Mass survey of leprosy in Lalitpur district, Nepal.

An intense mass survey of leprosy in Lalitpur District, Nepal, was carried for the period 1986 to 1990. This was the first such large scale survey in Nepal; 85% of the total population was examined. The 5-year case detection rate was 13 per 10,000; the 5-year child detection rate was 4 per 10,000. By the end of the survey the prevalence rate was 6.8 per 10,000; at the end of 1992 this had dropped to 2.2 per 10,000. In 1989, after a 3-year interval, a re-survey was done in three village development committees (VDCs) and 4 new cases were detected, bringing the 3-year case detection rate to 3.3 per 10,000; 36% of the old cases, 20% of the new adult cases, and 3% of the new child cases were classified as multibacillary. Overall, 62.7% of the patients had no disability, 18.8% had disability grade 1, and 12.7% had disability grade 2 while for 5.8% the data were incomplete. By the end of the survey 91% of the patients needing medical treatment were on multidrug therapy (MDT). At present this has increased to 100%. The regularity rate was 86%; at the end of 1992 this had increased to 96%. The cost for detecting one new patient was US$298. Because of the high cost, it is recommended that intense mass surveys not be performed when the estimated prevalence rate is less than 10 per 10,000 inhabitants. From the data collected conclusions were drawn and recommendations were formulated for developing new strategies for the National Leprosy Control Programme of the Government of Nepal.

Comparative pharmacokinetics of oxytetracycline in rainbow trout (Salmo gairdneri) and African catfish (Clarias gariepinus).

A comparative pharmacokinetic study was conducted in rainbow trout (Salmo gairdneri) and African catfish (Clarias gariepinus) following intravenous (i.v.) and intramuscular (i.m.) administration of oxytetracycline (OTC) at a dose rate of 60 mg/kg body weight. Trout and catfish were kept in aerated tap water in tanks at constant temperatures of 12 degrees C and 25 degrees C, respectively. The two- and three-compartment open models adequately described plasma drug disposition in African catfish and rainbow trout respectively, following i.v. OTC administration. Compared to catfish (COP = 86 +/- 10 micrograms/ml) an eightfold higher extrapolated zero time concentration was obtained in trout (COP = 753 +/- 290 micrograms/ml). A significant difference was observed with respect to the relatively large apparent distribution volumes (Vd(area] after i.v. OTC administration (trout, mean value: 2.1 l/kg; catfish, mean value: 1.3 l/kg). The mean final elimination half-lives of both fish species were greater than previously reported in mammals (trout, 89.5 h; catfish, 80.3 h). A mean maximum plasma concentration (Cmax = 56.9 micrograms/ml) was obtained in trout at 4 h after i.m. administration of OTC. In catfish a lower Cmax of 43.4 micrograms/ml was determined at about 7 h. No significant difference was observed with respect to bioavailability following i.m. administration of OTC (trout, 85%; catfish, 86%).

Pharmacokinetics of ciprofloxacin in carp, African catfish and rainbow trout.

The plasma disposition of ciprofloxacin was studied in carp, African catfish and trout after intravenous (IV) and intramuscular (IM) administration at a dose rate of 15 mg/kg. Pharmacokinetic analysis of IV data showed that ciprofloxacin was well distributed (distribution volume Vd(area): 3.08-5.59 litre/kg) and exhibited a similar elimination half-life of about 14 h in these 3 fish species. After IM administration to carp and trout a rapid absorption was noticed; the maximum ciprofloxacin plasma concentrations (mean: 3.49 and 2.37 micrograms/ml, respectively), were achieved within 1 h after injection. At the dose level applied, ciprofloxacin has potential therapeutic value for 2-5 days especially against gram-negative bacterial fish pathogens.