseminadas a partir da inoculação intratorácica de extrato de glândulas acessórias de seus machos coespecíficos. Nossos resultados mostraram que a atividade locomotora de machos e fêmeas de Cx. quinquefasciatus é noturna, com pico pronunciado no apagar das luzes. Observamos que tanto as fêmeas virgens quanto as inseminadas, após alimentação sanguínea, apresentam redução da atividade locomotora durante a escotofase em comparação com os demais grupos, especialmente as inseminadas e alimentadas com sangue. Em contrapartida, as fêmeas inseminadas e não alimentadas apresentaram aumento significativo na atividade locomotora durante a escotofase em comparação aos demais grupos. Ao compararmos os grupos de fêmeas não injetadas - virgens e inseminadas - com os grupos das fêmeas injetadas, observamos que estas apresentaram menor atividade locomotora do que aquelas. Entre as não injetadas, fêmeas inseminadas apresentaram maior atividade locomotora do que as virgens, enquanto, entre os grupos das injetadas, as fêmeas virgens inoculadas com glândulas acessórias de machos coespecíficos apresentaram maior atividade do que as inseminadas injetadas com solução salina. Esse estudo fornece importantes informações acerca da atividade locomotora dessa espécie, que podem ajudar na compreensão da dinâmica de transmissão de patógenos, direcionar novas pesquisas, além de auxiliar na elaboração de estratégias de vigilância e controles.

Biological rhythms of insect vectors have been studied for better understanding their behavior and designing more efficient control strategies to reduce the spread of pathogens. Culex quinquefasciatus has vector competence for several pathogens of medical importance, such as the filaria that causes Bancroftian Filariasis and the West Nile arbovirus (WNV). The present study aims to evaluate the locomotor activity of Cx. quinquefasciatus in different physiological conditions, comparing males, virgin females, inseminated females, blood-fed females and inseminated and blood-fed females. In addition, we compared the locomotor activity of females inseminated by mating with males with that of females inseminated by intrathoracic inoculation of accessory gland extract from their conspecific males. Our results showed that the locomotor activity of males and females of Cx. quinquefasciatus is nocturnal, with a pronounced peak at the lights-off. We observed that both virgin and inseminated females, after blood feeding, showed reduced locomotor activity during scotophase compared to the other groups, especially inseminated and blood fed females. In contrast, inseminated and unfed females showed a significant increase in locomotor activity during scotophase compared to the other groups. When comparing the groups of non-injected females - virgin and inseminated - with the groups of injected females, we observed that the latter showed lower locomotor activity than the former. Among non-injected females, inseminated females showed greater locomotor activity than virgin ones, whereas, among injected groups, virgin females inoculated with accessory glands from conspecific males showed greater activity than inseminated females injected with saline solution. This study provides important information about the locomotor activity of this species, which can help in understanding the dynamics of pathogen transmission, direct new research, and help in the development of surveillance and control strategies.

Las TICs aplicada a la salud mental comunitaria y enfermedades endémicas / ICTs applied to community mental health and endemic diseases

Las enfermedades tropicales desatendidas suelen presentar una evolución crónica y se caracterizan por producir discapacidad física y mental a quienes las padecen, siendo asociadas a la estigmatización social. Se realizó un estudio descriptivo en 182 pacientes con enfermedades tropicales en regiones endémicas para leishmania, enfermedad de Chagas, filariasis linfática, oncocercosis, dengue y parasitosis intestinales; con el fin de evaluar la salud mental comunitaria, aplicando las tecnologias de información y comunicación (TIC), mediante el uso de telefónos móviles y telefonía fija. Se aplicó una encuesta para valorar el conocimiento y disposición de los pacientes respecto a las TIC, se valoró la salud mental calificada y la percibida por los pacientes mediante una escala de Likert. A partir de la calificación de la salud mental comunitaria se asociaron los estigmas sobre las enfermedades endémicas y luego se aplicó una encuesta para conocer la percepción de los pacientes, respecto a la influencia de los estigmas en la salud mental comunitaria. La mayor proporción de los participantes coincidieron en ser evaluados por parte del personal de salud, mediante herramientas de TIC y manifestaron tener problemas emocionales. Asimismo, el rechazo social como las secuelas de la enfermedad resultaron ser las manifestaciones más frecuentes de los participantes. En conclusión, el empleo de las TIC, en el área de salud mental comunitaria, supone un avance importante en el intercambio de información entre terapeutas y pacientes con enfermedades tropicales desatendidas, contribuyendo a disminuir el estigma social al que se ven sometidos y reestablecer su bienestar mental(AU)

