Epidemiology and Control of Filariasis in Sri Lanka

1.血清丝虫抗原检测是目前最可靠的诊断方法。然而，血清的收集和储存在野外条件下常常是有问题的。我们已经开发了一种ELISA，它使用吸附在滤纸上的全血并干燥储存。使用上述ELISA，在马塔拉总共检查了2763人。抗原阳性率为14.3%，而微丝蚴血症率仅为3.2%，说明常规方法存在大量的假阴性.免疫诊断最严重的缺点是它需要收集血液样本。我们用尿液代替血清检测丝虫抗体，并建立了检测丝虫特异性IgG4的ELISA新体系。到目前为止，ELISA的敏感性和特异性接近100%。必须进行大规模试验以验证ELISA在田间条件下的有用性。如果尿液可以作为血清，将大大方便现场的免疫诊断.对于单剂量治疗，已测试了乙胺嗪（DEC）、阿苯达唑和伊维菌素。DEC的疗效得到了证实，阿苯达唑和伊维菌素联合用药是一个很有前途的方案.对微丝蚴血症者象皮肿和血压进行了临床研究。数据正在分析中。研究了致倦库蚊的季节性流行规律和传播效率.马塔拉最早引入地理信息系统来描述和分析丝虫病的分布。

1. Detecting filarial antigen in serum is, at present, the most reliable method of diagnosis. However, the collection and storage of sera is often problematic in field conditions. We have deve1oped an ELISA which uses the whole blood absorbed on a filter paper and dried for storage.2. Using the above ELISA, a total of 2763 people in Matara were examined. The antigen positive rate was 14.3%, whereas the microfilaraemia rate was only 3.2%, indicating that the conventional method resulted in a large number of false, negatives.3. A most serious disadvantage with imrnunodiagnosis is that it requires collecting blood samples. We utilized urine instead of serum to detect filarial antibodies, and developed a new ELISA system detecting filaria specific IgG4. The ELISA gave, so far, near 100% sensitivity and specificity. A large-scale trial has to be carried out to verify the usefulness of the ELISA in field conditions. If urine can be used for serum, it will greatly facilitate immunodiagnosis in the field.4. For a single-dose treatment, diethylcarbamazine (DEC), albendazole and ivermectin have been tested. The efficacy of DEC was confirmed by this time, and the combination of albendazole and ivermectin seems to be a very promising regimen.5. Clinical studies on elephantiasis and blood pressure among microfilaraemics were carried out. The data are under analysis.6. Seasonal prevalence of Culex quinquefasciatus, and transmission efficiency of the mosquito have been studied.7. Geographic Information System was first introduced in Matara to describe and analyze distribution of filariasis .