Remarkable richness of trypanosomes in tsetse flies (Glossina morsitans morsitans and Glossina pallidipes) from the Gorongosa National Park and Niassa National Reserve of Mozambique revealed by fluorescent fragment length barcoding (FFLB).

Trypanosomes of African wild ungulates transmitted by tsetse flies can cause human and livestock diseases. However, trypanosome diversity in wild tsetse flies remains greatly underestimated. We employed FFLB (fluorescent fragment length barcoding) for surveys of trypanosomes in tsetse flies (3086) from the Gorongosa National Park (GNP) and Niassa National Reserve (NNR) in Mozambique (MZ), identified as Glossina morsitans morsitans (GNP/NNR=77.6%/90.5%) and Glossina pallidipes (22.4%/9.5%). Trypanosomes were microscopically detected in 8.3% of tsetse guts. FFLB of gut samples revealed (GNP/NNR): Trypanosoma congolense of Savannah (27%/63%), Kilifi (16.7%/29.7%) and Forest (1.0%/0.3%) genetic groups; T. simiae Tsavo (36.5%/6.1%); T. simiae (22.2%/17.7%); T. godfreyi (18.2%/7.0%); subgenus Trypanozoon (20.2%/25.7%); T. vivax/T. vivax-like (1.5%/5.2%); T. suis/T. suis-like (9.4%/11.9%). Tsetse proboscises exhibited similar species composition, but most prevalent species were (GNP/NNR): T. simiae (21.9%/28%), T. b. brucei (19.2%/31.7%), and T. vivax/T. vivax-like (19.2%/28.6%). Flies harboring mixtures of trypanosomes were common (~ 64%), and combinations of more than four trypanosomes were especially abundant in the pristine NNR. The non-pathogenic T. theileri was found in 2.5% while FFLB profiles of unknown species were detected in 19% of flies examined. This is the first report on molecular diversity of tsetse flies and their trypanosomes in MZ; all trypanosomes pathogenic for ungulates were detected, but no human pathogens were detected. Overall, two species of tsetse flies harbor 12 species/genotypes of trypanosomes. This notable species richness was likely uncovered because flies were captured in wildlife reserves and surveyed using the method of FFLB able to identify, with high sensitivity and accuracy, known and novel trypanosomes. Our findings importantly improve the knowledge on trypanosome diversity in tsetse flies, revealed the greatest species richness so far reported in tsetse fly of any African country, and indicate the existence of a hidden trypanosome diversity to be discovered in African wildlife protected areas.

National health surveys and health policy: impact of the Jamaica Health and Lifestyle Surveys and the Reproductive Health Surveys.

Over the last six decades, comprehensive national health surveys have become important data-gathering mechanisms to inform countries on their health status and provide information for health policy and programme planning. Developing countries have only recently begun such surveys and Jamaica has been at the forefront of this effort. Jamaica's Reproductive Health Surveys and programme response to their findings have resulted in an almost 50% reduction infertility rates over three decades as well as a 40% reduction in unmet contraceptive needs and a 40% reduction in unplanned pregnancies over the last two decades. The Jamaica Health and Lifestyle Surveys have served to reinforce the major burden that non-communicable diseases place on the society and the extent to which these are driven by unhealthy lifestyles. These surveys have shown that obesity, hypertension, diabetes and dyslipidaemia affect approximately 50%, 25%, 10% and 10% of the adult population, respectively. These surveys have documented low rates of treatment and control for these chronic non-communicable diseases despite two major policy initiatives, the National Programme for the Promotion of Healthy Lifestyles and the creation of the National Health Fund which subsidizes healthcare provision for chronic diseases. In order to maximize the uptake of the findings of future surveys into effective health policy, there will need to be effective collaborations between academia, policy-makers, regional and international health agencies, non-government organizations and civil society. Such collaborations should take into account the social, political and economic issues, thus ensuring a more comprehensive approach to health policy and result in improvement of the nation's health status and by extension national development.

