A series of 250 patients with filariasis due to periodic type of Brugia malayi was selected for the mass treatment with diethylcarbamazine from two areas in Cheju-Do. Two types of dosage schedules have been employed: the one was the conventional dosage schedule (uninterrupted dose of 6 mg/kg once daily 6 times repeated with an interval of one or two month totaling 72 mg/kg), and the other was the low dosage schedule (uninterrupted dose of 0.5, 1, 2, 4, 6 mg/kg body weight given once a day with an additional 6 mg/kg once daily totaling the maximum 37.5 mg/kg). The relative effectiveness of those two schedules was evaluated under the basis of the effects on microfilaria counts and the results of analysis of side-reactions observed. The results obtained in this experiment are summarized as it follows. In the conventional dosage treatment, 118 out of 141 microfilaria positives treated (83.7%) became negative and microfilaria reduction rate was about 99%. However, in the low dosage treatment, 35 out of 43 positives treated (85.4%) became negative and reduction rate of microfilaria, 99.5% in average. Total dose and duration of treatment were 72 mg/kg and about 60 days in the former schedule but it were maximum 37.5 mg/kg and 10 days in the latter. The recurrence of filariasis after treatment in both conventional and low dosage was negligible. Comparative analyses regarding the resulting side-reactions between the two schedules were made on their frequency, severity, onset and duration and relationship with microfilaria density. The febrile reaction was most frequently observed in 80.5% in the conventional, 43.9% in the low dosage schedule. The main side-reactions usually appeared within 6 to 10 hours and lasted 48 to 72 hours in the former threament, however they occurred in 7 to 8 hours and lasted 24 to 43 hours in the latter dosage schedule. It is assumed that the side-reactions are not directly related with the microfilaria count. However, the febrile reaction seems to be correlated with microfilaria density if it is above a certain limit. The presence of adult worm in a lymphnode involved with local reaction was ascertained from the biopsy specimens performed and local reactions such as lymphangitis and lymphadenitis after drug administrations were assessed from clinical and pathological point of view. It was conclusively indicated that the chemotherapeutic response to low dosage schedule within shorter length of treatment was equal to that of larger doses in long term medication from the point of the reduction in microfilaria, and particularly the resulting side-reactions were also reduced in the low dosage schedule.
parasitology-helminth-nematoda-Bruigia malayi ; chemotherapy-diethylcarbamazine ; microfilaria ; diethylcarbamazine

Control programme of malayan filariasis by diethylcarbamazine was set up in village, Cheju-Island, Korea. The daily dose of 6 mg per kg of body weight for 6 days was chosen as a chemotherapeutic course only for microfilaria positives, which was repeated with an interval of one or two months. For the evaluation of drug control programme the yearly posttreatment blood survey was carried out. The results collected from 1970 to 1973 were analysed from the various points of view, such as microfilaria positive rates, incidence as well as prevalence rates. The change of microfilaria counts was also utilized for the comparison of the intensity of infection among population in the four year blood surveys. Considering the extremely skewed distribution of average microfilaria density, the mode of frequency distribution of microfilaria density in a population was particularly taken into account for the evaluation of changing endemicity affected by diethyecarbamazine treatment. The equation; Y= a+b log X(a , b: constants, X=microfilaria density; Y=probit scale of cumulative frequency of positives to X microfilariae) was found to fit farily well the data collected from four-year surveys before and after treatment. From these data obtained, four regression lines have been drawn by determining "a" and "b"; two paramenters, which were increased year by year since inauguration of control programme. In the present investigation, it was verified that the chmotherapeutic control measure of malayan filariasis applied in a village of Cheju-Island has been successfully carried out and the quantitative level of endemicity inthis area has also been distinctly lowered within the four-year control programme.
parasitology-helminth-nematoda-Brugia malayi ; chemotherapy-diethylcarbamazine ; control ; filariasis ; diethylcarbamazine