Neglected tropical diseases usually present a chronic evolution and are characterized by causing physical and mental disability to those who suffer from them, being associated with social stigmatization. A descriptive study was carried out in 182 patients with tropical diseases in endemic regions for leishmania, Chagas disease, lymphatic filariasis, onchocerciasis, dengue and intestinal parasites; in order to assess community mental health, applying information and communication technologies (ICT), through the use of mobile phones and landlines. A survey was applied to assess the knowledge and disposition of the patients regarding ICT, the qualified mental health and that perceived by the patients was assessed using a Likert scale. From the qualification of community mental health, stigmas about endemic diseases were associated and then a survey was applied to know the perception of patients regarding the influence of stigmas in community mental health. The largest proportion of the participants agreed to be evaluated by health personnel, using ICT tools, and reported having emotional problems. Likewise, social rejection as the sequelae of the disease turned out to be the most frequent manifestations of the participants. In conclusion, the use of ICTs in the area of community mental health represents an important advance in the exchange of information between therapists and patients with neglected tropical diseases, helping to reduce the social stigma to which they are subjected and reestablish their mental health(AU)

Avaliação do kit Filaria Deteção; IgG4 produzido com o antígeno recombinante Wb123 para diagnóstico da filariose linfática no Brasil / Evaluation of the Filaria Detection; IgG4 kit employing recombinant Wb123 antigen for diagnosis of lymphatic filariasis in Brazil / Evaluación de pruebas de anticuerpos antifiláricos IgG4, fabricado con el antígeno recombinante Wb123, para el diagnóstico de la filariasis linfática en Brasil

RESUMO O Plano Global de Eliminação da Filariose Linfática, lançado pela Organização Mundial da Saúde em 2000, propõe o uso de testes de detecção de antígeno circulante filarial como ferramenta diagnóstica para avaliação e monitoramento das ações de controle da parasitose. Entretanto, esses testes, apesar de apresentarem alta sensibilidade, não conseguem detectar com eficiência a infecção em seu estágio inicial, quando ainda não existe a presença de helmintos adultos. Considerando essa limitação, a pesquisa de anticorpos antifilariais tem sido apontada como uma alternativa, uma vez que os anticorpos produzidos contra as larvas infectantes do parasito são detectados antes da presença de antígeno circulante filarial. O objetivo deste estudo foi definir o ponto de corte e avaliar a acurácia do kit Filaria Detect™ IgG4 produzido com o antígeno recombinante Wb123 para diagnóstico da filariose linfática no Brasil. Para isso, foi realizado um estudo de avaliação de teste diagnóstico, no qual foram utilizadas 256 amostras de soro: 79 (30,9%) obtidas de indivíduos microfilarêmicos e 177 (60,1%), de indivíduos amicrofilarêmicos e que testaram negativo para os testes imunológicos Bm14 CELISA e Og4C3 ELISA. A definição do ponto de corte ideal, bem como da acurácia do kit Filaria Detect™ IgG4, foi obtida através da construção de curvas ROC, sendo a densidade óptica de 0,239 aquela na qual o teste obteve melhor desempenho, com sensibilidade de 81,0% e especificidade de 96,6%. Os resultados obtidos demonstraram que o kit Filaria Detect™ IgG4 é uma ferramenta promissora para investigação e monitoramento de áreas submetidas ao tratamento em massa para filariose linfática.

