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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The endemicity of human onchocerciasis was assessed in eight rural, at-risk communities in Ningi Local Government Area, Bauchi State, Nigeria, between July 1990 and March 1991. Of the 1536 subjects skin-snipped, 334 (21.7%) were positive for Onchocerca volvulus microfilariae. Surprisingly, there was a significant inverse relationship between prevalence and mean microfilarial load (r = -0.608; P < 0.05). Males were more likely to be infected than females (P < 0.01) and cattle rearers (71.0% infected), farmers (49.8%) and fishermen (40.0%) had significantly higher prevalences than students/schoolchildren, housewives or traders (P < 0.001). Pruritus and itchy eyes were recorded in all age groups and appeared in much younger subjects than any other manifestations of the infection. Prevalence and onchocercal blindness were linearly related to intensity of infection. The epidemiological significance of these findings, in terms of a future community-wide programme of long-term chemoprophylaxis with Mectizan, is highlighted.
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PMID:Studies on filariasis in Bauchi State, Nigeria. 1. Endemicity of human onchocerciasis in Ningi Local Government Area. 774 92

This paper examines the extent to which onchocercal skin lesions affect the age at marriage and the duration of lactation among infected women in forest areas of Nigeria. In a retrospective study, 145 multiparous women were asked about their breast-feeding behaviour. Ninety-seven per cent routinely breast-fed after delivery, although the duration of lactation for 75 infected and 70 non-infected women was different. Of the 75 women with Onchocerca volvulus infection, 73% experienced itching during breast-feeding; 26% breast-fed for not more than 3 months compared to 2.1% of non-infected women who breast-fed for the same period (p < 0.005). A multiple regression model showed severity of onchocercal lesions as an independent predictor of shorter duration of lactation for women with O. volvulus infection. Duration of breast-feeding was reduced by more than 9 months for 6 (25%) out of 24 infected women who breast-fed infants before and after the onset of itching from lesions. Also, while the minimum age at marriage was 9 years for non-infected women, it was 17 years for women whose lesions appeared before marriage. This preliminary study suggest that incessant itching and severe onchocerciasis lesions may be important predictors of failure of women to breast-feed for longer periods in rain-forest areas of Nigeria.
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PMID:Detrimental effects of onchocerciasis on marriage age and breast-feeding. 785 22

An epidemiological study of 14 communities situated along the major road passing through Bali district in Taraba State, Nigeria, was carried out in continuation of a statewide filariasis survey which began in 1989. Of the 4,024 people that were examined for Onchocerca volvulus microfilaria and for clinical symptoms of the disease, onchocerciasis, an unusually low 13.3% prevalence rate was recorded with a range between 1.1% and 45.5%. Only one community had prevalence rate beyond 30.0%, six had infection rates between 10 and 29% while the remaining seven had less then 10% prevalence of the disease. However, infection was recorded in every community. The prevalence of physical symptoms was equally low. Pruritus was 7.3% and leopard skin was 0.4%. The prevalence of onchocerciasis increased with age in both male and female thus supporting the age and sex specific pattern of infection that had been reported in other parts of the state. A case is made for the continued prospection for onchocerciasis in the other districts of the state in order to identify and treat all communities that must benefit from the ongoing ivermectin treatment.
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PMID:Onchocerciasis in Taraba State, Nigeria: intensity, rate of infection and associated symptoms in 14 communities of Bali district. 808 52

A three-year placebo-controlled, double-blind trial involving 7148 persons was conducted to determine adverse reactions to ivermectin given annually for treatment of onchocerciasis by mass distribution. Musculoskeletal pains, oedema of the face or extremities, itching and papular rash were statistically associated with ivermectin treatment in the first year. In the second year of treatment these reactions were less frequently reported, although still more prevalent in ivermectin recipients. During the third year of treatment all persons received ivermectin. Persons who had missed ivermectin treatment in the second year did not have significantly more adverse reactions after treatment in the third year. Those who had received placebo during the first 2 years reported some adverse reactions more frequently following ivermectin than did those who had received ivermectin from the beginning of the study. Oedema was the adverse reaction of greatest concern to patients and this involved the face most commonly. A single episode of bullous skin lesions developed in 5 persons who had received ivermectin. These lesions did not reoccur with subsequent treatment. No episode of hypotension after treatment was observed.
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PMID:Adverse reactions to ivermectin treatment for onchocerciasis. Results of a placebo-controlled, double-blind trial in Malawi. 823 5

Prior to the initiation of an onchocerciasis control program based on the mass administration of ivermectin in the rain forest of southwestern Cameroon, a preliminary baseline study of the area was conducted. The results of this study showed that onchocerciasis was hyperendemic in the area. Skin symptoms and signs were observed including pruritus (67.4% of the population examined), onchocerca nodules (51.6%), skin depigmentation (18.5%), and hanging groins (5.7%). Except for pruritus, the prevalence of these symptoms increased with age. Of the eyes examined, 44.9% had microfilariae in the anterior chamber, 33.5% had choroidoretinitis, 28.0% had punctate keratitis, 8.3% had papillary abnormalities, and 3.6% had sclerosing keratitis. Vision in 10.5% of the eyes examined was classified as blind or very poor (visual acuity = 0-0.10), in 15.7% as poor (visual acuity = 0.11-0.39), and in 73.8% as good (visual acuity = 0.4-1.00). Unlike previous reports that have linked serious ocular damage mainly to savanna onchocerciasis, the present study showed that forest onchocerciasis also caused significant ocular pathology, including blindness. Parasitologically, positive skin snips were recorded for 92.7% of the persons examined, with both sexes being equally infected. The parasite load, expressed as the geometric mean number of microfilariae per skin snip, was 53.6, and was much higher in males than in females. The flv vector, Simulium squamosum, had a high infection rate of 7.5% infective females in Bakumba and 6.8% infective females in Ngbandi, the two fly-catching points. The transmission potential was 266 infective larvae per person per month in Bakumba and 189 in Ngbandi.
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PMID:A study of onchocerciasis with severe skin and eye lesions in a hyperendemic zone in the forest of southwestern Cameroon: clinical, parasitologic, and entomologic findings. 842 83