National health surveys and health policy: impact of the Jamaica health and lifestyle surveys and the reproductive health surveys / Estudios y políticas nacionales de salud: repercusión de los estudios de estilo de vida y salud, así como de los estudios de salud reproductiva en Jamaica

Over the last six decades, comprehensive national health surveys have become important data-gathering mechanisms to inform countries on their health status and provide information for health policy and programme planning. Developing countries have only recently begun such surveys and Jamaica has been at the forefront of this effort. Jamaica's Reproductive Health Surveys and programme response to their findings have resulted in an almost 50% reduction in fertility rates over three decades as well as a 40% reduction in unmet contraceptive needs and a 40% reduction in unplanned preg-nancies over the last two decades. The Jamaica Health and Lifestyle Surveys have served to reinforce the major burden that non-communicable diseases place on the society and the extent to which these are driven by unhealthy lifestyles. These surveys have shown that obesity, hypertension, diabetes and dyslipidaemia affect approximately 50%, 25%, 10% and 10% of the adult population, respectively. These surveys have documented low rates of treatment and control for these chronic non-communicable diseases despite two major policy initiatives, the National Programme for the Promotion of Healthy Lifestyles and the creation of the National Health Fund which subsidizes healthcare provision for chronic diseases. In order to maximize the uptake of the findings of future surveys into effective health policy, there will need to be effective collaborations between academia, policy-makers, regional and international health agencies, non-government organizations and civil society. Such collaborations should take into account the social, political and economic issues, thus ensuring a more comprehensive approach to health policy and result in improvement of the nation's health status and by extension national development.

Durante las últimas seis décadas, los estudios de salud integrales nacionales han devenido importantes mecanismos de recolección de datos para informar a los países sobre sus respectivos estados de salud, así como brindar información para el planeamiento de los programas y políticas de salud. Sólo recientemente los países en desarrollo han comenzado a realizar esos estudios, y Jamaica ha estado a la vanguardia de este esfuerzo. Los Estudios de Salud Reproductiva en Jamaica y los programas en respuesta a sus hallazgos han traído como resultado una reducción de casi un 50% en las tasas de fertilidad por espacio de más de tres décadas, así como una reducción de 40% de las necesidades anticonceptivas insatisfechas y una reducción de 40% de embarazos no planificados en las últimas dos décadas. Los Estudios sobre Estilo de Vida y Salud en Jamaica han servido para dar mayor peso a evaluar la gran carga que las enfermedades no comunicables imponen a la sociedad y determinar hasta que punto las mismas son consecuencia de estilos de vida no saludables. Estos estudios han mostrado que la obesidad, la hipertensión, la diabetes y la dislipidemia afectan a la población adulta en proporciones aproximadas de 50%, 25%, 10% y 10% respectivamente. Estos estudios han suministrado datos que ponen de manifiesto bajas tasas en el tratamiento y control de estas enfermedades no comunicables, a pesar de dos iniciativas principales: el Programa Nacional para la Promoción de Estilos de Vida Saludables y la creación del Fondo de Salud Nacional. En ambos casos, se trata de políticas encaminadas a subvencionar el cuidado de la salud en el caso de enfermedades crónicas. Para aumentar al máximo la respuesta a los resultados de estudios futuros y su introducción efectiva en las políticas de atención a la salud, será necesario establecer colaboraciones efectivas entre la academia, los encargados de trazar políticas, las agencias de salud regionales e internacionales, las organizaciones no gubernamentales, y la sociedad civil. Tales colaboraciones deben tener en cuenta los problemas sociales, políticos y económicos, asegurando de este modo un enfoque más integral de las políticas de salud, así como el mejoramiento del estado de salud de la nación, y por extensión del desarrollo nacional.

