徐闻县消除丝虫病的研究

目的 总结和分析徐闻县消除丝虫病的经验、措施和效果。方法 采用回顾性调查方法，对徐闻县丝虫病的流行分布情况、丝虫病防治试点研究和控制丝虫病的策略和措施及其效果进行总结和分析。结果 1970年徐闻县有94．44％(17／18)的乡镇流行班氏丝虫病，人群微丝蚴率为4．06％(8785／216440)，传播媒介为致倦库蚊。在流行病学调查的基础上，开展了海群生不同治疗方案治疗丝虫病的疗效，人群微丝蚴率与蚊媒自然感染率的关系及反复查治防治丝虫病的效果等丝虫病防治试点研究，确立了以消灭传染源为主导的策略，采取了反复查治结合重点人群服药的措施。至1986年省级基本消除丝虫病达标考核，人群平均微丝蚴率下降为0．24％。随后采取分层整群监测方法进行监测，1988～1992年病原学监测10个乡镇44个村，微丝蚴率为O．019％；1994年后，病原和蚊媒监测均未发现人体丝虫感染。2000年8月经省审评组审评，达到卫生部消灭丝虫病标准。结论 在流行病学调查和防治试点研究的基础上，采取以消灭传染源为主导的策略和基本消除丝虫病后分层整群的监测方法对消除丝虫病都是切实可行、卓有成效的．     

九江市消除淋巴丝虫病的研究

目的总结和分析九江市消除淋巴丝虫病的经验、措施和效果。方法采用回顾性调查方法，对九江市丝虫病的流行分布情况、丝虫病防治试点研究和控制丝虫病的策略、措施及其效果进行总结和分析。结果1972年前九江市有11个县区165个乡、镇流行丝虫病，人群微丝蚴率为14．85％(165237／1112540)，传播媒介为中华按蚊和致倦库蚊。在流行病学调查的基础上，开展了微丝蚴染色方法的研究、海群生不同治疗方案治疗丝虫病的疗效及反复查治防治丝虫病的效果等丝虫病防治试点研究，确立了消灭传染源为主导的策略，采取了反复查治结合重点人群服药的措施。至1988年省级基本消除丝虫病达标考核，人群平均微丝蚴率为0．16％。随后采取分层整群监测，1989～1999年病原学监测34个乡、镇50个村，平均微丝蚴率0．29％(140／47321)，2000年后病原学和蚊媒监测均未发现人体丝虫感染。2001年经省审评组审评，达到卫生部消除丝虫病标准。结论采取以消灭传染源为主的防治措施以及基本消除丝虫病后的流行病学监测和全民服药、药盐防治，可实现消除丝虫病的目标。     

九江市消除淋巴丝虫病的研究

目的　总结和分析九江市消除淋巴丝虫病的经验、措施和效果。　方法　采用回顾性调查方法 ,对九江市丝虫病的流行分布情况、丝虫病防治试点研究和控制丝虫病的策略、措施及其效果进行总结和分析。　结果　 1972年前九江市有 11个县区 165个乡、镇流行丝虫病 ,人群微丝蚴率为 14 .85 % (165 2 3 7/ 1112 5 40 ) ,传播媒介为中华按蚊和致倦库蚊。在流行病学调查的基础上 ,开展了微丝蚴染色方法的研究、海群生不同治疗方案治疗丝虫病的疗效及反复查治防治丝虫病的效果等丝虫病防治试点研究 ,确立了消灭传染源为主导的策略 ,采取了反复查治结合重点人群服药的措施。至 1988年省级基本消除丝虫病达标考核 ,人群平均微丝蚴率为 0 .16%。随后采取分层整群监测 ,1989～ 1999年病原学监测 3 4个乡、镇 5 0个村 ,平均微丝蚴率 0 .2 9% (14 0 / 473 2 1) ,2 0 0 0年后病原学和蚊媒监测均未发现人体丝虫感染。2 0 0 1年经省审评组审评 ,达到卫生部消除丝虫病标准。　结论　采取以消灭传染源为主的防治措施以及基本消除丝虫病后的流行病学监测和全民服药、药盐防治 ,可实现消除丝虫病的目标。     

