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)

Intestinal parasites of man in Oriental Mindoro, Philippines, with emphasis on schistosomiasis.

An intestinal parasite survey was conducted in the town of Victoria, Oriental Mindoro, Philippines in 1978 in order to estimate the current schistosomiasis situation in this area of the Philippines and Schistosoma japonicum eggs were detected in 20% of 1058 fecal specimens examined. The prevalence was more than twice as high as had been previously estimated. Infection rates were higher in males than in females, 26 versus 15% and age-wise were infrequent in young children (8%) and moderately common in other age groups (20-32%). Other intestinal helminths and protozoan parasites of man in Oriental Mindoro were: Ascaris lumbricoides, Trichuris trichiura, Necator americanus, Enterobius vermicularis, Strongyloides stercoralis, Capillaria sp, taenid tapeworm, echinostome, dicrocoelid and opisthorchiid trematode, Entamoeba histolytica, Entamoeba coli, Endolimax nana, Giardia lamblia, Iodamoeba bütschlii, Trichomonas hominis and Chilomastix mesnili.

Intestinal parasites of man in Northern Bohol, Philippines, with emphasis on schistosomiasis.

A survey for intestinal parasites with emphasis on Oriental schistosomiasis was conducted in the townships of Trinidad and Talibon, Bohol Province, Philippines and approximately 1,700 stool samples were examined. Schistosoma japonicum is still endemic to these areas of northern Bohol but infection rates were much lower than expected, 5% rather than 30%. Soil-transmitted helminths were the most common parasitic infections. Hookworms were found in 71% of the samples tested, most infections were due to Necator americanus 97% and Ancylostoma duodenale accounted for only 3%. Trichuris trichiura and Ascaris lumbricoides eggs were diagnosed in 58% and 45% respectively of the fecal samples examined. Other helminths and protozoan parasites detected were Enterobius vermicularis, Stronglyoides stercoralis, Entamoeba histolytica, Entamoeba hartmanni, Entamoeba coli, Endolimax nana, Iodamoeba bütschlii, Giardia lamblia and Chilomastix mesnili.

Further studies on Capillaria philippinensis: development of the parasite in the Mongolian gerbil.

Capillaria philippinensis larvae from the digestive tract of a Northern Luzon freshwater fish (Hypselotris bipartita) experimentally exposed to embryonated eggs, were given by stomach tube to Mongolian gerbils (Meriones unguiculatus). The larvae developed into adults within 10 to 11 days and female worms produced larvae within 13 to 14 days. These larvae developed into second generation adults by days 22 to 24 and the second generation females produced eggs that were present in the feces of the animal on the average 26 days after infection. Most females were oviparous but a few larviparous females were always present. The gerbils died on an average of 46 days after infection, with the highest numbers of worms recovered between days 36 and 46. All stages of the parasite were generally found at necropsy. Gerbils developed patent infections after receiving 2 or 3 laeval from fish, and 852 to 5,353 worms were recovered at necropsy. These studies show that autoinfection in an integral part of the life cycle of C. philippinensis, both initially and in maintaining the infection. The natural transmission of the parasite was demonstrated when H. bipartita from a lagoon in the endemic area were fed to gerbils and 3 became infected. The parasite can also be maintained in the laboratory by transfer of worms by stomach tube from the small intestines of an infected gerbil to a clean gerbil.

Counterimmunoelectrophoresis in the detection of antibodies to Schistosoma japonicum.

Counterimmunoelectrophoresis (CIE) was used to detect antibodies to Schistosoma japonicum soluble egg antigen in 118 sera from people living in a schistosomiasis endemic area in the Philippines. The sera were also tested for antibodies by the circumoval precipitin test (COPT); 53% were found positive by CIE and 48% positive by COPT. No significant differences were found between the tests (P = 0.18 by McNemar's test). Cross-reactions with sera from patients with intestinal capillariasis and monkeys with experimental angiostrongyliasis were not found and no false reactions were detected with sera from "normal" controls. The CIE test as used in the present studies was found to be comparable to the COPT in sensitivity and specificity as related to cross-reactivity with sera from nematode infections such as intestinal capillariasis and angiostrongyliasis. Results are usually available quickly with nearly 70% of any reactions occurring within 1 h. The test should be of value in seroepidemiologic surveys in schistosomiasis-endemic areas.

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.

Serology of Capillaria philippinensis infection: reactivity of human sera to antigens prepared from Capillaria obsignata and other helminths.

The reactivity of sera from 151 confirmed human cases of Capillaria philippinensis infection was examined by double diffusion and indirect hemagglutination (IHA) tests chiefly against Capillaria obsignata antigen because of the present unavailability of C. philippinensis antigen. Antigens from additional parasites and other human and animal sera representing a variety of helminthic infections were used for comparison. Of 71 pre-treatment human sera, 56.3% were reactive by double diffusion test and 85.9% by IHA test (titer greater than 1:16) with C. obsignata antigen. C. philippinensis sera were also reactive with Trichinella spiralis and Trichuris vulpis antigens but not with Schistosoma japonicum antigens. Sera from other infections such as with T. spiralis, T. vulpis, and S. japonicum were also reactive with C. obsignata antigen but sera from Trichuris trichiura infection were not. With C. obsignata antigen, IHA titers in human C. philippinensis sera are apparently not related to clinical severity of the disease; the titers remain at fairly stable levels during the course of the illness but may tend to decrease after chemotherapy. The cross-reactivities observed dictate caution in the use and interpretation of any serologic procedure for human intestinal capillariasis; nevertheless, the IHA test using C. obsignata antigen may be a useful addition tool in the study of C. philippinensis infection both for clinical and epidemiologic purposes especially when the efficiency of stool examination is decreased by changes in the reproductive activity of the helminth.

Pararosaniline pamoate (CI-403-A) in the treatment of Schistosoma japonicum infection in the Philippines.

Trials have been carried out, first on a relatively small scale among patients in Manila and later on a larger scale among domiciliary patients in an area of endemic schistosomiasis in Leyte Province, Philippines, with various dosage schedules of pararosaniline pamoate (CI-403-A) to determine that drug's efficacy and optimum dosage against Schistosoma japonicum infection.Given orally in gelatin capsules, the drug was well tolerated even in children, with few side-effects, and was both curative and suppressive when administered in a maximum dosage of 35-40 mg/kg body-weight per day for as many as 52 days spread over a total treatment period of 203 days.The authors recommend its use for mass treatment, especially among schoolchildren, in combination with other established schistosomiasis control measures-health education, environmental sanitation, and snail control.