A survey on the drug compliance and side effects of DEC with dose of 6mg/kg and albendazone with dose of 400mg/kg was conducted in 5 communes of Khan Vinh district, Khan Hoa province. 831 people were interviewed for KAP, the average rate of taking medicines was 86%. The rate of side effects was 14%, including giddiness 6%, fever 0.6%, headache 1.68%, colic and nausea 1.32%, body pain 2.52%, tiredness 1.32% and others 4.69%
Diethylcarbamazine ; Pharmaceutical Preparations ; adverse effects ; drugs

This study was carried out for three years from 1968 to 1970. Three coastal villages and four remote islets of Che Ju Island were surveyed and 90% of all inhabitants were blood smeared. These study areas were grouped into five according to its characteristic for evaluation of mass treatment with diethylcarbamazine citrate (Hetrazan U.S.P.) and insecticide spray in control of human filariasis. To set baseline up for control group, placebo was administered. Followings are the results obtained: 81.1% of all mf positives accepted and completed the mass chemotherapy; main reason for refusal was side reactions told by neighboring villagers who experienced them. 6 mg of hetrazan/kg B.W. x 12 doses given every day turned mf postives to mf negative in 92.1%. The patients who had high mf density remained mf positive in 16.5% whereas only 2.1% for low mf density. 73.8% of mf positives after the treatment showed marked decrease in mf density. Most of them to less than 15n mg/20 mm(3) of blood that can not infect mosquito effectively. Mosquito infection rates were also dropped markedly in areas where mf positive were mass treated. Side reaction induced by diethylcarbamazine was frequent(64%-90%) and various. The most frequent symptom was headache and fever. DDT spray did not influence human mf rate and mosquito infection rate.
parasitology-helminth-nematoda ; chemotherapy-diethylcarbamazine citrate ; epidemiology ; Brugia malayi ; filariasis ; diethylcarbamazine citrate

A study on the effect of diethylcarbamazine (DEC) (Supatonin) against Brugia malayi infection was conducted on Cheju Island in September 1965. A total of 182 persons living in a village of Aiwol Myun, Bukcheju-Gun was examined for microfilaraemia. Microscopic examination of smears of 20 microliter of blood revealed a microfilaria positivity rate of 28.5 per cent. At the end of September 1965, 34 confirmed microfilaria positive cases were treated with DEC at a daily dosage of 5 mg/kg body weight. A full course of 12 days of drug administration divided of two rounds for 6 days each was used. The first round of treatment was given under a strict supervision of the author in order to observe carefully side-effects of the drug. The second round of treatment was given in January 1966. The microfilaria density in 20 microliter of blood of those who received the drug was checked four times; before the treatment, during the first round of the treatment, 2 weeks and 4 months after the completion of the first round. The pre-treatment mean microfilaria density of 104.6 diminished to nearly zero (only two cases with one microfilaria respectively) 2 weeks after the first round and again slightly rose up to 0.5 four months after the first round. These results indicate that DEC (Supatonin) is highly effective to eliminate the microfilaria of B. malayi. However, severe side-effects, e.g. fever (average 38.6C, maximum 39.7C), headache, backache and seldom abdominal discomfort ect. were observed. There were two cases of withdrawal from the scheme due to refusal.
parasitology-helminth-nematoda ; Brugia malayi ; chemotherapy-diethyl carbamazine ; diethylcarbamazine

