Visceral schistosomiasis among domestic ruminants slaughtered in Wayanad, South India.

This short communication reports the prevalence of visceral schistosomiasis by worm counts from the mesentery of domestic ruminants of the hilly district of Wayanad, located in Kerala, one of the states in South India. We found 57.3, 50, and 4.7% of cattle, buffaloes and goats, respectively, had visceral schistosomiasis upon slaughter at a municipal slaughter house in Kalpetta. Our findings show that the prevalence of Schistosoma spindale infection is very high in Wayanad in comparison to previous reports from this and neighboring countries.

Freshwater mollusks of medical importance in Kalasin Province, northeast Thailand.

A snail survey was performed in six districts around irrigation areas of Lampao Dam, in Kalasin Province. The survey caught a total of 5,479 live snails and classed them into five families, 12 genera and 15 species, of which 7 species are suspected of transmitting human parasitic diseases. The seven species were Pila polita, Pomacea canaliculata, Filopaludina (S.) m. martensi, Bithynia (Digoniostoma) siamensis goniomphalos, Melanoides tuberculata, Radix rubiginosa, and Indoplanorbis exustus. Of these, B. (D.) s. goniomphalos and I. exustus were found to harbor emergent cercariae. Only B. (D.) s. goniomphalos hosted several types of cercariae--Opisthorchis viverrini, unidentified species of intestinal flukes, echinostomes, xyphidio and furcocercous cercariae. Indoplanorbis exustus shed only echinostome cercariae. B. (D.) s. goniomphalos showed a rather high natural infection rate with O. viverrini, 1.3% in Yang Talat district, and 0.61% in Kamalasai district, in Kalasin Province.

Endotoxemia in patients with chronic liver disease

This study was conducted on 100 selected patients with chonic liver disease to find the relationship between plasma endotoxin level and the severity of liver disease. Twenty normal controls were in the study for Comparison. Patients were classified according to Child Classification into Child A group [30 Patients] and Child Band C groups [70 Patients]. Endotoxin level was assayed in the plasma of patients and controls using a quantitative chromogenic Limulus Amaebocyte Lysate Test [LAL]. The level of endotoxin was significantly in Child groups A, B and C than in the normal controls. Also it was found that the level of endotoxin in Child group B and C was significantly higher than in group A [P<0.05]. The endotoxin level was also significantly higher in cases with cirrhotic or mixed pattern than in those with schistosomal pattern [p=0.05]. It was found that the level of endotoxin correlated significantly with the incidence of ascites. It was concluded that endotoxaemia becomes more prominent with the progression of liver disease especially when associated with a mixed aetiology which may have its impact on the hepatic state and extrahepatic manifestationss

Paddy field dermatitis in Assam: a cercarial dermatitis.

Rice field dermatitis is an occupational health problem in Assam. The afflicted paddy field workers develop exanthema on the exposed parts of their skin mainly legs and arms when they come in contact with water in rice fields. Itching sensations start after 30 minutes to 1 1/2 hours after initial exposure. After 6-12 hours there is intensely pruritic macular eruption and in a few cases secondary skin infection may also develop. The clinical course of the disease is suggestive of cercarial dermatitis. Numerous gastropod snails belonging to families Lymnaeidae, Bulinidae and Planorbidae were collected from paddy fields and were investigated for cercarial infection. It was found that planorbid snails were infected with animal schistosome cercariae. These cercariae were able to invade human skin and caused dermatitis in human volunteers after repeated exposure.

Schistosomiasis in Cambodian refugees at Ban-Kaeng Holding Centre, Prachinburi province, Thailand.

The epidemiologic investigation on schistosomiasis in 21,496 Cambodian refugees residing at Ban-Kaeng Holding Centre was conducted by using the skin sensitivity test as a screening test. A positive diagnosis of Schistosoma mekongi was confirmed in 74 of these cases through ova recovery in the stool. The resultant prevalence of schistosomiasis in Ban-Kaeng refugee Holding Center was 3.44 cases per 1,000 population. All of positive cases came from areas in Cambodia where schistosomiasis has not been previously reported. Sixty out of 74 schistosomiasis cases were from Battambang province in Cambodia. This study indicates that schistosomiasis in Cambodia at present is more widespread than has previously been reported.

A survey on intestinal parasitic infections in Laotian refugees at Ubon Province, Northeastern Thailand, with special reference to schistosomiasis.

454 stool specimens were collected from the Laotian refugees residing in the refugee camp, Ubon Province, from August 8 to 11, 1978, and were examined by formalin ether sedimentation technique. One of them (0.22%) was infected with Schistosoma mekongi. Since there are freshwater hydrobiid snails, Lithoglyphopsis aperta, the intermediate host of S. mekongi in that area, it is probable that the disease may become established in Northeastern Thailand in the future, which will eventually lead to health and economic problems in Thailand.