Intercorrência entre leucose enzoótica e brucelose em búfalos (Bubalus bubalis) em sistema de produção extensivo / Intercurrence of enzootic leucosis and brucellosis in buffaloes (Bubalus bubalis) in extensive production system

Objetivou-se com este estudo avaliar a intercorrência entre leucose enzoótica e brucelose em búfalos (Bubalus bubalis) em sistema de produção extensivo, pelo estabelecimento da prevalência de bubalinos reagentes às provas diagnósticas específicas. Foram analisados sorologicamente 232 animais, pela técnica de imunodifusão dupla em gel de agarose para diagnóstico de leucose enzoótica e o teste do antígeno acidificado tamponado, seguida pelos testes confirmatórios 2-mercaptoetanol e soroaglutinação lenta em tubos para diagnóstico de brucelose. As prevalências de búfalos que apresentaram positividade para leucose e brucelose foram 4,21% (10/232) e 5,18% (12/232), respectivamente. Os resultados obtidos nesta pesquisa permitiram concluir que as infecções estudadas encontram-se presentes na população avaliada, entretanto, com baixa prevalência e sem dependência de ocorrência entre ambas.

This study was carried out to evaluate the intercurrence of brucellosis and enzootic leucosis in buffaloes in extensive production system by establishing the prevalence of reagent buffaloes for specific diagnostic tests. We analyzed 232 animals serologically by the technique of double immunodiffusion in agarose gel (AGID) for diagnostic of leucosis and the tampon acidified antigen (TAA) test, followed by confirmatory tests of 2-mercaptoethanol (2-ME) and slow serum agglutination (SSA) in tubes for diagnostic of brucellosis. The prevalence of buffaloes that were positive for leucosis and brucellosis tests were 4.21% (10/232) and 5.18%(12/232) respectively. The results of this investigation indicated that the diseases occur in the population studied, however, with low prevalence and without depending on the occurrence of both.

Intercorrência entre leucose enzoótica e brucelose em búfalos (Bubalus bubalis) em sistema de produção extensivo / Intercurrence of enzootic leucosis and brucellosis in buffaloes (Bubalus bubalis) in extensive production system

Objetivou-se com este estudo avaliar a intercorrência entre leucose enzoótica e brucelose em búfalos (Bubalus bubalis) em sistema de produção extensivo, pelo estabelecimento da prevalência de bubalinos reagentes às provas diagnósticas específicas. Foram analisados sorologicamente 232 animais, pela técnica de imunodifusão dupla em gel de agarose para diagnóstico de leucose enzoótica e o teste do antígeno acidificado tamponado, seguida pelos testes confirmatórios 2-mercaptoetanol e soroaglutinação lenta em tubos para diagnóstico de brucelose. As prevalências de búfalos que apresentaram positividade para leucose e brucelose foram 4,21% (10/232) e 5,18% (12/232), respectivamente. Os resultados obtidos nesta pesquisa permitiram concluir que as infecções estudadas encontram-se presentes na população avaliada, entretanto, com baixa prevalência e sem dependência de ocorrência entre ambas.(AU)

This study was carried out to evaluate the intercurrence of brucellosis and enzootic leucosis in buffaloes in extensive production system by establishing the prevalence of reagent buffaloes for specific diagnostic tests. We analyzed 232 animals serologically by the technique of double immunodiffusion in agarose gel (AGID) for diagnostic of leucosis and the tampon acidified antigen (TAA) test, followed by confirmatory tests of 2-mercaptoethanol (2-ME) and slow serum agglutination (SSA) in tubes for diagnostic of brucellosis. The prevalence of buffaloes that were positive for leucosis and brucellosis tests were 4.21% (10/232) and 5.18%(12/232) respectively. The results of this investigation indicated that the diseases occur in the population studied, however, with low prevalence and without depending on the occurrence of both.(AU)

Validation of the Jamaican Maternal Sexual Role Modelling Questionnaire.