广东省阳山县丝虫病防治与监测

目的了解广东省阳山县丝虫病流行情况,总结消除丝虫病的策略及经验,巩固丝虫病的防治成果。方法采取以消灭传染源为主导,反复查治,重点人群服药治疗,全民普服海群生药盐的综合性防治措施控制丝虫病的流行。基本消除丝虫病后继续开展流行病学监测,清除残存传染源,阻断其传播。结果经过反复查治,阳山县微丝蚴率从防治前的4.35%降至0.12%,1980年达到基本消除丝虫病标准,1996年经广东省卫生厅组织评审,确认全县范围已阻断丝虫病传播,达到了消除丝虫病标准。基本消除和消除丝虫病后进行的病原及蚊媒监测,均未发现新的微丝蚴血症者及蚊媒幼丝虫感染。结论阳山县防治丝虫病各项技术措施可行,防治效果和消除丝虫病的远期效果巩固。     

广东省阳山县丝虫病防治与监测

目的了解广东省阳山县丝虫病流行情况，总结消除丝虫病的策略及经验，巩固丝虫病的防治成果。方法采取以消灭传染源为主导，反复查治，重点人群服药治疗，全民普服海群生药盐的综合性防治措施控制丝虫病的流行。基本消除丝虫病后继续开展流行病学监测，清除残存传染源，阻断其传播。结果经过反复查治，阳山县微丝蚴率从防治前的4．35％降至0．12％，1980年达到基本消除丝虫病标准，1996年经广东省卫生厅组织评审，确认全县范围已阻断丝虫病传播，达到了消除丝虫病标准。基本消除和消除丝虫病后进行的病原及蚊媒监测，均未发现新的微丝蚴血症者及蚊媒幼丝虫感染。结论阳山县防治丝虫病各项技术措施可行，防治效果和消除丝虫病的远期效果巩固。     

日照市丝虫病防治与监测研究

目的 总结和分析丝虫病的防治方法和效果,探讨消除丝虫病的有效途径。 方法 用回顾性调查方法,对日照市丝虫病的流行趋势、防治措施、效果进行总结和分析。 结果 1956年调查,日照市人群微丝蚴率为15.13％,传播媒介为淡色库蚊。经过反复普查普治,1980年微丝蚴率降为0.09％,达到了部颁基本消除丝虫病标准。此后,经过针对性查治和监测,残存传染源得到彻底净化,1984年以来,病原学和蚊媒监测未再发现丝虫感染者和阳性蚊。2003年经省级审评确认达到部颁消除丝虫病标准。 结论 日照市丝虫病流行趋于终止。以消除传染源为主导的防治策略和措施,是切实可行和卓有成效的。在丝虫病防治后期开展对残存传染源的管理与监测,是消除丝虫病的有效途径。     

日照市丝虫病防治与监测研究

目的总结和分析丝虫病的防治方法和效果，探讨消除丝虫病的有效途径。方法用回顾性调查方法．对日照市丝虫病的流行趋势、防治措施、效果进行总结和分析。结果1956年调查，日照市人群微丝蚴率为15．13％．传播媒介为淡色库蚊。经过反复普查普治．1980年微丝蚴率降为0．09％，达到了部颁基本消除丝虫病标准。此后，经过针对性查治和监测，残存传染源得到彻底净化，1984年以来，病原学和蚊媒监测未再发现丝虫感染者和阳性蚊。2003年经省级审评确认达到部颁消除丝虫病标准。结论日照市丝虫病流行趋于终止。以消除传染源为主导的防治策略和措施，是切实可行和卓有成效的。在丝虫病防治后期开展对残存传染源的管理与监测，是消除丝虫病的有效途径。     

济南市消除淋巴丝虫病的对策与效果

目的 总结丝虫病防治对策和技术措施，评价防治效果。方法 采用回顾性调查的方法，收集济南市丝虫病防治资料，对防治丝虫病对策及效果进行总结和评价。结果 在流行病学调查的基础上，开展了海群生治疗丝虫病，海群生药盐防治丝虫病的试点研究，确立了以消灭传染源为主导的对策，采取了分阶段实施不同查治方法结合重点人群预防服药的措施。1980年通过了基本消除丝虫病效果考核，平均微丝蚴率由防治前的3．10％降为0．12％(75／62216)。1981～2002年开展丝虫病纵、横向监测，检出微丝蚴血症者30人，微丝蚴率0．03％。末次病原学阳性后血检37944人，未发现微丝蚴阳性者。2003年达到卫生部消除丝虫病标准。结论 在流行病学调查和防治试点的基础上，采取以消灭传染源为主的防治对策和预防服药以及基本消除丝虫病后进行纵、横向监测的方法，是消除丝虫病的关键措施。     

周宁县基本消灭丝虫病后监测结果

丝虫病在我县流行已久。防治前各村原微丝蚴率为0.12％～20.0％,全县平均为2.45％,以马来丝虫为主。1958年以来开展多次大规模的查治,并采取以消灭传染源为主的综合防治措施,到1976年经省、地组织考核,居民微丝蚴率降至0～0.64％,平均为0.16％,达到基本消灭丝虫病的标准。1977～1990年,先后9次对原微丝蚴率较高的乡、村进行人群和蚊媒监测。     