ABSTRACT The Global Programme to Eliminate Lymphatic Filariasis, launched by the World Health Organization in the year 2000, proposes the use of circulating filarial antigen tests as a diagnostic tool to assess and monitor initiatives to control filarial infection. However, despite a high sensitivity, these tests are not efficient to detect infection at early stages, before worms have reached the adult stage. Considering this limitation, anti-filarial antibody testing has been suggested as an alternative, given that the antibodies produced against the larvae are detectable before the presence of circulating filarial antigen. The objective of the present study was to determine the diagnostic cut-off and the accuracy of the Filaria Detect™ IgG4 kit employing recombinant Wb123 antigen for diagnosis of lymphatic filariasis in Brazil. For that, we performed a diagnostic evaluation study in which 256 serum samples were analyzed: 79 (30.9%) obtained from microfilaremic individuals and 177 (60.1%) from amicrofilaremic individuals who tested negative with the Bm14 CELISA and Og4C3 ELISA immunologic tests. The ideal cutoff as well as the Filaria Detect™ IgG4 kit accuracy were determined based on ROC curve analyses, with an optical density of 0.239 identified as the cutoff with the best performance, with 81.0% sensitivity and 96.6% specificity. The results show that the Filaria Detect™ IgG4 kit is a promising tool for investigation and monitoring of areas undergoing mass drug administration for lymphatic filariasis.

RESUMEN En el programa mundial de eliminación de la filariasis linfática, puesto en marcha por la Organización Mundial de la Salud en el año 2000, se propone el uso de pruebas de detección del antígeno filárico circulante como instrumento de diagnóstico para la evaluación y el seguimiento de las medidas de control de la parasitosis. Sin embargo, esas pruebas, a pesar de tener un alto grado de sensibilidad, no permiten detectar con eficiencia la infección en su fase inicial, cuando todavía no existen helmintos adultos. En vista de esa limitación, se ha señalado como una opción el estudio de anticuerpos antifiláricos, puesto que los anticuerpos producidos contra las larvas infectantes del parásito se detectan antes de la existencia de antígeno filárico circulante. El objetivo de este estudio fue definir el punto de corte y evaluar la exactitud del estuche Detect™ para pruebas de anticuerpos antifiláricos IgG4, fabricado con el antígeno recombinante Wb123, para el diagnóstico de la filariasis linfática en Brasil. Para ello, se realizó un estudio de evaluación de la prueba diagnóstica, en el cual se utilizaron 256 muestras de suero, a saber, 79 (30,9%) obtenidas de personas microfilarémicas y 177 (60,1%) de personas amicrofilarémicas, que arrojaron resultados seronegativos en las pruebas inmunológicas CELISA Bm14 y ELISA Og4C3. La definición del punto de corte ideal y de la exactitud del estuche Detect™ se obtuvo con la construcción de curvas de la característica operativa del receptor (ROC); una densidad óptica de 0,239 marcó el mejor nivel de desempeño de la prueba, con una sensibilidad de 81,0% y una especificidad de 96,6%. Los resultados obtenidos demostraron que el estuche Detect™ es un instrumento prometedor para la investigación y el seguimiento de las regiones donde se realiza un tratamiento masivo de la filariasis linfática.

Interruption of lymphatic filariasis transmission in Manaus, a former focus of Wuchereria bancrofti in the Western Brazilian Amazon / Interrupción de la transmisión de la filariasis linfática en Manaos, anteriormente un foco de Wuchereria bancrofti en la Amazonia occidental de Brasil / Interrupção da transmissão da filariose linfática em Manaus, anteriormente um foco de Wuchereria bancrofti na parte leste da Amazônia brasileira

ABSTRACT Objective. To confirm the absence of Wuchereria bancrofti autochthonous cases in Manaus, a former focus of lymphatic filariasis in the Western Brazilian Amazon. Methods. A field survey was carried out in 2016 using immunochromatographic rapid tests (ICT card) for the detection of circulating filarial antigens in blood. The sample included a group of 3 000 schoolchildren aged 6 to 10 years enrolled in schools from different urban areas of Manaus (including the former lymphatic filariasis focus in the city) and a group of 709 adolescents and adults, between the ages of 11 and 85 years, born and raised in different areas of Manaus. Results. All of the individuals tested negative for W. bancrofti antigen. Conclusions. Although Manaus was once considered endemic, this focus no longer seems to be active for lymphatic filariasis transmission. The results of this study could support the certification by the World Health Organization of the lymphatic filariasis transmission elimination exercise in Brazil.