The Phase 1 semiannual single-dose 6 mg/kg diethylcarbamazine (DEC) treatment program demonstrated a significant reduction for Wuchereria bancrofti in the Ok Tedi area of Western Province, Papua New Guinea. The rate of detectable microfilaraemia was effectively reduced from 39% to 11% and mean microfilarial (mf) densities from 79mf/20 microliters to 19mf/20 microliters. The Phase 2 annual single-dose treatment of 6mg/kg DEC not only maintained the gains made during Phase 1 but reduced the microfilaraemia rate to less than 5% by 1990, with mf densities remaining stable at less than 20mf/20 microliters, amongst all participating villagers screened within the 5 original villages. The annual treatment program was expanded into 7 remote villages not subject to any form of active vector control. The microfilaraemia rate in these villages declined from 41% before treatment to 17% after only two annual administrations of 6mg/kg DEC, and mf blood densities were reduced from 71mf/20 microliters to 20mf/20 microliters. As was observed in the 5 original villages participating in the program, a significant reduction in splenomegaly associated with the DEC treatment was reported for the 7 villages in the expanded program during Phase 2; enlarged spleen rates were reduced from 50% (1986) to 32% (1990) and from 76% (1988) to 48% (1990), respectively. Malaria rates on the other hand increased slightly or remained stable. Malaria infections associated with W. bancrofti (mixed parasite infections) stimulated a greater splenic response than either parasite detected on its own.
Adolescent ; Child, Preschool ; Diethylcarbamazine - administration & ; dosage ; Drug Administration Schedule

Malayain filariasis in Korea is reviewed in the point of history, parasitology, epdidemiology, pathology and clinical aspects, diagnosis and chemotherapy.
parasitology-helminth-nematoda ; Brugia malayi ; filariasis ; epidemiology ; pathology ; clinical finding ; diagnosis ; chemotherapy ; diethylcarbamazine ; Aedes togoi

OBJECTIVE: Elimination eforts for lymphatic flariasis are underway in the Philippines using mass drug administration (MDA) of diethylcarbamazine and albendazole as one of the main strategies. This cost analysis was done to determine the MDA implementation cost and provide useful information to the control programme on how to best utilize limited resources.

METHODS: This cost analysis study was conducted in the province of Sorsogon, Philippines in 2004. The study was done from a program perspective. Cost data for 2003 was obtained retrospectively via key informant interviews and records review using a standardized guide from a multi-country cost analysis study of flariasis elimination programs. Cost fgures were classifed as either economic or fnancial costs and expressed in real terms using 2002 as base year. Sensitivity analysis was likewise performed.

RESULTS: The total economic cost and cost per person treated with MDA were estimated at US$223,549.55 (Php12,116,385.48) and US$0.40, respectively. The fnancial costs were less than half of the economic costs. The main cost driver was drug distribution. The highest economic and fnancial costs were incurred at the national (54.5%) and municipal (74.4%) levels, respectively. High variation in costs of MDA activities was observed.

CONCLUSION: This cost analysis provides reasonable estimates which may be used to assist government and other stakeholders in program planning and resource generation for flariasis elimination programs in endemic areas.

*Anopheles ; *Ascariasis ; *Communicable Disease Control ; *Diethylcarbamazine ; *Filariasis ; *Malaysia ; *Mosquito Control ; *Wuchereria

A successful experience of lymphatic filariasis control in the Republic of Korea is briefly reviewed. Filariasis in the Republic of Korea was exclusively caused by infection with Brugia malayi. Over the past several decades from the 1950s to 2006, many investigators exerted their efforts to detection, treatment, and follow-up of filariasis patients in endemic areas, and to control filariasis. Mass, combined with selective, treatments with diethylcarbamazine to microfilaria positive persons had been made them free from microfilaremia and contributed to significant decrease of the microfilarial density in previously endemic areas. Significant decrease of microfilaria positive cases in an area influenced eventually to the endemicity of filariasis in the relevant locality. Together with remarkable economic growth followed by improvement of environmental and personal hygiene and living standards, the factors stated above have contributed to blocking the transmission cycle of B. malayi and led to disappearance of this mosquito-borne ancient disease in the Republic of Korea.
Animals ; Brugia malayi/isolation & purification ; Diethylcarbamazine/therapeutic use ; Elephantiasis, Filarial/diagnosis/*drug therapy/*epidemiology/parasitology ; Endemic Diseases ; Filaricides/therapeutic use ; Humans ; Republic of Korea/epidemiology