济南市消除淋巴丝虫病的对策与效果

目的　总结丝虫病防治对策和技术措施 ,评价防治效果。　方法　采用回顾性调查的方法 ,收集济南市丝虫病防治资料 ,对防治丝虫病对策及效果进行总结和评价。　结果　在流行病学调查的基础上 ,开展了海群生治疗丝虫病 ,海群生药盐防治丝虫病的试点研究 ,确立了以消灭传染源为主导的对策 ,采取了分阶段实施不同查治方法结合重点人群预防服药的措施。 1980年通过了基本消除丝虫病效果考核 ,平均微丝蚴率由防治前的 3 .10 %降为 0 .12 % (75 /62 2 16)。1981～ 2 0 0 2年开展丝虫病纵、横向监测 ,检出微丝蚴血症者 3 0人 ,微丝蚴率 0 .0 3 %。末次病原学阳性后血检 3 7944人 ,未发现微丝蚴阳性者。 2 0 0 3年达到卫生部消除丝虫病标准。　结论　在流行病学调查和防治试点的基础上 ,采取以消灭传染源为主的防治对策和预防服药以及基本消除丝虫病后进行纵、横向监测的方法 ,是消除丝虫病的关键措施。     

滕州市消灭丝虫病的技术措施

目的　总结滕州市消灭丝虫病的技术措施。　方法　将滕州市 4 0余年丝虫病防治研究资料进行整理分析。　结果　通过流行病学调查、普查普治、全民食用乙胺嗪药盐 ,达到基本消灭丝虫病的标准。之后 ,对原微丝蚴血症者开展复查复治 ,于 1995年达到了消灭丝虫病的标准。　结论　确立以消灭传染源为主的防治策略 ,落实监测方案 ,可达到消灭丝虫病的目标。     

Effects of ivermectin and diethylcarbamazine on microfilariae and overall microfilaria production in bancroftian filariasis

Ivermectin and diethylcarbamazine (DEC) are used in mass treatment programs for the elimination of lymphatic filariasis because of their strong effects on microfilaremia. However, the effects of treatment on adult worms and the degree of individual variation in efficacy are unclear. We analyzed series of microfilaria (Mf) counts from individuals treated with a single dose of 400 microg/kg ivermectin or 6 mg/kg DEC (N = 23 in each group; 1 year follow-up). For each individual, we estimated the microfilaricidal effect and the reduction in overall Mf production (e.g., caused by death or sterilization of worms, or inhibited Mf release from the female worm uterus). Ivermectin on average killed 96% of Mf and reduced Mf production by 82%. DEC killed 57% of Mf and reduced Mf production by 67%, with some individuals responding very poorly. The strong reduction in overall Mf production is good news for control of lymphatic filariasis, but the prospects of elimination will be diminished if part of the population systematically responds poorly to treatment.     

Prolonged persistence of residual Wuchereria bancrofti infection after cessation of diethylcarbamazine-fortified salt programme

Summary A diethylcarbamazine (DEC)‐fortified salt intervention programme was implemented between 1982 and 1986 in Karaikal district, Union territory of Pondicherry, south India, to control Culex transmitted bancroftian filariasis. The intervention reduced the microfilaria (Mf) rate from 4.49% to 0.08%. To eliminate the residual microfilaraemia, the health department detected and treated Mf carriers from 1987 to 2005 and mass‐administered drugs in 2004 and 2005. Surveillance from 1987 to 2005 revealed persistent microfilaraemia in 0.03–0.42% of the population. In 2006, we conducted a more detailed Mf survey and a child antigenaemia (Ag) survey in 15 urban wards and 17 rural villages. These surveys showed an overall Mf rate of 0.46% in the high‐risk urban areas and 0.18% in the rural areas; none of the sampled children was positive for Ag. All detected Mf carriers were >20 years old. The age of the youngest Mf carrier was 30 years in urban and 21 years in rural areas, which suggests that transmission was interrupted and there was no incidence of new Mf case after cessation of DEC salt programme. Eleven of 15 urban and 15 of 17 villages were totally free from microfilaraemia. Nevertheless, three of 15 surveyed urban localities and two of 17 villages showed >1% Mf rate. Thus, it seems that (i) post‐intervention very low levels of microfilaraemia can continue as long as 20 years; (ii) 0.60–0.70% Mf rate is a safe level and at this level recrudescence of infection may not occur; (iii) there can be isolated localities with >1% Mf rate and their detection for further intervention measures could be challenging in larger control/elimination programmes and (iv) the residual infection mostly gets concentrated in the adult population, in underdeveloped urban areas and in historically highly endemic or large endemic rural areas. These groups and areas should be targeted with rigorous intervention measures such as mass drug administration to eliminate the residual infection.     

