The chemoprophylactic use of diethylcarbamazine citrate at total oral doses of 15--180 mg/kg body weight was tested against subperiodic Brugia malayi infection in the leaf monkey (Presbytis melalophos). A total dose of 45 mg/kg body weight given over 9 days killed all developing infective larvae. Similarly, a total dose of 35 mg/kg body weight given over 7 days killed all fourth stage larvae. The minimum effective dose that prevents infection would be 5 mg/kg body weight daily for 7 days every month.
Quantitation of serum immunoglobulin M, G, A, D and E levels was carried out in Malaysians with Brugia malayi infections. Results showed highly elevated levels of IgM and IgE as well as moderately elevated levels of IgG. These were most significant in patients with tropical pulmonary eosinophilia or elephantiasis. Serum IgE levels were extremely high in microfilaraemic patients (6,060 +/- 3,958 IU ml) probably due to a constant antigenic stimulation by dead and dying microfilariae.
Breinlia booliati Singh and Ho, 1973 is described from the Malaysian wood rat, Rattus rattus jalorensis Bonhote. The parasites presented here were originally discovered in 1955 in Kuantan, Malaysia, but were not classified until now. On the basis of morphological observations of anatomical structures and comparisons with other species of Breinlia, it was determined that the parasites were B. booliati. The parasites discussed here show slight deviation from B. booliati, but they do not warrant a new species classification. There is some variation in anatomical measurements, the number of male caudal papillae, and the morphology of the microfilariae. Breinlia booliati from a new host is described in this article, with a brief discussion on Rattus species that are hosts of B. booliati and vectors that transmit the parasite. The occurrence of B. booliati in R. r. jalorensis represents the first report of the parasite in this host.
The blood filtration method was used as the gold standard to determine the detection level of simple blood-spot sampling and nested-polymerase chain reaction (PCR) for Brugia malayi. Of 100 samples, 48 were filtration-positive. Of these, 26 had microfilaria counts that were low enough (<1-29 microfilariae/ml) to accurately assess the limit of detection by nested-PCR. Nested-PCR consistently detected B. malayi DNA in samples with > or = 10 microfilariae/ml. Post-filtration, microfilaria-depleted, blood-spots from microfilaria-positive samples were screened by nested-PCR and B. malayi specific 'free' DNA was detected in 51.7% of these samples. There was no evidence for 'free' DNA in microfilaria-negative individuals from this endemic community.
Laboratory strain of the Malaysian Culex quinquefasciatus was susceptible to Wuchereria bancrofti. Thirty three percent of the Cx. quinquefasciatus that fed on W. bancrofti patient were infective after 12-14 days. There is a possibility for W. bancrofti to occur in the urban areas of the Malaysia in the near future.
Breinlia booliati exhibited nocturnal subperiodicity in its natural host, Rattus sabanus in contrast to experimentally infected laboratory-reared albine rats which showed irregular fluctuations of microfilariae throughout the 24 hour cycle. All the infected albino rats showed a prepatent period between 11-14 weeks postinoculation. Three patterns of microfilaraemia were discerned during the course of infection 38/49 rats displayed a single peak, 4/49 displayed 2 peaks about 12-15 weeks apart and 7/49 showed a sustained high plateau-like pattern of microfilaraemia. Cortisone had no effect on microfilarial levels when administered to rats near postpatency and some at postpatency.
A total of 82 persons have been found to be positive for microfilaria a sub-periodic Brugia malayi out of 1,613 examined in seven villages in Serian District. This represents an average microfilaria infection rate of 5.1% with a range of zero to 10.7%. It is found that males are more predominantly affected than females with a ratio of 3:1. It is also confirmed that Mansonia dives and M. bonneae are possible vectors for the transmission of the disease although Anopheles species cannot be ruled out owing to the small number of specimens examined. The study is confined to areas where indoor DDT spraying has been done since 1960 and only in two of the areas it has been terminated in 1966. Yet to be published data shows higher filaria infection rate than any of these villages.
Similar HLA association was found in patients with elephantiasis in Sri Lankans and Southern Indians. HLA-B15 was observed in 13/44 (30%) Sri Lankan patients with elephantiasis compared to 1/27 (4%) Sri Lankan controls (p = .0058; RR = 10.9) and in 5/8 (28%) Southern Indian elephantiasis compared to 10/101 (10%) Southern Indian controls (p = 0.04; RR = 3.5). In combining the data, the significance of the difference of the frequency of B15 between patients with elephantiasis and controls was even more marked (p = 0.00045; corrected p = 0.012; RR = 4.4).
Studies on age groups within activity cycles, age composition and survivorship in natural populations of Mansonia in Kampung Pantai, Bengkoka Peninsula of Sabah state have been described. Early activity of 3-5 parous Ma. bonneae during the first hour after sunset was noted. Age composition of Ma. bonneae at forest shade, indoor and outdoor of house, comparative buffalo vs human bait outdoor in Kampung Pantai showed all round high parous rates ranging from 66.7 to 75.4%. Population 3-parous and older ranged from 18.8 to 26.7%. Nine of the 14 infective Ma. bonneae were 3-parous and this segment of the population was engaged in active transmission. High parous rates were observed in Ma. dives and Ma. uniformis taken in small numbers. Parous rates of Ma. bonneae taken in Kampung Delima and Kampung Taradas were also high. Estimates of daily survivorship of Ma. bonneae and Ma. dives determined by two methods were very high.
