The recent trends of parasitic infections in Korea include remarkable decreases of soil-transmitted nematode infections and elimination of lymphatic filariasis. In comparison, enterobiasis (pinworm infection) continues to be prevalent among children and the cases of zoonotic tissue-invading nematode infection are slightly increasing or they are being increasingly diagnosed. In addition, imported parasitoses continue to be problems from the clinical and public health points of view. In this review, the advances in the management and anthelmintic treatment of these nematode infections are briefly reviewed. Albendazole, mebendazole, thiabendazole, flubendazole, pyrantel pamoate, pyrvinium pamoate, oxantel pamoate, levamisole, ivermectin, and diethylcarbamazine are the examples of anti-nematode anthelmintics that are currently being used. Although several of these drugs are known to be broad-spectrum anthelmintics, selection of each drug should be done specifically for each nematode infection, and with consideration of the specific conditions of each patient and the purposes, for example, when performing individual or mass treatment. It is hoped that the chemotherapy regimens reviewed here will help physicians to treat their patients infected with nematode parasites.
Albendazole ; Anthelmintics ; Child ; Diethylcarbamazine ; Elephantiasis, Filarial ; Enterobiasis ; Humans ; Ivermectin ; Korea ; Levamisole ; Mebendazole ; Nematode Infections ; Parasites ; Public Health ; Pyrantel Pamoate ; Pyrvinium Compounds ; Thiabendazole

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

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.

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

Human toxocariasis is a helminthozoonosis due to the migration of Toxocara species larvae through human organism. Humans become infected by ingesting either embryonated eggs from soil (geophagia, pica), dirty hands or raw vegetables, or larvae from undercooked giblets. The diagnosis relies upon sensitive immunological methods (ELISA or western-blot) which use Toxocara excretory-secretory antigens. Seroprevalence is high in developed countries, especially in rural areas, and also in some tropical islands. The clinical spectrum of the disease comprises four syndromes, namely visceral larva migrans, ocular larva migrans, and the more recently recognized "common" (in adults) and "covert" (in children) pictures. Therapy of ocular toxocariasis is primarily based upon corticosteroids use, when visceral larva migrans and few cases of common or covert toxocariasis can be treated by anthelmintics whose the most efficient appeared to be diethylcarbamazine. When diagnosed, all of these syndromes require thorough prevention of recontamination (especially by deworming pets) and sanitary education.
Animals ; Anthelmintics/therapeutic use ; Antibodies, Helminth/blood ; Biological Markers/blood ; Diethylcarbamazine/therapeutic use ; Enzyme-Linked Immunosorbent Assay ; Human ; Immunoglobulin E/blood ; *Larva Migrans, Visceral/diagnosis/epidemiology ; Toxocara/immunology

It is well known that tumor necrosis factor (TNF-a), interleukin-1, platelet-activating factor (PAF) and arachidonic acid metabolites, such as thromboxane and leukotriens, are major mediators involved in the pathogenesis of endotoxic shock. In this study, we have investigated the effect of pentoxifylline (inhibitor of TNF-a release), BN50739 (PAF antagonist), indomethacin (cyclooxygenase inhibitor) and diethylcarbamazine (lipoxygenase inhibitor) on LPS- induced lethality as well as the relationship between major mediators in endotoxic shock. All inhibitors described above except diethylcarbamazine significantly protected mice against LPS- induced lethality. BN50739 and indomethacin were also effective in protection of TNF-a-induced lethality. The elevation of circulating TNF-a by LPS was significantly blocked by BN50739, but not affected by indomethacin. Convulsion appeared shortly after LPS injection was prevented by BN50739 but not by indomethacin, whereas diarrhea and limited movement was prevented by indomethacin but not by BN50739. These results indicate that i) TNF-a, PAF and cyclooxygenase products are important mediators involved in the pathogenesis of septic shock and ii) TNF-a directly influenced the release or production of PAF as well as cyclooxygenase products, and strongly suggest that i) TNF-a and PAF stimulate the release of each other via positive feedback network but TNF-a and cyclooxygenase products do not form the network and ii) PAF and cyclooxygenase product appear not to affect the release of each other.
Animals ; Arachidonic Acid ; Diarrhea ; Diethylcarbamazine ; Gene Expression* ; Indomethacin ; Interleukin-1 ; Mice ; Pentoxifylline ; Prostaglandin-Endoperoxide Synthases ; Seizures ; Shock, Septic ; Tumor Necrosis Factor-alpha*

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

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

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

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