RESUMEN Objetivo. Confirmar la ausencia de casos autóctonos de Wuchereria bancrofti en Manaos, anteriormente un foco de filariasis linfática en la Amazonia occidental de Brasil. Métodos. En el 2016 se llevó a cabo una encuesta en el terreno con pruebas rápidas inmunocromatográficas (tiras inmunocromatográficas) para detectar antígenos filáricos circulantes en sangre. La muestra constó de un grupo de 3 000 escolares de 6 a 10 años matriculados en escuelas de diferentes zonas urbanas de Manaos (incluida la zona que anteriormente era el foco de filariasis linfática en la ciudad) y de un grupo de 709 adolescentes y adultos, de edades comprendidas entre 11 y 85 años, nacidos y criados en diferentes áreas de Manaos. Resultados. Todas las personas dieron negativo en la prueba de antígeno de Wuchereria bancrofti. Conclusiones. Aunque hubo un tiempo en que Manaos se consideraba zona endémica, parece que este foco de transmisión de la filariasis linfática ya no está activo. Los resultados de este estudio podrían brindar apoyo a la certificación de la Organización Mundial de la Salud respecto de los esfuerzos realizados en Brasil para eliminar la transmisión de la filariasis linfática.

RESUMO Objetivo. Confirmar a ausência de casos autóctones de Wuchereria bancrofti em Manaus, anteriormente um foco da filariose linfática na parte leste da Amazônia brasileira. Métodos. Uma pesquisa de campo foi realizada em 2016 com o uso de teste rápido por imunocromatografia (cartão ICT) para detecção de antígenos de microfilárias circulantes no sangue. A amostra estudada consistiu de um grupo de 3 000 crianças escolares entre 6 e 10 anos de idade matriculados em escolas de diferentes áreas da zona urbana de Manaus (englobando a área anteriormente com o foco de filariose linfática) e um grupo de 709 adolescentes e adultos entre 11 e 85 anos de idade nascidos e crescidos em diferentes áreas de Manaus. Resultados. Todos os indivíduos pesquisados tiveram teste negativo para o antígeno da W. bancrofti. Conclusões. Apesar de Manaus ter sido anteriormente uma área endêmica, parece que não existe mais foco ativo de transmissão da filariose linfática na cidade. Os resultados deste estudo podem servir para embasar a certificação pela Organização Mundial da Saúde da eliminação da transmissão da filariose linfática no Brasil.

Gonotrophic discordance in Culex quinquefasciatus (Diptera: Culicidae) in the city of São Paulo, Brazil

Abstract INTRODUCTION: This study aimed to assess the occurrence of gonotrophic discordance in females of Culex quinquefasciatus in São Paulo, Brazil. METHODS: Resting females were collected monthly for 8 months. Females of Cx. quinquefasciatus were identified, and their midgut and ovaries were dissected. RESULTS: Two hundred females were dissected, out of which, 27.5% were nulliparous and 57% were parous. Most females had no blood in the midgut, but gonotrophic discordance was found in 21% females. CONCLUSIONS: Females of Cx. quinquefasciatus showed a high parity rate and gonotrophic discordance, which could favor the vector capacity of this species.

Elefantiasis vulvar por filarias / Vulvar Elephantiasis by Filarias

En el año 2000, había más de 120 millones de personas infectadas por filarias en el mundo; unos 40 millones están desfiguradas e incapacitadas por la enfermedad. La infestación de los ganglios linfáticos por el parásito Wuchereira bancrofti, es la causa más frecuente del linfedema secundario. Se presenta un caso inusual de elefantiasis vulvar por filariasis. Se analizan las alternativas terapéuticas que incluyen el tratamiento farmacológico y quirúrgico, con el fin de considerar esta última como un tratamiento paliativo más que curativo tanto para el linfedema como para la cirugía reconstructiva(AU)

In 2000, there were more than 120 million people infected by filarias in the world; some 40 million are disfigured and disabled by the disease. Infestation of the lymph nodes by Wuchereira bancrofti parasite is the most frequent cause of secondary lymphoedema. An unusual case of vulvar elephantiasis due to filariasis is reprted in this paper. The therapeutic alternatives that include pharmacological and surgical treatment are analyzed, in order to consider the latter as a palliative rather than a curative treatment both for lymphedema and for reconstructive surgery(AU)

