الفهرس 
Material and methodsOnly 14 pages are availabe for public view
 |  | from | 222 |  |  |
| | | from | 222 | | |
Abstract
Wuchereria bancrofti is endemic in Egypt. Lt is present
in some Governorates, such as Qalubia, Sharkiya and Damitta
and completely absent in other GovernoratEs such as Minia
and Aswan although the intermediate host (Culex pipiens) is
present allover Egypt (Khalil, 1936).
Seven hundreds and fifty individuals were chosen from
five centers, endemic for filariasis,in Qalubia Governorate, as
recorded by Ministry of Public Health (1980-1989). These centers
were; Benha center (177 subjects from 4 villages), Tokh
center (128 subjects from three villages), Qalu:lbe center
(168 subjects from two villages), El-Khanka center (112 subjects
from one village), and Shebin EI-Kanater center (165
subjects from five villages).
A case sheet was designed to cover the aspects of personal,
present and past histories, especially those related
to filariasis. Every person was submitted to clinical examination
with special scress on examination for enlargement
of lymph nodes, swelling of lower or upper limbs, elephanti.
asis, hydrocele or other genital rswe LL ing:.1. Persons were
[159]
examined for microfilariae by wet preparation and counting
chamber techniques. Urine and stool samples from positive
clinically manifested cases as well as microfilaraemic cases
were examined.
Microfilari.al acid phosphatase activity was studied.
These microfilariae were extracted from blood samples of
37 cases with high density of microfilariae in their blood
(more than 4 m.f./lOO mm~ by counting chamber technique)
according to Chalifoux and Hunt (1971).
Total number of microfilariae were 4355. They were
stained according to Chalifoux and Hunt (1971) and examined
for measuring length and breadth, demonstration of anatomical
land marks (excretory vesicle, 3nal vesicle, inner bodies
and phasmides) and their distance from anterior end.
We study H.L.A. typing of 140 individuals free from
other parasites (screened by urine and stool analysis). They
were grouped into :
1) Microfilaraemic group (29 cases).
2) Clinically manifested cases (21 cases).
3) Non-filarial subjects in E’ndemic areas (50 persons).
4) Control (from Ain Shams Blood Bank) (40 personE).
[160]
The following results were obtained
” Microfilariae were detected in s:lxty eight cases (9.07%),
51 males and 17 females (9.34% and 8.33%, respectively).
* The rate of microfilaraemia was greater in young age.
«. As regards filarial clinical manHestations 54 cases showed
clinical evidence of filariasis (i.e. 7. :W%), eleven of them
had microfilaraemia in addition (1.e. 20.37%). The rest (43)
were amicrofilaraemic (Le. 79. 73:Z:).The clinical manifestations
were in the form of elephantiasis in lower limbs
(65.1%), elephantiasis in upper and lower limbs (6.96%), hydrocele
(25.58%) and Chyluria with hydrocele (2.33%).
There is a positive correlation between percentage of
filarial clinical cases and percEntage of microfilaraemia
(P<0.05).
The number of microfilariae in 100 mm~ ranged between
(1-10) and average density was 6 m.L/lOO mm~ using counting
chamber technique.
The density of m.f. in venous blood varied in different
centers. Mean number in one mI. was 22.5, i.e. in 100 mm~ was
2.25.
[ 161 1
The length and breadth of rrri.c rof Ll.ar i ae ranged between
26S-302 microns and 6-10 microns, respectively.
il· Acid-.phosphatase activity of microfilariae revealed two
patterns of reactions according t.o method of incubation.
When slides were incubated in staining solution at room
temperature for 2 hours, the over all body was diffusely
stained faint red, the precipitec: azo-dye indicating sites
of acid phosphatase activity appeared red to deep red at
excretory vesicle, anal vesicle, inner bodies and phasmids ..
When slides were incubated at 37”C for one hour, anal vesicle,
excretory vesicles and phasmids somtime stained. Inner bodies
were not sr.a i.ned ,
The mean distances between excretory, anal vesicles
and inner bodies from the anterior end were 29.73%, S2. 21%
and 70.2S%, respectively.
* As regards H.L.A. typing; It was found that H.L.A.-BS-B7-BS
were more frequent in microfilaraemic cases and H.L.A.-A9-
B
S
-B
7
-B
S
were more frequent in cl inical cases in comparison
to non-filarial persons in endemic areas. The H.L.A.-B7-BS
were more frequent in microfilaraemic cases and H.L.A.-
[162]
B
S
-B
7
-B
S
were more frequent in clinical cases in comparison
to control. By Odds ratio, H.L.A.-B7 showed high susceptibility
lor retaining the mjcrof t la rinc in their blood and to
develop the clinical manifestations in filarial areas.
[ 163 ]
CONCLUSION
[1] from this study it was shown that microfilarial rate in endemic
areas in Qalubia Governorate was 9.07%.
[2] Microfilarial rate is not related to sex and it was high at
age group below 15 years.
[3] There were early clinical manifestations at young age and
chronic manifestations at old age. There is a positive correlation
between percentage of clinical cases and percentage
of microfilaraemia.
[4] There is no correlation between percentage of clinical cases
and density of microfilariae.
[5] from histochemical studies and length and breadth measurements,
the strain of microfilaria of Wuchereria bancrofti was the same
as that isolated in previous studies.
[6] H.L.A. typing indicates that H.L.A.-Bs-B
7
-B
S
were more frequent
in microfilaraemic cases and H.L.A.-A
9
-Bs-B
7
-B
S
were more frequent
in clinical cases. Also, H.L.A.-B
7
showed high susceptibility
among filarial cases in filarial areas.
[164]
RECOMMENDATIONS
[1] It is recommended to advance the system,’ of irrigation, close
opened wells and improve health services including, the methods
of insect control and continuous drug supply to give complete
courses of treatment for every patient.
[2] Further study of the immune system of patients with H.L.A.-B
7
to spot the weak points that can predispose to the continuity
of microfilaraemia and developing of clinical manifestations.
[:I] Cellular and humeral immune studies of both asymptomatic microfilaraemic
cases and clinically manifested cases to clear out
the host parasite relation leading to developing the manifestations
of the disease.
[4] Further studies of the host factors (im~une response, age, sex,
et c . ) and the parasite factors (strains, inoculating, dose,
acid phosphatase activities, .... etc.) and vectors and enviromental
factors that can lead to the con t i.nui ty of the di sea se Ln
specific endemic areas.