New approaches to eliminate filariasis in Sri Lanka

1.处理实验：通过每4个月监测一次微丝蚴计数和抗原水平，对乙胺嗪（DEC）单独使用、阿苯达唑（ALB）单独使用、ALB+伊维菌素联合使用以及DEC + ALB联合使用的效果进行了研究。在感染后20个月，DEC单独治疗与联合治疗一样有效，由于协同作用，联合治疗据说更有效。尿液免疫诊断方法的建立及应用：建立了尿液IgG 4 ELISA法。“尿酶联免疫吸附试验”的敏感性为95.6%，特异性为99.0%。样品可在37℃下保存4周而不变质，尿液采集时间不影响IgG 4滴度。对473例受检者进行了ICT试验和尿ELISA检测。10岁以下儿童IgG_4阳性率为72.1%，与成人相似，尿ELISA法适用于婴幼儿和极幼儿。新生儿丝虫病的阳性率和IgG 4抗体滴度的测定为了解丝虫病的传播动力学提供了有价值的信息.丝虫病分布图：对Matara区（人口90万）约2500名村领导进行了问卷调查，询问象皮病和鞘膜积液的患病率以及社会经济状况。研究表明，与过去的看法相反，象皮病和鞘膜积液在该地区很普遍。证实了过去几十年来丝虫病逐渐向内地蔓延。

1. Treatment experiments : A study on the effects of diethylcarbamazine (DEC) alone, albendazole (ALB) alone, combinations of ALB plus ivermectin, and DEC plus ALB has been conducted by monitoring microfilaria counts and antigen levels every 4 months. At 20 months post infection, DEC alone was as effective as the combination therapies, which have been said to be more effective due to synergy.2. Establishment and application of immunodiagnosis using urine as samples : IgG4 ELISA using urine without concentration has been developed. The 'urine ELISA' has the sensitivity of 95.6% and the specificity of 99.0%. The samples could be kept at 37℃ for 4 weeks without deterioration, and the timing of urine collection did not influence IgG4 titers. ICT test, which detects filarial antigen, and urine ELISA were compared on 473 subjects. The latter detected 2.5 times more infection.The IgG4 positive rate of children of age<10 years was 72.1% which was similar to that of adults.The urine ELISA is applicable to infants and very young children. The positive rate and the IgG4 titers among the newborns will provide valuable information for understanding transmission kinetics of filariasis.3. Distribution map of filariasis : A survey was done using a questionnaire to about 2500 village leaders in Matara District (population 900,000) asking the prevalence of elephantiasis and hydrocele, and socio-economic status. The study revealed that, contrary to the past belief,elephantiasis and hydrocele are widespread in the District. Gradual spread of filariasis in the past decades toward inland was confirmed.