Elefantiasis escrotal. Presentación de un caso en Gambia / Elefantíase escrotal. Apresentação de caso na Gâmbia / Scrotal elephantiasis. Case presentation in the Gambia

Se presentó un paciente masculino con 25 años de edad, procedencia rural. Refirió en la cara lateral del hemiescroto derecho secreciones de color amarillo. En los genitales externos presentó una masa de 38 cm de largo y 35 cm de ancho, bordes irregulares, piel circundante edematosa, seca, acartonada, ulcera de 10 x 5 cm, no dolorosa y secreciones blanquecinas y serohemática escasa, pérdida de la anatomía del pene y disuria. Se confirmó el diagnóstico de elefantiasis escrotal secundaria a filariasis. Se aplicó tratamiento con dietilcarbamazina y quirúrgico. El tratamiento posibilitó la curación y la reincorpación social y sexual del paciente(AU)

A 25-year-old male patient was presented, of rural origin to the Urology office of the Royal Victoria National Hospital in the Republic of Gambia. He reported on the lateral side of the right hemiescrot yellow secretions. In the external genitalia it presented a mass of 38 cm long and 35 cm wide, irregular edges, surrounding edematous, dry, cracked skin, ulcer of 10x5 cm, non-painful and whitish secretions and serohematic scarce, loss of penile anatomy and dysuria The diagnosis of scrotal elephantiasis secondary to filariasis was confirmed. Diethylcarbamazine treatment and surgical intervention were applied. The treatment allowed the healing and social and sexual reincorpation of the patient(AU)

Um paciente do sexo masculino, 25 anos, foi apresentado, de origem rural, ao consultório de Urologia do Royal Victoria National Hospital, na República da Gâmbia. Ele relatou no lado lateral das secreções amarelas hemiescrot à direita. Na genitália externa, apresentava massa de 38 cm de comprimento e 35 cm de largura, bordas irregulares, circundando pele edematosa, seca e quebradiça, úlcera de 10x5 cm, secreções não dolorosas e esbranquiçadas e escassez seroemática, perda de anatomia peniana e disúria O diagnóstico de elefantíase escrotal secundária à filariose foi confirmado. Tratamento com dietilcarbamazina e intervenção cirúrgica foram aplicados. O tratamento permitiu a cura e a reincorpação social e sexual do paciente(AU)

Semi analytical method for solving lymphatic filariasis epidemic model

In this paper, we present a deterministic model on the transmission dynamics of Lymphatic Filariasis. Non-Standard Finite Difference Method (NSFDM) is employed to attempt the solution of the model. The validity of the NSFDM in solving the model is established by using the computer in-built classical fourth-order Runge-Kutta method. The comparism between Non-Standard Finite Difference Method solution and Runge-Kutta (RK4) were performed which were found to be efficient, accurate and rapidly convergence

Current Status of Parasite Infections in Indonesia: A Literature Review

Indonesia and South Korea have become inseparable in various respects since the 2 countries established diplomatic relation in 1973. Indonesia is a tropical region that stretches across the equator, comprised of 5 main islands (Java, Kalimantan, Sumatra, Sulawesi, and Papua) and 4 archipelagoes (Riau, Bangka Belitung, Nusa Tenggara, and Maluku). As most population of Eastern Indonesia (Sulawesi, Papua and Nusa Tenggara & Maluku) live in poor areas, it is expected that there will be many parasites. Nevertheless, little is known about the status of parasites in Indonesia. This study examines the prevalences of malaria and lymphatic filaria, which are prevalent in Indonesia, as well as those of soil-transmitted-helminths (STH). As a result, the Plasmodium falciparum and P. vivax case loads are almost equal. The current prevalence of P. vivax is uniformly low (<5%) in all age groups and annual parasite incidence (API) showed decreasing tendency as 0.84 per 1,000 population in 2016. However, more than 65 million people still live in malaria epidemic regions. Lymphatic filariasis remains an important public health problem and 236 cities were classified as endemic areas in 514 cities/districts in 2017. It is difficult to ascertain the current prevalence rate of STH in Indonesia, although West Sumba and Southwest Sumba in East Nusa Tenggara reported prevalence rate of more than 20%. The study also considers the (sero) prevalences of other parasites identified in Indonesia. This report should be useful not only to parasitologists but also to travelers and people with business in Indonesia.

