In , French surgeon Jean-Nicolas Demarquay became the first to record the observation of microfilariae in fluid extracted from a hydrocoele another common symptom of lymphatic filariasis.
Three years later, Otto Henry Wucherer discovered microfilariae in urine in Brazil. However, the connection between these two discoveries was not made until Timothy Lewis noted the occurrence of microfilariae in both blood and urine. Lewis was also the first to make the association between these microfilariae and elephantiasis. Soon after the discovery of microfilariae, the adult worm was documented by Joseph Bancroft.
The observed species was later named after Bancroft, and we now recognize it as W. Perhaps the most important discovery related to lymphatic filariasis was that made by Patrick Manson in Manson was the first to look for an intermediate host for lymphatic filariasis microfilariae.
Tan, G. Snounou, and R. Casiraghi, T. Anderson, C. Bandi, C. Bazzocchi, and C. Altschul, W. Gish, W. Miller, E. Myers, and D. Nei and S. Babu and T. Phantana, S. Sensathein, J. Songtrus, S. Klagrathoke, and K. Rocha, C. Braga, M. Kwan-Lim, K. Forsyth, and R. Kurniawan, M. Yazdanbakhsh, R. Van Ree et al. View at: Google Scholar G. Weil, P. Lammie, and N. McCarthy, M. Zhong, R.
Gopinath, E. Ottesen, S. Williams, and T. Zhong, J. McCarthy, L. Bierwert et al. Ramzy, H. Farid, I. Kamal et al. Amaral, G. Dreyer, J.
Figueredo-Silva et al. Weerasooriya, M. Mudalige, N. Gunawardena, E. Kimura, and W. Bockarie, E. Pedersen, G. White, and E. Zagaria and L. Das, A. Manoharan, S. Subramanian et al. Amerasinghe and N. Triteeraprapab, K. Kanjanopas, S. Suwannadabba, S. Sangprakarn, Y. Poovorawan, and A. View at: Google Scholar W. Generally speaking, the total dosage of 0. Two to four courses three-month treatment were given intermittently to get good effects.
In a hyper-endemic area, where a portion of MF-positive people had comparatively high MF counts, the total dosage of 9 g DEC could not be sufficient to turn the high-density microfilaremia cases negative [ 32 , 34 , 35 ].
The use of DEC salt was not very suitable in the coastal region of China because there were many salt works and it was very difficult to control the salt sold by private merchants. Residents in some districts liked to use soy sauce or shrimp soy instead of cooking salt.
Under such circumstances, DEC was mixed with other salt products e. Comparing the three control schemes discussed above, the target treatment can save drug, but even repeated night blood surveys are unable to find out all the microfilaremia cases, and thus multiple treatments cannot cure all MF positives. The scheme needs a longer time period, and more manpower and money.
For the control program long-term, repeated surveys and treatments will make people, as well as disease control workers, tired of the activities, and result in little enthusiasm and morale [ 37 ]. The target treatment combined with mass chemotherapy can result in good effects quickly. However, the success depends upon a high drug intake rate.
The large workload for drug delivery, especially when people live scattered in mountainous regions, is a big shortcoming. Also, it is difficult to confirm that the full dosages were actually taken by people. In addition, attention has to be paid to possible acute abdomen among children due to ascarids after DEC treatment. The merits of DEC salt are its rare side reactions and safety.
These advantages solve the problem of low acceptability by people experienced with the other two regimens. The scheme can also reduce difficulty in drug delivery, thus saving lots of manpower [ 24 ]. The regimen of target treatment combined with mass chemotherapy or DEC salt is suitable for the meso- and hyper-endemic areas to make up for the weakness of the target treatment, and to reduce the MF rate of the population quickly.
According to the data accumulated in the entire control stage from to in China, Filariasis control with DEC was carried out for The number of people who took DEC salt accounted for China [ 34 ].
In , the Ministry of Health MOH issued a document entitled Criteria for the basic elimination of filariasis and assessment methods. The composition of the evaluation group, the evaluated range, the number of persons to be checked, sites to be selected, and quality control were all assigned [ 38 ]. In , the MOH approved the study on the transmission threshold of filariasis as a key project, and a nation-wide collaboration was developed with a unified design and method.
Twenty-one villages from 11 provinces with a total population of 32, were selected for the study. The microfilaria rate in the population was approximately 0. In the 21 research villages, there were microfilaremia cases. No control measures were taken in these villages, and follow-up blood surveys for residual microfilaremia were done every year or every two years.
Mosquitoes were collected and dissected, and changes in larval infection rates were observed in relation to human microfilaria rates.
In the transmission season, surveys on mosquito biting density and the use of mosquito nets were carried out [ 40 ]. In , data from the collaborative studies in the 21 villages were put together. It was considered that filariasis transmission in these villages had already dropped below the critical threshold level and that the transmission was virtually interrupted [ 41 ]. In , the MOH issued a document entitled Technical scheme for surveillance work in areas of basic elimination of filariasis.