OBJECTIVE: Urban Jamaican adolescent girls face significant risk for sexually transmitted infections including HIV Studies from the United States ofAmerica have found that parents influence adolescents' sexual risk attitudes and behaviours through parent-child sexual communication and monitoring/supervision. Data from an ongoing mother-daughter HIVrisk reduction intervention study in Kingston, Jamaica identified an additional influence of adolescent girls' sexual risk - maternal sexual role modelling (MSRM). As no reliable and valid questionnaires existed to measure MSRM, one was developed. The objective of the current study was to evaluate the psychometric properties of the Jamaican Maternal Sexual Role Modelling questionnaire. METHOD: Data were collected from 209 Jamaican female adolescents recruited from Kingston, St Andrew and St Catherine parishes. RESULTS: The final 19-item Jamaican MSRM questionnaire was found to have excellent internal reliability (Cronbach's alpha = 0.89). Content validity expert ratings and modified kappa statistics were all 1.0. Principal component analysis identified a three-factor structure that accounted for 53.7% of the variance. Greater MSRM scale scores, indicating more positive and protective maternal sexual role modelling, were associated with less sexual experience, lower intentions to have sex, greater intentions to use condoms if having sex and greater condom use self-efficacy among adolescent girls. CONCLUSION: The MSRM scale was found to be a reliable and valid measure of Jamaican adolescent females'perceptions of their mothers'sexual role modelling. Further research is needed to assess the reliability and validity of the instrument with other populations.

Identification and lineage genotyping of South American trypanosomes using fluorescent fragment length barcoding.

Trypanosoma cruzi and Trypanosoma rangeli are human-infective blood parasites, largely restricted to Central and South America. They also infect a wide range of wild and domestic mammals and are transmitted by a numerous species of triatomine bugs. There are significant overlaps in the host and geographical ranges of both species. The two species consist of a number of distinct phylogenetic lineages. A range of PCR-based techniques have been developed to differentiate between these species and to assign their isolates into lineages. However, the existence of at least six and five lineages within T. cruzi and T. rangeli, respectively, makes identification of the full range of isolates difficult and time consuming. Here we have applied fluorescent fragment length barcoding (FFLB) to the problem of identifying and genotyping T. cruzi, T. rangeli and other South American trypanosomes. This technique discriminates species on the basis of length polymorphism of regions of the rDNA locus. FFLB was able to differentiate many trypanosome species known from South American mammals: T. cruzi cruzi, T. cruzi marinkellei, T. dionisii-like, T. evansi, T. lewisi, T. rangeli, T. theileri and T. vivax. Furthermore, all five T. rangeli lineages and many T. cruzi lineages could be identified, except the hybrid lineages TcV and TcVI that could not be distinguished from lineages III and II respectively. This method also allowed identification of mixed infections of T. cruzi and T. rangeli lineages in naturally infected triatomine bugs. The ability of FFLB to genotype multiple lineages of T. cruzi and T. rangeli together with other trypanosome species, using the same primer sets is an advantage over other currently available techniques. Overall, these results demonstrate that FFLB is a useful method for species diagnosis, genotyping and understanding the epidemiology of American trypanosomes.

Tele-surgery: a new virtual tool for medical education.

The rapid evolution of telecommunication technology has enabled advances to be made in low cost video-conferencing through the improvement of high speed computer communication networks and the enhancement of Internet security protocols. As a result of this progress, eHealth education programs are becoming a reality in universities, providing the opportunity for students to have greater interaction at live surgery classes by means of virtual participation. Undergraduate students can be introduced to new concepts of medical care, remote second opinion and to telecommunication systems, whilst virtually experiencing surgical procedures and lectures. The better access this provides to the operating theater environment, the patient and the surgeon can improve the learning process for students. An analogical system was used for this experimental pilot project due to the benefits of it being low cost with a comparatively easy setup. The tele-surgery lectures were also transmitted to other universities by means of a Pentium 4 computer using open source software and connected to a portable image acquisition device located in the São Lucas University Hospital. Telemedicine technology has proven to be an important instrument for the improvement of medical education and health care. This study allowed health professionals, professors and students to have greater interaction during surgical procedures, thus enabling a greater opportunity for knowledge exchange.