The situation of lymphatic filariasis in the municipality of Paulista, Pernambuco, Brazil

Cases of Lymphatic Filariasis (LF) have been notified since 1959 in the municipality of Paulista, yet it is still considered an LF-free area. The purpose of this study was to describe the situation of Paulista Health Department. The data were gathered via antigenic surveys carried out in the town, using POC-ICT-AD12 tests. A total of 1,000 individuals, aged 10 and over, were examined in the neighborhoods of Mirueira, Engenho Maranguape, Janga and Maranguape II (250 individuals in each district). Among the individuals evaluated, seven (0,7%) tested positive for antigens using CFA POC-ICT-AD12, 5 out of 250 (2.0%) in the Engenho Maranguape neighborhood and 2 out of 250 (0.8%) in Janga. In this group, one particular individual presented microfilaremia, quantified at 5 Mf/mL. These results suggest that the municipality of Paulista might be a "silent" source of LF continuous transmission, fact that could impact negatively on the goals of the GPELF program meant to provide certification of parasitic disease control and elimination by the year 2022

Evaluation of the recombinant antigens Wb14 and WbT for the capture antibody diagnosis of lymphatic filariasis

BACKGROUND Lymphatic filariasis (LF) is a parasitic disease caused mainly by the Wuchereria bancrofti worm and that affects up to 120 million people worldwide. LF is the second cause of chronic global deformity, responsible for 15 million people with lymphedema (elephantiasis) and 25 million men with scrotal hydrocele. Its diagnosis is still associated with numerous difficulties, such as the sample collection periods (microfilaria nocturnal periodicity) and limited diagnostic kits. OBJECTIVES The aim of this work was to evaluate two recombinant antigens (Wb14 and WbT) as part of an enzyme-linked immunosorbent assay (ELISA) based antibody capture tests for LF. METHODS The recombinant antigens rWb14 and rWbT were expressed in Escherichia coli BL21 and an antibody capture ELISA was performed. For this, sera were used from microfilaremic individuals with W. bancrofti (MF), chronic pathology (CP), individuals infected with Strongyloides (SP) and healthy controls from endemic (EN) and non-endemic (NE) areas. FINDINGS Both tests showed similar results, with 90% sensitivity and 96.6% specificity. In comparison with the BM14 ELISA commercial test, the Wb14 and WbT antigens performed with identical sensitivity but greater specificity. Reduced positivity with the CP suggested a potential to monitor cure. This was not confirmed, however, when sera from individuals up to seven years after treatment were assayed. MAIN CONCLUSIONS The Wb14 and WbT ELISAs were considered efficient and promising diagnostic tests. Due to the importance of antibody capture analysis to evaluate the Global Program to Eliminate Lymphatic Filariasis (GPELF), the tests proposed here appear as great alternatives to the available commercial system.

Prevention and Control Strategies for Parasitic Infections in the Korea Centers for Disease Control and Prevention

Korea is successfully controlled intestinal parasitic infections owing to economic development and high health consciousness. The Division of Vectors and Parasitic Diseases (formerly the Division of Malaria and Parasitology) is in the Center for Laboratory Control of Infectious Diseases of the Korea Centers for Disease Control and Prevention. It has been the governmental agency responsible for controlling and leading scientific research on parasitic diseases. The Division of Vectors and Parasitic Diseases has conducted and funded basic research and disseminated the research results to various medical fields, ultimately promoting public health in Korea. Among the noteworthy achievements of this division are the national surveillance of healthcare-associated parasitic infections, prevention and control for parasitic infections, and the elimination of lymphatic filariasis from Korea. On a broader scale, the division's research programs and academic supports were influential in preventing and treating infectious parasitic diseases through public policies and laws. In this review, we summarize the past and present role of the Division of Vectors and Parasitic Diseases in preventing and treating infectious parasitic diseases in Korea.

