Clinical, parasitological and social studies on Wuchereria bancrofti in Egypt

This study was conducted on patients attending AlHussein University Hospital and Mansura University Hospitals. Sheets were filled out on each patient [age, residence, occupation, family similar condition, travelling, disease duration, symptoms suggesting acute dermatolymphangitis attacks, frequency and duration. They were 25 lymphoedema patients and 8 controls [17 males and 16 females] and subjected to clinical and parasitological examinations. According to residence, five patients were from Giza Governorate [18.18%], four from Dakahlia G. [12.12%], four from Gharbia G. [12.12%], five from Menoufia G. [15.15%], four from Sharkia G. [12.12%], two cases from Kafr Elsheikh G. [6.06%] and one patient from Assiut G. [3.03%]. In controls, 6 were from Al Hussein Cairo G. [15.15%], and two cases [6.06] from Al Abbassia. They were 48% farmers [10 male and 2 female]; 4% grocers [1 male]; 8% carpenters [2 male]; and 40% house wife [10 female]. According to lymphedema site: 3 cases [12%] were bilateral lower limbs lymphedema [2 female and 1 male], 13 cases [52%] had right lower limb lymphedema [6 female and 7 male], and 9 cases [36%] had left lower limb lymphedema [4 female and 5 male]. They were 18 [72%] with below knee extension of lymphedema [10 male and 8 female] and 7 [28%] above knee extension of lymphedema [3 male and 4 female]. Grade of lymphedema was one case [male] with grade II lymphedema [4%], 13 cases [52%] with grade III [7 male and 6 female] and 11 cases [44%] with grade IV [5 male and 6 female]. Duration of lymphedema was one case with grade II lymphedema in a period of 3 years, 13 cases with grade III lymphedema and the durations of lymphedema for these cases were [one case with 5 years duration, 3 cases were>6-9 years, 6 cases were>9-12 years and 3 cases were>12 years] and 11 cases with grade IV lymphedema and duration of lymphedema for these cases were [one case with 6 years duration, 2 cases were>6-9 years, 3 cases were>9-12 years and 5 cases were>12 years]

A preliminary study of filariasis related acute adenolymphangitis with special reference to precipitating factors and treatment modalities.

Episodic adenolymphangitis (ADL) is one of the important clinical manifestations of lymphatic filariasis. Recurrent ADLs contribute to the progress of the disease and also have important socioeconomic implications since they cause significant loss of man days. The present study was conducted in order to identify the precipitating factors responsible for ADL attacks and also to examine the different modalities of treatment. Sixty-five individuals with filariasis related ADL attacks, who are residents of Alleppey district (endemic for Brugia malayi) were studied. All efforts were taken to identify the precipitating factors for ADLs in these individuals. They were hospitalized for a period of five days or more. All of them received symptomatic antipyretic/antiinflammatory therapy and topical antibiotic/antifungal treatment of the affected limbs. They were then randomly allocated to one of the following four regimens: group I - symptomatic alone; group II - symptomatic plus antibiotics; group III - symptomatic followed by diethylcarbamazine citrate (DEC) and group IV - symptomatic plus antibiotic followed by DEC. Patients in groups III and IV received DEC every three months up to one year. There was a significant relationship between the number of ADL attacks and the grade of edema. Presence of focus of infection in the affected limb could be identified in 28 of the 65 patients. In the majority of patients (48) response to treatment was rapid (resolution in less than five days). Neither antibiotics nor DEC (given at intervals of three months) appeared to alter the frequency of ADL attacks. On the otherhand simple hygienic measures combined with good foot care and local antibiotic/antifungal cream application (where required), were effective in reducing the number of ADL attacks.

The association of clinical filariasis and Wuchereria bancrofti infections in Jakarta.

In a study carried out in Jakarta, Indonesia between 1969--1977, patients with clinical manifestations of filariasis were examined for microfilaremia. Finger blood (3 X 20 microliter) were examined by conventional methods, venous blood by membrane filtration, urine and hydrocele fluid by concentration methods. A total of 1,422 patients were examined and 182 (12.8%) were positive by blood smear; however, examination by membrane filtration and concentration of urine and hydrocele fluid did not appreciably increase the association between clinical manifestations and Wuchereria bancrofti infection. Approximately 16% of the patients without patent infection were indirectly associated with filariasis, since they co-habitated with persons with microfilaremia. Results of these studies showed that more than 60% of the patients were without patent infection. Factors that may be responsible for these findings are briefly discussed.

Studies with Brugia pahangi. 11. Measurement of lymph flow in infected cats.

Rates of lymph flow in cats were measured by calculating the disappearance of radioactive colloidal gold (198Au) from the feet of (1) uninfected cats, (2) cats infected for various periods after primary infection with Brugia pahangi, and (3) cats repeatedly challenged with B. pahangi infective larvae over long periods. The results of the study showed that (1) there is great variation in gold disappearance rates in different cats in all 3 groups above, (2) the cat lymphatic system is functionally highly efficient, and (3) in a cat with lymphoedema and early elephantiasis, there was a significant impairment of gold removal from the affected foot. The study proved useful in finding lymph drainage rates in the various animals but did not, as hoped, show any pattern of lymph flow decrease which might have enabled the use of the technique as a diagnostic tool for lymphatic pathology prior to the occurrence of external clinical manifestations of filariasis.