基本消灭班氏丝虫病后的远期监测

本文报道采用海群生对象治疗加流行村全民服药和对象治疗加食用海群生药盐基本消灭班氏丝虫病后的纵向和横向监测结果。两种不同措施基本消灭丝虫病后已监测9－11年，人群微丝蚴率均在逐年下降，前6年仍可检出残存微丝蚴血症者，以后连续5年未再发现微丝蚴阳性，蚊媒调查亦未发现幼丝虫自然感染，IFAT检测人群丝虫抗体阳性率为1．4－5．5％，降至非丝虫病流行区抗体水平，证明丝虫病的传播已被阻断。认为基本消灭班氏丝虫病后监测年限以10年左右为宜，并需连续3年以上未检出微丝蚴血症者和感染蚊，人群丝虫抗体阳性率降至当地非流行区水平，可以确认丝虫病已达到消除。     

The effect of six rounds of single dose mass treatment with diethylcarbamazine or ivermectin on Wuchereria bancrofti infection and its implications for lymphatic filariasis elimination

Annual mass treatment with single-dose diethylcarbamazine (DEC) or ivermectin (IVM) in combination with albendazole (ALB) for 4-6 years is the principal tool of lymphatic filariasis (LF) elimination strategy. This placebo-controlled study examined the potential of six rounds of mass treatment with DEC or IVM to eliminate Wuchereria bancrofti infection in humans in rural areas in south India. A percentage of 54-75 of the eligible population (> or =15 kg body weight) received treatment during different rounds of treatment - 27.4% in the DEC arm and 30.7% in the IVM arm received all six treatments, 4.8% and 5.6% received none, and the remainder received one to five treatments. After six cycles of treatment, the microfilaria (Mf) prevalence in treated communities dropped by 86% in the DEC arm (P < 0.01) (n = 5 villages) and by 72% in the IVM arm (P < 0.01) (n = 5 villages), compared with 37% in the placebo arm (P < 0.05) (n = 5 villages). The geometric mean intensity of Mf fell by 91% (t = 8.11, P < 0.05), 84% (t = 6.91, P < 0.05) and 46% (t = 2.98, P < 0.05) in the DEC, IVM and placebo arms, respectively. The proportion of high-count Mf (>50 Mf per 60 mm(3) of blood) carriers was reduced by 94% (P < 0.01) in the DEC arm and by 90% (P < 0.01) in the IVM arm. Among those who received all six treatments, 1.4% in the DEC arm and 2.4% in the IVM arm remained positive for Mf. Two of five villages in the DEC arm and one of five in the IVM arm showed zero Mf prevalence, but continued to have low levels of transmission of infection. The results also indicate that DEC is as effective as or slightly better than IVM against microfilaraemia. Results from this and other recent operational studies proved that single-dose treatment with antifilarials is very effective at community level, feasible, logistically easier and cheap and hence a highly appropriate strategy to control or eliminate LF. Higher treatment coverage than that observed in this study and a few more than six cycles of treatment and more effective treatment tools/strategies may be necessary to reduce microfilaraemia to zero level in all communities, which may lead to elimination of LF.     

A pilot study on the status of lymphatic filariasis in a rural community of Bihar

A pilot study of lymphatic filariasis was conducted in two contiguous villages of Patna district in Bihar situated at the side of the river Ganges, known to be endemic for lymphatic filariasis, to study present status of transmission parameters of filariasis. Of the 1872 persons examined, 8.4% were found asymptomatic but microfilaraemic. Morbidity pattern due to filarial infection showed an increase with advancement of age and significantly high in males as compared to female (p < 0.001). Acute and chronic filarial disease was observed as 0.5% and 9% respectively. Microfilaria was found in 10% of acute and 11.2% of chronic filarial cases. The Mf rate was found to be 9.9% in males and 9.0% in females respectively. The parasite species was identified as W. bancrofti. The vector fauna surveyed show highest prevalence of vector species of Cx. quinquefasciatus (43%) in both domestic as well as predomestic area in the community. Other species like Cx. vishnui and Ma. uniformis were also seen. Each household and predomestic area was searched for mosquito fauna at night. The infection rate in vectors was found to be 14% and infectivity rate (L3) was 8%. The filariasis cases detected in the study were treated with 12 days course of DEC 6 mg/kg body weight.