Wuchereria bancrofti infection in Haitian immigrants and the risk of re-emergence of lymphatic filariasis in the Brazilian Amazon

Abstract INTRODUCTION: Lymphatic filariasis (LF) is a public health problem in Haiti. Thus, the emigration of Haitians to Brazil is worrisome because of the risk for LF re-emergence. METHODS: Blood samples of Haitian immigrants, aged ≥18 years, who emigrated to Manaus (Brazilian Amazon), were examined using thick blood smears, membrane blood filtration, and immunochromatography. RESULTS: Of the 244 immigrants evaluated, 1 (0.4%) tested positive for W. bancrofti; 11.5% reported as having received LF treatment in Haiti. CONCLUSIONS: The re-emergence of LF in Manaus is unlikely, due to its low prevalence and low density of microfilaremia among the assessed Haitian immigrants.

Knowledge, attitudes and perceptions regarding lymphatic filariasis: study on systematic noncompliance with mass drug administration

ABSTRACT The aim of this study was to investigate the epidemiological characteristics, antigenic profile, perceptions, attitudes and practices of individuals who have been systematically non-compliant in mass drug administration (MDA) campaigns targeting lymphatic filariasis, in the municipality of Olinda, State of Pernambuco, Northeastern Brazil. A pretested questionnaire was used to obtain information on socioenvironmental demographics, perceptions of lymphatic filariasis and MDA, and reasons for systematic noncompliance with treatment. A rapid immunochromatographic test (ICT) was performed during the survey to screen for filariasis. It was found that the survey subjects knew about filariasis and MDA. Filariasis was identified as a disease (86.2%) and 74.4% associated it with the presence of swelling in the legs. About 80% knew about MDA, and the main source of information was healthcare workers (68.3%). For men the main reasons for systematic noncompliance with MDA were that “the individual had not received the medication” (p=0.03) and for women “the individual either feared experiencing adverse reactions”. According to the ICT, the prevalence of lymphatic filariasis was 2%. The most important causes of systematic noncompliance were not receiving the drug and fear of side-effects. For successful implementation of MDA programs, good planning, educational campaigns promoting the benefits of MDA, adoption of measures to minimize the impact of adverse effects and improvement of drug distribution logistics are needed.

Integrated morbidity management for lymphatic filariasis and podoconiosis, Ethiopia

Problem Lymphatic filariasis and podoconiosis are the major causes of tropical lymphoedema in Ethiopia. The diseases require a similar provision of care, but until recently the Ethiopian health system did not integrate the morbidity management. Approach To establish health-care services for integrated lymphoedema morbidity management, the health ministry and partners used existing governmental structures. Integrated disease mapping was done in 659 out of the 817 districts, to identify endemic districts. To inform resource allocation, trained health extension workers carried out integrated disease burden assessments in 56 districts with a high clinical burden. To ensure standard provision of care, the health ministry developed an integrated lymphatic filariasis and podoconiosis morbidity management guideline, containing a treatment algorithm and a defined package of care. Experienced professionals on lymphoedema management trained government-employed health workers on integrated morbidity management. To monitor the integration, an indicator on the number of lymphoedema-treated patients was included in the national health management information system.Local setting In 2014, only 24% (87) of the 363 health facilities surveyed provided lymphatic filariasis services, while 12% (44) provided podoconiosis services.Relevant changes To date, 542 health workers from 53 health centres in 24 districts have been trained on integrated morbidity management. Between July 2013 and June 2016, the national health management information system has recorded 46 487 treated patients from 189 districts.Lessons learnt In Ethiopia, an integrated approach for lymphatic filariasis and podoconiosis morbidity management was feasible. The processes used could be applicable in other settings where these diseases are co-endemic

Follow-up Study of Patients Previously Diagnosed with Lymphatic Filariasis in Korea

OBJECTIVES: Korea was an endemic area for lymphatic filariasis (LF), caused by the nematode parasite Brugia malayi, until the 1970s. The World Health Organization recognized Korea as LF-free in June 2008. However, it is necessary to confirm that patients that have had LF in the past still test negative, to prevent the re-emergence of LF in Korea. METHODS: We followed up a total of 83 patients who had been diagnosed with LF between 2002 and 2010 in endemic LF areas. RESULTS: Fifty-two of the 83 subjects were negative for LF, whereas 31 subjects had re-located to a different city or province, were dead, or were unaccounted for. Most subjects with negative test results still exhibited edema in the legs or the arms, and some complained of redness and swelling in the legs or ankle joints. However, we found that these symptoms were due to diseases other than LF. CONCLUSION: In this follow-up study, we did not find any evidence indicating the potential re-emergence of LF in Korea.