A clinico-pathologic study of cases with Schistosoma japonicum infection in Indonesia.

Combined clinico-pathological and laboratory examinations were carried out on 52 S. japonicum infected patients from an endemic area in Central Sulawesi, Indonesia. All of these patients exhibited signs and symptoms of chronic hepato-splenic schistosomiasis. None of the patients showed evidence of liver cirrhosis on histopathological examination. However, varying degrees of portal fibrosis were exhibited. The correlation between the degree of fibrosis and the clinical and laboratory findings were presented and discussed. Based on the results, liver biopsy proved to be a vaulable method of diagnosis in this particular type of infection. This study provides new information on S. japonicum infection in the area and may support a more solid basis for treatment.

Control of Schistosoma japonicum infection in Lindu Valley, Central Sulawesi, Indonesia.

In Indonesia, schistosomiasis is presently confined to two endemic areas in Central Sulawesi; Lindu (1,500) and Napu (5,000 inhabitants) valleys. Because of various development schemes now underway, it is feared that the natural balance which existed for many years between the parasite, the snail intermediate hosts and man, will be upset and will place some 70,000 people of the adjoining Palu and Palolo areas at risk. Measures are being taken to control and prevent the spread of the disease. A pilot control programme is planned for two years in the village of Anca in Lindu with a population of 391 and a prevalence rate of 70.5%. Langko village with a population of 464 and a prevalence rate of 53.7% will be utilized as the comparison area. Baseline data on human, malacological and animal reservoir hosts are being collected and control operations are anticipated to commence in July 1975. Measures to be applied to control schistosomiasis in the order of priorities are: (a) agro-engineering or modification of the environment; (b) environmental sanitation through the provision of adequate water supply and construction of latrines; (c) mollusciciding of remaining snail infested areas; (d) chemotherapy, and (e) health education campaign. At the end of the two-year control programme, the following activities will be carried out to determine the degree of intervention achieved; (a) human data: calculation of prevalence rates, incidence rates, and changes in the intensity of infection based on quantitative egg counts; (b) malacological data: changes in the number and extent of snail foci; snail density, and snail infection rates; (c) reservoir hosts: changes in the prevalence rates among domestic and wild animals. Calculation of reclaimed areas and increase in agricultural production will also be assessed together with the overall cost/benefit analysis of the project undertaking.

Drug trial of Schistosoma japonicum enfection in Indonesia.

A limited drug trial was carried out on 42 cases with schistosomiasis japonica from an endemic area of Central Sulawesi. The drugs used were niridazole and stibophen. The effects of treatment were reported and discussed. The results of this study offer promise for treating S. japonicum infection in Central Sulawesi on a larger scale.

Ambilhar in the treatment of Schistosoma japonicum infection and as an egg suppressant for mass treatment.

Ambilhar or niridazole at a dose of 25 mg per kg body weight for 7 days was found ineffective against Sl japonicum infection. Longer period of treatment for 10 to 14 days gave impressive stool negative conversion and egg reduction rates but with moderately severe reactions, the most alarming of which was hallucination. To minimize toxicity, the daily dose was reduced but given for a longer duration so that the total amount of the drug given per kilogram body weight was approximately the same as the 25 mg pre kg per day for 10 to 14 days. Of the two treatment schedules tried, the 15 mg per kg per day for 24 days was found relatively effective. Although the drug with this treatment regimen was well tolerated, a drop-out of 50.8% was observed. Ambilhar was therefore tried as an egg suppressant. With a 10-day treatment, all patients were again positive after 6 months. Egg reduction rates during the 6 months stool follow-up ranged from 69.8 to 93.5%. Further trials using this dose to be repeated every 3 to 6 months is contemplated.

Agro-engineering and sanitation improvement in the control of schistosomiasis japonica in the Philippines: a review.

Measures that would change the habitat of the snails were found to prevent its breeding. Among these are clearing and drainage of waterlogged areas; filling of depressions where filling materials are available; ponding of areas which cannot be drained, and improved rice culture. The degree of success in snail control depends to a large extent on the amount of change brought about in the habitat. The more radical the change, the greater the reduction in snail density. It can be expected that improvement in sanitation in the form of toilet construction and use, provision of safe water supply, building of footbridges and the control of stray animals will bring a further decline in the transmission of the disease. Studies have shown that perfect sanitation in the form of toilet construction and use will reduce transmission by about 75%, the other 25% being contributed by lower mammals. Agro-engineering control measures are presently being carried out intensively in 7 town of Leyte, with food assistance from the UN/FAO World Food Program being given to volunteer workers as incentives for them to work. Snail evaluation after 2 years has shown a snail reduction by 72% in the areas covered. It may be mentioned here that sanitation improvement, especially latrine construction, is an ongoing program of the Department of Health in all rural areas.