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[
Tropenmed Parasitol,
1980]
The paper describes observations made on 32 chimpanzees experimentally infected with Onchocerca volvulus. The mean pre-patent intervals for the Cameroon forest and the Guatemalan strains of O. volvulus were 13-16 months and 12-15 months respectively. That for the Cameroon Sudan-savanna strain was much longer, i.e. 22-23 months. The numbers of microfilariae found in the skins of animals infected with the Cameroon Sudan-savanna strain were also much lower than in animals infected with the other two strains. Long-term observations on infected animals showed that microfilarial infections had virtually died out 6.5-9 years after the last inoculation with infective larvae. Those animals which were inoculated with infective larvae in the head or above the waist tended to show a higher proportion of microfilariae in the upper parts of the body, than did those inoculated with infective larvae below the waist. In animals which showed adult worm-bundles on only one side of the body, the concentration of microfilariae was usually greater on that side of the body. Worm-bundles in the chimpanzee varied in size from 8 x 5 x 2 mm to 4 x 3 x 2 cm. Out of 47 worm-bundles found, only two were subcutaneous. The remainder lay deep in the tissues, most commonly adjacent to the posterior surface of the capsule of the hip joint. No onchocerciasis eye lesions were seen in any of the infected animals.
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[
Bull World Health Organ,
1968]
Previous work on monkeys and on human volunteers led to the development of a schedule of diethylcarbamazine dosage suitable for the chemoprophylaxis of loiasis. In several parts of Africa where this chemoprophylaxis is practised against Loa loa, infections with Onchocerca volvulus are also common. Attempts were therefore made to determine whether diethylcarbamazine has any prophylactic action against the latter parasite by making use of chimpanzees exposed to experimental infections, and also by using biopsy techniques to study the fate of infective larvae inoculated into volunteers.Both experimental methods proved more difficult to apply in O. volvulus infections than had been the case with L. loa, but evidence was obtained that diethylcarbamazine is not an effective chemoprophylactic for O. volvulus.Further experiments were then carried out with suramin and with melarsonyl potassium (Mel W). Although both gave some evidence of partial prophylactic activity, their use for this purpose is at present neither practical nor safe.
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[
Trop Med Parasitol,
1991]
The paper records the numbers of 1-2 mm shotty papules developing in the author's skin after 2-day courses of diethylcarbamazine (DEC) repeated every 16 days before, during and after a 7.1 G suramin course for cutaneous onchocerciasis. Assuming, from biopsy evidence, that each papule represented a dead Onchocerca volvulus microfilaria (mf), the number of mfs reaching the skin every 16 days did not begin to fall until 96 days after the first full dose of suramin; and only reached zero by day 224. The histopathology of nodules excised from Cameroonian patients before, and at intervals of 56-335 days after, the start of a 7.1 G suramin course, revealed changes in the worms that correlated over time with the disappearance of mfs from the skin. Suramin sterilized and killed the male worms between days 77 and 105 and, in the females, it adversely affected the staining and subsequent development of small morulae from about day 56. It was estimated that new embryogenesis ceased about 56-77 days after the first full dose; development of the last viable embryos to mfs was complete by about 136 days; and the last mfs, perhaps having reduced vitality, emerged from the females by 160 days and reached the skin within 16-32 days.
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[
Trop Med Parasitol,
1993]
The quantitative aspects of onchocerciasis that focus on the relationship between the number of adult female Onchocerca volvulus in the human host, the total numbers of microfilariae (mfs) in the body at any one time, and the numbers of infective larvae (L3) to which a person is exposed over time, have received little attention. This paper attempts to investigate the problem from three starting points:--(a) using the numbers of palpable nodules to estimate the numbers of productive female worms in the body; (b) using the concentrations of mfs in skin snips to estimate the total load of mfs in the body; and (c) using the Annual Transmission Potential to estimate the numbers of L3 developing to productive female maturity. By analysing published and unpublished data relating to the forest and savanna zones of West Africa, these three approaches indicate that a relatively large proportion of adult female worms lie deep in the body and are impalpable from the surface. They also provide numerical results, of the same order to magnitude, which can be linked to provide estimates of the total numbers of adult female worms and mfs in the bodies of persons with infections of different intensities.
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[
Parasitol Today,
1990]
Onchocerca volvulus causes a disease of significant socio-economic importance in West Africa, the Arabian Peninsula and regions of South America. Brian Duke explains that, despite the advent of ivermectin, the prospects for the eradication of this potentially highly debilitating infection are remote. Moreover, the logistical problems associated with the control of morbidity caused by the parasite are considerable, and are highly dependent on the ability to sustain financial support and political will over many decades.
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[
Trop Med Parasitol,
1990]
Onchocerca volvulus worms, extracted from nodules by collagenase digestion, stained with haematoxylin and cleared in glycerol, were unravelled for longitudinal examination and later embedded in brain blocks for study of serial transverse sections. A classification system for female worms is proposed, based on the reproductive status of 446 worms from Guatemala, 94 from Liberia and 125 from Mali. They were categorized into fecund, inseminated specimens; uninseminated, but potentially fertile specimens, shedding ova destined to degenerate; worms changing from the uninseminated to the inseminated state and vice versa, which were few in number; old worms, with degenerate ovaries, whose genital tracts were either empty or had disappeared; and moribund or dead worms, characterized by loss of turgor, collapse and degeneration, calcification, or invasion by polymorphic, basophilic cells. Potentially fertile worms shed oocytes continuously and, when they were inseminated, embryonic development ensured. No evidence was found of a periodic cycle of reproduction. Inseminated worms were found in nodules without a male worm, and uninseminated worms in nodules harbouring male worms. Measurements are recorded of portions of the female reproductive tract and of the length of uterus occupied by the various embryonic stages in fully fecund worms. A significant difference in the length of the body behind the first and second ovaries was observed as between worms from West African savanna (Mali) and forest (Liberia). Limited observations were also made on meiosis in the oocyte, penetration of the oocyte by sperm, formation of the ovum, syngamy and zygote formation.