Perfil de pacientes com linfedema atendidos no serviço de referência nacional em filarioses da Fundação Oswaldo Cruz, Pernambuco, Brasil / Profile of lymphedema patients attended at the national center of lymphatic filariasis of the Oswaldo Cruz Foundation, Pernambuco, Brazil

A filariose linfática é uma parasitose endêmica em 73 países e afeta, aproximadamente, 120 milhões de pessoas em todo o mundo. Este trabalho buscou traçar o perfil de pacientes com linfedema que residem em áreas endêmicas de filariose, com ou sem diagnóstico comprovado de doença prévia. Trata-se de um estudo transversal que envolveu pacientes com linfedema, cadastrados no SRNF-CPqAM-FIOCRUZ-PE, residentes nas principais cidades da região metropolitana de Recife, capital do estado de Pernambuco, aos quais foi aplicado um questionário para avaliação do perfil sociodemográfico e epidemiológico. Foram selecionados 35 pacientes, sendo 80% do sexo feminino, a maioria com idade entre 40 e 59 anos (48,6%). Do total examinado, 40% apresentaram linfedema bilateral de membros inferiores e presença de dor moderada no membro afetado. Além disso, dos indivíduos atendidos, apenas 20% receberam diagnóstico de filariose e 68% relataram morar em ruas pavimentadas com disponibilidade de coleta regular de lixo e acesso à água potável. Os resultados deste estudo propiciaram um conhecimento mais abrangente do perfil dos pacientes com linfedema atendidos pelo serviço de referência e poderão auxiliar no aprimoramento das políticas públicas de saúde.

Mosquito identification and molecular xenomonitoring of lymphatic filariasis in selected endemic areas in Giza and Qualioubiya governorates, Egypt

Lymphatic filariasis is a vector-borne health problem that has been focally endemic in Egypt for centuries. The chief vectors of transmission are Culicinae species. Control measures in the form of mass drug administration of DEC citrate treatment have been implemented in Nile delta for almost a decade. This study aimed to identify the prevalent mosquito species in endemic areas in Giza and Qualioubiya governorates and to monitor Wuchereria bancrofti infection by detecting the parasite DNA in collected mosquitoes. Adult mosquitoes were collected using light traps hung indoors. Microscopic examination was performed to identify and examine the morphologic characters of mosquitoes. Female Culex mosquitoes were subjected to semi-nested PCR to detect filarial DNA targeting repetitive DNA sequences [pWb12 repetitive region] specific for W.bancrofti

The results revealed 3 species of mosquitoes Culex pipiens, Culex pusillus and Culex quinquefasciatus with the predominance of Culex pipiens [85.7%]. Wuchereria bancrofti DNA was not detected in any of the collected mosquito pools. With the progress of elimination programme in Nile Delta, follow up studies with larger sample size are recommended as the predominance of Culex pipiens the main lymphatic filariasis vector remains a risk of transmission in such areas

Antifilarial and Antibiotic Activities of Methanolic Extracts of Melaleuca cajuputi Flowers

We evaluated the activity of methanolic extracts of Melaleuca cajuputi flowers against the filarial worm Brugia pahangi and its bacterial endosymbiont Wolbachia. Anti-Wolbachia activity was measured in worms and in Aedes albopictus Aa23 cells by PCR, electron microscopy, and other biological assays. In particular, microfilarial release, worm motility, and viability were determined. M. cajuputi flower extracts were found to significantly reduce Wolbachia endosymbionts in Aa23 cells, Wolbachia surface protein, and microfilarial release, as well as the viability and motility of adult worms. Anti-Wolbachia activity was further confirmed by observation of degraded and phagocytized Wolbachia in worms treated with the flower extracts. The data provided in vitro and in vivo evidence that M. cajuputi flower extracts inhibit Wolbachia, an activity that may be exploited as an alternative strategy to treat human lymphatic filariasis.