Pressure study of monoclinic ReO2 up to 1.2 GPa using X-ray absorption spectroscopy and X-ray diffraction.

The crystal and local atomic structure of monoclinic ReO2 (alpha-ReO2) under hydrostatic pressure up to 1.2 GPa was investigated for the first time using both X-ray absorption spectroscopy and high-resolution synchrotron X-ray powder diffraction and a home-built B4C anvil pressure cell developed for this purpose. Extended X-ray absorption fine-structure (EXAFS) data analysis at pressures from ambient up to 1.2 GPa indicates that there are two distinct Re-Re distances and a distorted ReO6 octahedron in the alpha-ReO2 structure. X-ray diffraction analysis at ambient pressure revealed an unambiguous solution for the crystal structure of the alpha-phase, demonstrating a modulation of the Re-Re distances. The relatively small portion of the diffraction pattern accessed in the pressure-dependent measurements does not allow for a detailed study of the crystal structure of alpha-ReO2 under pressure. Nonetheless, a shift and reduction in the (011) Bragg peak intensity between 0.4 and 1.2 GPa is observed, with correlation to a decrease in Re-Re distance modulation, as confirmed by EXAFS analysis in the same pressure range. This behavior reveals that alpha-ReO2 is a possible inner pressure gauge for future experiments up to 1.2 GPa.

Molecular and geographic analyses of vampire bat-transmitted cattle rabies in central Brazil.

BACKGROUND: Vampire bats are important rabies virus vectors, causing critical problems in both the livestock industry and public health sector in Latin America. In order to assess the epidemiological characteristics of vampire bat-transmitted rabies, the authors conducted phylogenetic and geographical analyses using sequence data of a large number of cattle rabies isolates collected from a wide geographical area in Brazil. METHODS: Partial nucleoprotein genes of rabies viruses isolated from 666 cattle and 18 vampire bats between 1987 and 2006 were sequenced and used for phylogenetic analysis. The genetic variants were plotted on topographical maps of Brazil. RESULTS: In this study, 593 samples consisting of 24 genetic variants were analyzed. Regional localization of variants was observed, with the distribution of several variants found to be delimited by mountain ranges which served as geographic boundaries. The geographical distributions of vampire-bat and cattle isolates that were classified as the identical phylogenetic group were found to overlap with high certainty. Most of the samples analyzed in this study were isolated from adjacent areas linked by rivers. CONCLUSION: This study revealed the existence of several dozen regional variants associated with vampire bats in Brazil, with the distribution patterns of these variants found to be affected by mountain ranges and rivers. These results suggest that epidemiological characteristics of vampire bat-related rabies appear to be associated with the topographical and geographical characteristics of areas where cattle are maintained, and the factors affecting vampire bat ecology.

Phylogenetic characterization of rabies virus isolates from Carnivora in Brazil.

The incidence of canine rabies has been widely reported in Brazil, and new rabies virus (RV) variants, genetically similar to canine RV, have recently been isolated from foxes. In order to derive the epidemiological characteristics of Brazilian Carnivora RV, Brazilian RVs isolated from dogs, cats, and foxes were genetically analyzed. Brazilian Carnivora RV isolates were divided into 2 main lineages. The predominant lineage was found in dogs and cats, which included the Argentinean and Bolivian Carnivora RV isolates, and was extensively distributed throughout Brazil and surrounding countries. The other lineage consisted of three sublineages containing Brazilian dog and fox RV isolates, with the dog sublineages located on an internal branch of 2 fox sublineages, suggesting that RV transmission events might have occurred between foxes and dogs in the past. These results suggest that contact between dogs and wildlife has the potential to generate new rabies variants and that it is important to control RV infection cycles in both dogs and wildlife to prevent spread of rabies infection.