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[
Bull World Health Organ,
1970]
The effects of the arsenical drug melarsonyl potassium on Onchocerca volvulus were investigated in patients in Cameroon infected with the Cameroon forest and Sudan savanna strains of the parasite. Two intramuscular dosage schedules were tested: the first comprised 4 consecutive daily doses of 200 mg repeated once after a 10-14 day interval, i.e., 2 (4x200 mg). The second was a single dose schedule at 7.1 mg/kg-10 mg/kg, with a maximum of 500 mg.In most trials the drug had no immediate action on microfilarial concentrations. Only after the 2(4x200 mg) melarsonyl course against the Sudan savanna strain was a slight microfilaricidal action detected.The 2(4x200 mg) course of melarsonyl apparently killed or sterilized most or all of the adult female worms in the patients tested, leaving the residual population of microfilariae to decline gradually, from natural mortality, over the ensuing 2 years. These residual microfilariae could be killed with diethylcarbamazine.Single doses of melarsonyl at 7.1 mg/kg-10 mg/kg were somewhat less effective in killing or sterilizing adult worms, but it is suggested that if doses at the higher end of this range were to be repeated annually patients could be rendered free from microfilariae by the end of 3 years.It is emphasized that the risks of arsenical encephalopathy should at present preclude the use of melarsonyl potassium in the treatment of onchocerciasis, but that if this danger could be avoided the drug might prove to be of considerable use for mass therapy in control campaigns.
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[
Bull World Health Organ,
1968]
Antimonial preparations (Pentostam, Neostibosan, stibophen, and tartar emetic) have occasionally been used in the treatment of onchocerciasis without very promising results. The advent of the preparations TWSb (stibocaptate) and MSbE (Friedheim) of allegedly reduced toxicity made it desirable to test them against Onchocerca volvulus.The action of both preparations on the parasites was found to vary from one patient to another, ranging from complete elimination of all parasites in a few cases to no detectable action in others. A microfilaricidal action was detectable in many patients, particularly after treatment with TWSb, which was used at higher doses than MSbE. A lethal or sterilizing action on some or all adult female worms was observed in some patients. However, toxic reactions to the drugs were common and distressing, and often it was necessary to stop treatment on this account. Anorexia, nausea, vomiting and prostration were the most common manifestations, and there was one fatality from coincident yellow fever, which may well have been aggravated by antimony treatment.The uncertain action of these preparations on O. volvulus and the toxic manifestations that accompany their use render them unsuitable for the treatment of onchocerciasis, and it is probable that the effects of antimony on O. volvulus are produced only at or above the normal level of human tolerance.
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[
Ann Trop Med Parasitol,
1991]
Knowledge of the morphology, migrations and development rates of the L3, L4 and prepubertal L5 stages of Onchocerca volvulus in the vertebrate host is an essential prerequisite to work vaccine development of chemoprophylaxis. After a brief review of the scanty literature available on this subject a description is given of two immature worms, one male and one female, found in an O. volvulus nodule from Guatemala. The male, which measured 12 mm x 40 micron(s), had fine regular transverse cuticular annulations, two prominent spicules, and an undifferentiated testis. The female, which measured 20 mm x 40 micron(s), had not yet developed cuticular ridges but showed a vulva, gut, and two rudimentary genital tracts. It is thought that these worms may have been six to 12 weeks old. The likely course of the early development of O. volvulus in the vertebrate host is discussed, based on analogy with O. lienalis in cattle; and some of the factors to be taken into account when pursuing the search for O. volvulus immatures are described.
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[
Parasitology,
2002]
A pleomorphic neoplasm (PN) is described from sections of Onchocerca volvulus worms in nodules excised from Cameroonian patients. PN is confined to older, non-fecund, female worms, and those classed as moribund/dead. It is mainly composed of small, roundish, basophilic cells of diverse sizes, often forming a 'rosette' pattern around amorphous eosinophilic centres. The cells have a high nuclear/cytoplasmic ratio and up to 2-3 mitoses/high-power field; some become grossly enlarged, highly polymorphic and contain large, irregular blocks of chromatin. The eukaryotic PN cells first appear posteriorly in the pseudocoelom, probably from ovarian cells; they spread anteriorly, invading or compressing the uteri. Ivermectin treatment increased the prevalence PN from 3.7% of 1422 female worms in 637 patients before treatment to 17.5% of 1134 worms in 511 patients after 3 years treatment. Ivermectin at 400-800 microg/kg annually, or at 150 microg/kg or 400-800 microg/kg 3-monthly, over 3 years, did not increase the PN prevalence significantly, as compared with standard doses of 150 microg/kg annually. In other small series of African patients, PN prevalence increased in worms 2, 4, 6 and 10 months after ivermectin treatment; but there was no increase after treatment with amocarzine, albendazole or diethylcarbamazine and suramin. PN may partly account for the increased macrofilaricidal action of ivermectin on female O. volvulus in patients treated for 3 years at 3-monthly intervals.