Both theoretical knowledge and control practice indicated that filariasis had two characters prone to its interruption and ultimate elimination. First, filariasis transmission efficiency was low and the residual low-density microfilaremia cases had no epidemiological significance. Second, if the basic elimination of filariasis had once been achieved, the residual infection sources would, without treatment, gradually disappear in a few years four to five years for brugian filariasis, and five to seven years for bancroftian filariasis.
It was considered unnecessary to carry out a general blood survey to find out the residual infection sources and treat them. Elimination of filariasis was possible through systemic surveillance over a period of time [ 32 ]. The surveillance system included three parts: longitudinal surveillance, cross-sectional surveillance, and floating population surveillance. The MF positive cases would not be treated.
The aim of the longitudinal surveillance, which included mosquito studies, was to observe the dynamics of transmission of filariasis. Based on the original prevalence of filariasis and the locality of sample villages, a stratified cluster sampling method was used to select the subjects for the blood survey. The main aim of cross-sectional surveillance was, from multiple cross-sections, to observe the change in MF rate and density in the locality to provide bases for the elimination of filariasis.
The microfilaremia cases observed should be treated by DEC. For those coming from an endemic area or living in the local place for at least six months, the blood examination or serological test for filariasis should be done to accumulate data and evaluate the impact of floating populations on the filariasis elimination program at different stages.
Observed microfilaremia cases should be treated regularly [ 32 ]. After the termination of control measures, the majority of residual microfilaremia cases turned to be negative one after another in the period of ten years. In the fifth and ninth year, no microfilaremia case was found for bancroftian and brugian filariasis spots, respectively, in the surveillance. In the first year of surveillance, , mosquitoes were dissected and were positive for filarial larvae.
The positive rate of mosquitoes decreased gradually, and after the eight year of the surveillance, no positive mosquito was found [ 42 ]. When these data were analyzed according to the number of years after basic elimination of filariasis, 8, residual cases, In the 14 th year, there were five positives MF rate: 0. From to , cross-sectional mosquito vector surveys were performed.
A total of 4. No positive mosquito was found since [ 42 ]. From to , surveillance of the floating population was carried out.
The total number of , persons was surveyed by blood examination and microfilaremia cases were observed, all of them being detected before In , the MOH formulated two documents: Criteria for the filariasis elimination preliminary and Evaluation of filariasis elimination preliminary , and issued them formally for practical use in The evaluation of LF elimination was performed at prefecture and provincial levels.
The overall data related to the surveillance and the original records of the control program were reviewed and evaluated. Spot checks of blood examination were performed when needed.
Margaret Chan, the Director-General of WHO, confirming that China had reached the criteria for elimination of lymphatic filariasis as a public health problem. After half a century of diligent and sustained efforts that depended upon the proper strategies and effective measures to control the disease, lymphatic filariasis LF , once heavily endemic in large areas of China and causing severe illnesses in the population had finally been wiped out.
This is the result of the special attention paid by the Chinese Government towards the disease, as well as the continuous, active control. This success is also attributed to the long, hard struggle to control LF endured by research professionals over many generations. Other trips are planned but will depend on budgets and donations received pharmaceutical firms, private persons or sponsors.
Donations are not used to pay for airline tickets but to pay for our actions in the field. No money is given. Each paid action is detailed in an invoice: the entire accounting system is transparent see Web site for additional information.
To finish this section and to catch a glimpse of the future, according to what was said by the Ambassador of Burkina Faso in France, his Excellency Luc Tiao, if completion of this first dispensary is a success, many other centers could be built in Burkina Faso.
We will make use of what has been done in India to fight this scourge www. In a word to restore their freedom. We have much work to do. Lymphatic filariasis continues to affect millions of people worldwide. One of its results is the occurrence of lower limb lymphedema which can assume massive proportions, whence the term elephantiasis.
Our humanitarian aid missions have enabled us to discover this terrible disease, and to make every effort to treat it so as to prevent the worst possible treatment, amputation. The basic treatment for reduction of elephantiasis is compression therapy, which we have used to good effect several times.
The most unbelievable event in this medical adventure was that some patients spontaneously managed fellow sufferers. What satisfaction! Carme B. Revue du Praticien. Filariose lymphatique. Vaqas B, Ryan TJ. Lymphoedema: Pathophysiology and management in resource-poor settings- relevance for lymphatic filariasis control programmes. Filaria Journal. Macrofilaricidal activity after doxycycline treatment of Wuchereria bancrofti: A double-blind randomised placebo-controlled trial.
Some observations on the effect of Daflon micronized purified flavonoid fraction of Rutaceae aurantiae in bancroftian filarial lymphoedema. Cornu-Thenard A. Un extenseur au service de la compression. The Compressive Treatment of Members.
Editions EPF. Multicentre randomised controlled trial of four-layer bandaging versus short-stretch bandaging in the treatment of venous leg ulcers? Cornu-Thenard A, Boivin P. A new technique for reduction of lower limbs edema: Elastic stockings. Ed PRM. Dallas, Texas, Moffat CJ. International development of the Lymphoedema Framework. Journal of Lymphoedema. Jacobson J. Servier — Phlebolymphology Phlebolymphology is an international scientific journal entirely devoted to venous and lymphatic diseases.
Discovery of lymphatic filariasis during a humanitarian aid mission to Burkina Faso.
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