Endometriose e sua apresentação na forma de hérnia da parede abdominal / Endometriosis and presentation as abdominal wallherniation

Revisar incidência, sintomatologia e melhor conduta relacionada à endometriose em sua apresentação incomum como hérnia da parede abdominal. Foi realizada uma revisão na Medline focada unitermos "endometriose" e "hernia". A manifestação de endometriose extraperitoneal deve ser sempre lembrada na avaliação de massa da parede abdominal em mulheres em idade fértil. A sintomatologia mais comum é de dor cíclica. A exploração cirúrgica ser indicada e o aspecto macroscópico da lesão é sugestivos do diagnóstico. Cirurgiões e ginecologistas devem estar preparados para trabalharem juntos. O alto grau de suspeição é chave na avaliação pré-operatória de paciente feminina em idade fértil apresentando massa na parede abdominal. A conduta mais adequada aponta para exploração da lesão extraperitoneal e laparoscopia como método diagnóstico e terapêutico da cavidade abdominal.

Effect of finishing time and techniques on marginal sealing ability of two composite restorative materials.

STATEMENT OF PROBLEMS: Finishing of composites may adversely influence the sealing ability of direct adhesive restorations. PURPOSE: This study was conducted to determine whether finishing time and techniques under wet or dry conditions affect the microleakage of 2 types of class V composite restorations. MATERIAL AND METHODS: Eighty class V preparations were made in the buccal surfaces of noncarious molars with the occlusal margins ending in enamel and the gingival margins in dentin. Dental adhesive (Single Bond) was applied according to the manufacturer's instructions. Half of the preparations were restored with a microfilled composite (Silux Plus) and the other half with a hybrid composite (Filtek Z250). Within each major composite group (n = 40), 4 subgroups (n = 10) were established based on finishing technique (diamond finishing burs or aluminum oxide discs) and finishing time (immediate or delayed by 24 hours). The specimens were stored for 24 hours in 37 degrees C water, thermocycled for 250 cycles between 5 degrees C and 55 degrees C, immersed in 2% methylene blue solution for another 24 hours, and sectioned longitudinally. For both enamel and dentin margins, dye solution penetration at the tooth/composite interface was scored from 0 to 4 under stereoscopy at original magnification x 20. Data were analyzed with the Kruskal-Wallis test (P<.05). RESULTS: Significantly lower leakage scores were recorded for teeth restored with microfilled composite and finished under wet conditions after 24 hours (P<.01). No significant differences were found among the hybrid composite groups. CONCLUSION: For microfilled composite restorations on dentin margins, delayed wet finishing with diamond burs resulted in significantly lower microleakage scores than all other finishing protocols. Hybrid composite restorations had equivalent levels of microleakage regardless of the finishing method.

Traumatismo duodenopancreático: análise de 10 anos em um serviço de urgência / Pancreatic duodenal trauma: analysis during 10 years in an emergency service

Os autores apresentam a análise retrospectiva de 148 casos de trauma duodenal e/ou pancreático tratados no Hospital de Pronto Socorro de Porto Alegre, no período de Janeiro de 1978 a dezembro de 1987. Os jovens do sexo masculino foram mais atingidos e o projétil de arma de fogo foi o principal agente. A segunda porçäo do duodeno e o corpo do pâncreas foram os segmentos mais vezes acometidos e bno fígado localizaram-se as lesöes associadas com maior freqüência. A sutura da lesäo foi o procedimento mais utilizado, sendo os resultados comparáveis aos da litertura

Lesöes traumáticas da veia porta / Traumatic injuries of the portal vein

É apresentado um estudo das lesöes traumáticas da veia porta encontradas em um levantamento realizado no Hospital de Pronto-Socorro de Porto Alegre, correspondendo aos traumatismos abdominais, de qualquer etiologia, tratados cirurgicamente no período compreendido entre 1978 e 1987. Entre 2.893 casos catalogados, apenas 9(0,3%) apresentavam lesäo da veia porta. Este tipo de traumatismo esteve, mais freqüentemente, associado aos ferimentos penetrantes de abdome (oito casos). O tratamento cirúrgico consistiu de rafia ou ligadura do vaso, em todos os casos. As lesöes associadas estiveram relacionadas com a mortalidade, assim como o tipo de procedimento adotado para o tratamento