A study to identify the knowledge of infected and uninfected respondents on filariasis and epidemiologic factors in one endemic community in Malaysia to determine their role in the transmission and control of filariasis was carried out. The data were collected by non-participant observations and interviews using semi-structured schedules. The majority of respondents in both groups had knowledge of filariasis. There was no marked difference between male and female respondents, and similarly, there was fair distributions of knowledgeable respondents with and without some years of schooling. On filarial transmission, 9.2% of the infected said that filariasis was contacted through mosquito bites, while among the uninfected it was 7.4%. Within the infected, 14.8% thought that filarial worms entered the human body through the consumption of unhygenically prepared foods and drinks while, among the uninfected it was 20.4%. Both groups were aware of the presence of mosquitoes in their village. However, the majority did not associate this factor with host's susceptibility to filarial infections. Rather, they were of the opinion that personal hygiene and proper meals had something to do with filariasis. The findings showed there was general awareness of filariasis in the community which might indicate that the health campaigns had reached various levels of the population. Yet, they still lacked knowledge on disease transmission. Also, they did not make direct association between environment and exposure to mosquitoes bites though they were aware of their presence but which they regarded as not directly harmful to their health.
We are reporting a case of an eye lesion caused by an adult Brugia malayi. The patient was a 3-year-old Chinese boy from Kemaman District, Terengganu, Peninsular Malaysia. He presented with a one week history of redness and palpebral swelling of his right eye. He claimed that he could see a worm in his right eye beneath the conjunctiva. He had no history of traveling overseas and the family kept dogs at home. He was referred from Kemaman Hospital to the eye clinic of Hospital Tengku Ampuan Afzan, Kuantan, Pahang, Malaysia. On examination by the ophthalmologist, he was found to have a subconjunctival worm in his right eye. Full blood count revealed eosinophilia (10%). Four worm fragments, each about 1 cm long were removed from his right eye under general anesthesia. A thick blood smear stained with Giemsa was positive for microfilariae of Brugia malayi. A Brugia Rapid test done was positive. He was treated with diethylcarbamazine.
Study site: Opthamolagy clinic, Hospital Tengku Ampuan Afzan
In 2011, we reported occurrence of natural human infections with Brugia pahangi, a filarial worm of dogs and cats, in a surburb of Kuala Lumpur, the capital city of Malaysia. Our preliminary entomological survey at that time suggested the mosquito species Armigeres subalbatus as the vector of the zoonotic infections. In this present report, we provide biological evidence to confirm our preliminary finding.
An IgG4 ELISA based on a novel recombinant antigen was evaluated for detection of Brugia malayi infection, using 2487 sera from various institutions: 2031 samples from Universiti Sains Malaysia, 276 blinded sera from 2 other institutions in Malaysia, 140 blinded sera from India and 40 blinded sera from Thailand. These sera were from various groups of individuals, i.e., microfilaraemics, chronic patients, endemic normals, non-endemic normals and individuals with other parasitic and bacterial infections. Based on a cut-off optical density reading of 0.300, the IgG4 ELISA demonstrated specificity rates of 95.6-100%, sensitivity rates of 96-100%, positive predictive values of 75-100% and negative predictive values of 98.9-100%. These evaluation studies demonstrated the high specificity and sensitivity of this test for the detection of active B. malayi infection. Thus, the IgG4 ELISA would be very useful as a tool in diagnosis and in elimination programmes for brugian filariasis.
The study compared the effectiveness of a single dose of diethylcarbamazine (DEC) (6mg/kg) with the standard regimen of 6 doses (total 36 mg/kg) in mass chemotherapy for the control of brugian filariasis. Mass chemotherapy with single-dose DEC was instituted in one area and standard dose in the other and treatment was repeated after one year. Parasitological surveys were conducted before, and 3, 7 and 12 months after treatment. Pretreatment characteristics were not significantly different between the 2 treatment areas. There was a significant reduction in microfilaraemia prevalence rate from 24.7% to 14.7% at 12 months and to 6.8% at 19 months in the single dose area and from 22.8% to 9.6% at 12 months and to 2.7% at 19 months with the standard dose. Maximum reduction was at 7 months after treatment with both regimens. There was also significant progressive reduction in mean microfilarial density from 4.39 +/- 20.37 to 0.89 +/- 4.16 per 60 microL in the single-dose area and from 4.43 +/- 17.31 to 0.75 +/- per 60 microL in the standard dose area. There was a greater reduction of both microfilarial prevalence and density using the standard regimen but it was not statistically significant. Thus, a single dose of DEC is as effective as the standard dose in controlling periodic brugian filariasis.
We conducted a field study of a rapid test (Brugia Rapid) for detection of Brugia malayi infection to validate its sensitivity and specificity under operational conditions. Seven districts in the state of Sarawak, Malaysia, which are endemic for brugian filariasis, were used to determine the test sensitivity. Determination of specificity was performed in another state in Malaysia (Bachok, Kelantan) which is non-endemic for filariasis but endemic for soil-transmitted helminths. In Sarawak both the rapid test and thick blood smear preparation were performed in the field. The rapid test was interpreted on site, whereas blood smears were taken to the district health centres for staining and microscopic examination. Sensitivity of Brugia Rapid dipstick as compared with microscopy of thick blood smears was 87% (20/23; 95% CI: 66.4-97.2) whereas the specificity was 100% (512/512). The lower sensitivity of the test in the field than in laboratory evaluations (> or =95%), was probably due to the small number of microfilaraemic individuals, in addition to difficulties in performing the test in remote villages by field personnel. The overall prevalence of brugian filariasis as determined by the dipstick is 9.4% (95% CI: 8.2-0.5) while that determined by microscopy is 0.90% (95% CI: 0.5-1.3) thus the dipstick detected about 10 times more cases than microscopy. Equal percentages of adults and children were found to be positive by the dipstick whereas microscopy showed that the number of infected children was seven times less than infected adults. The rapid dipstick test was useful as a diagnostic tool for mapping and certification phases of the lymphatic filariasis elimination programme in B. malayi-endemic areas.