Traumatismos pancreáticos: análise de 10 anos no Hospital de Pronto Socorro de Porto Alegre / Pancreatic injuries: analysis of 10 years in Hospital de Pronto Socorro from Porto Alegre

Análise dos traumatismos pancreáticos atendidos no Hospital de Pronto Socorro de Porto Alegre, no período de janeiro de 1978 a dezembro de 1987. Dos 78 casos, somente 12 tinham associaçäo com o duodeno. O adulto jovem masculino e branco foi o mais atingido. O trauma aberto causado por arma de fogo ou arma branca foi o mais freqüente. O figado foi o órgäo associado mais vezes e o tratamento empregado foi, na grande maioria das vezes, rafia com drenagem simples. A mortalidade geral foi de 17,9% e a causa mais comum de morte foi o choque hipovolêmico

Bancroftian filariasis in coastal north Trinidad: the effects of mass chemotherapy using spaced doses of diethylcarbamazine citrate on human microfilaraemias and vector infection rates.

The effects of a mass chemotherapy programme using spaced doses of diethylcarbamazine citrate on Wuchereria bancrofti microfilaraemias and vector infection rates were studied in an isolated rural community of 650 people in north Trinidad where a microfilaria rate of 15% had previously been recorded. A single oral dose of 6 mg/kg body weight was given at monthly intervals for one year. After 6 months, 79% (52/66) of persons previously microfilaraemic had become negative. After 12 months the negative proportion had increased to 90% (63/70). The geometric mean microfilaria density of those still microfilaraemic was reduced from 19.7 to 4.6 per 100 mm3 of blood. Of 147 initially negative persons, none had become positive following treatment. Filarial infection rates in Culex quinquefasciatus from randomly sampled houses fell from 6.4% to zero; in houses where occupants with microfilaraemia had been identified before treatment, the rate was reduced from 15.8% to zero. In a supplementary study, however, weekly collections from one initially positive house showed a rapid decline in the vector infection rate from 43% to 2% after three months but an additional 3 months elapsed before the index reached zero. There was negligible microfilarial uptake by the vectors from residual low-density microfilaraemias (less than 10 microfilariae per 100 mm3 of blood) after chemotherapy.

Parasitological and clinical studies of Wuchereria bancrofti and Mansonella ozzardi in coastal north Trinidad, West Indies.

PIP: A parasitological and clinical survey of Wuchereria bancrofti and Mansonella ozzardi was conducted in Blanchisseuse, an isolated rural community of 650 people in coastal north Trinidad. W. bancrofti microfilariae were found in 15% of the resident population and the prevalence was higher in males (19%) than in females (12%). Microfilaraemias were undetected in children under 5 years of age but 12% of children and adolescents between 5 and 19 years of age were positive. Microfilaraemias were most common in males aged 40-59 years (34%) and in females in the same age group (21%). Whereas geometric mean microfilaria densities were generally higher in females than in males under 40 years old, in the older age groups the pattern was reversed, the difference being especially pronounced in the over 60s. There were more than 2 times as many males with M. ozzardi microfilariae (35%) than there were females (15%). The prevalence was low in children and young adults but increased with age thereafter. In the older age groups microfilaria densities followed a similar trend. Genital signs compatible with lymphatic filarial disease were seen in 29% of males; these included hydrocoele (15%) and elephantiasis of the scrotum (1%). Most signs were seen in persons over 50 years of age. 6% of females had lymphoedema of the leg(s), and in 4 cases (2.3%) this had progressed to elephantiasis. A positive association was found between M. ozzardi microfilaraemia and clinical history of articular pain. The findings suggest that both filarial species are of some public health significance in at least 1 rural area of Trinidad, and they provide a basis for the development of a lymphatic filariasis control strategy in the community.^ieng