In the onchocerciasis-endemic rain forest area of the Rumpi Hills in southwestern Cameroon, a community-based trial of ivermectin, given either once or twice a year over a three-year period (1988-1991), confirmed that the drug is a potent microfilaricide. The side effects recorded following the first treatment were edema, fever, pruritus, generalized body pains and lymphadenitis. Following subsequent treatments, the same adverse reactions were recorded, but these were generally milder when compared with those of the first treatment. The prevalence of skin microfilaria (mf) was more reduced in zone two, in which treatment was given every six months (76.9% reduction at the end of one year) than in the zone one, in which treatment was given once a year (7.4% reduction). In both zones, the impact of the drug in reducing the intensity of infection was more significant than that for prevalence. Besides pruritus, other skin symptoms were not significantly modified by ivermectin treatment. Ivermectin reduced the prevalence of ocular mf as well as the mf load of the anterior chamber of the eye, resulting in improvement of certain eye lesions such as punctate keratitis, anterior uveitis, and papillary anomalies. There was also some improvement in visual acuity. The level of participation of the village populations was somewhat low, ranging from 52% to 66%, despite excitement over the drug's additional benefit of expelling intestinal round worms.
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PMID:A community-based trial of ivermectin for onchocerciasis control in the forest of southwestern Cameroon: clinical and parasitologic findings after three treatments. 842 94

Plausible reversal of secondary amenorrhoea in three women infected with onchocerciasis after Mectizan treatment in Imo State, Nigeria, is presented. The women aged 30, 28, and 32 years with drastic reduction in mean microfilaria scores had reversed amenorrhoea 8, 13 and 10 days post Mectizan treatment, respectively. They had typical manifestation of onchocerciasis including nodules, pruritic rash, body itching and musculo-skeletal pains. The manifestations eased off 4 days post treatment. The plausible link between loss of fertility due to premature menopause in women and onchocerciasis is discussed.
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PMID:Reversal of amenorrhoea after Mectizan treatment. 855 49

In the last ten years ivermectin appeared an efficient and safe alternative to diethylcarbamazine which is known to induce severe adverse reactions in loiasis, including encephalitis. After these results, large scale ivermectin treatments against onchocerciasis were carried out in Central Africa where loiasis is also endemic; and seven cases of severe reaction were reported in Cameroon since 1991, during these mass ivermectin treatments. In order to study adverse reactions in patients harbouring high load of Loa loa microfilariae (mf), we realized careful hospital based treatment in 112 patients with more than 3,000 mf/ml (ml) blood. Patients received once 200 micrograms ivermectin per kilogram at day 0 (D0). Clinical examination was made daily during the four following days (D1 to D4). Blood and urine samples were analysed before treatment and at D1 and D3. Lumbar puncture was made at D1 for 39 patients with more than 10,000 mf/ml; at D3 for the 49 following patients without consideration for the level of parasitaemia, and at D0 and D3 for ten voluntary patients. For analysis the patients were distributed in 3 groups according to initial parasitaemia: the first group included 50% out of the patients, those whose parasitaemia was fewer than 15,000 mf/ml blood; the second group included 25% patients whose parasitaemia was between 15,000 and 30,000 mf/ml; the third group included the last 25% patients whose parasitaemia was higher than 30,000 mf per ml blood. Adverse reactions were observed in 71% out of the patients. Symptoms described were fever, pruritus, headache, arthralgia. Most symptoms appeared 24 to 36 hours after treatment. Temperature increased significantly in group 3. Microfilaraemia decreased by 85% in the 3 groups during the 4 days following treatment. C-reactive-protein increased dramatically after treatment in all patients (p < 10(-4)). Some patients presented blood in urine in three groups but haematuria reached 35% of patients in group 3. Proteinuria is noted among 33% of all patients but 20% in group 1 and 2 versus 70% in group 3. Loa loa mf were observed in urine of half the patients, but in low amounts (< 10 mf per 50 ml urine). In cerebro-spinal fluid (CSF), some mf appeared at D1 or D3 in people heavily infected with Loa loa, reaching 80% of the patients of group 3. LP made at D0 in ten patients with parasitaemia higher than 30,000 mf/ml blood confirmed that CSF was naturally microfilaria free before treatment. One patient presented severe troubles with fever, asthenia and conscience troubles beginning at D3, reactive coma at D4, renal impairment with transitory anuria; progressive improvement in 2 weeks and complete recovery at D22; he presented 102 mf/ml CSF at D6. The study confirmed that ivermectin treatment is generally well tolerated. Among people with high Loa loa parasitaemia the symptoms after treatment are frequent but mild. However severe cases with conscience troubles are possible, and may occur in about 1% of subjects with more than 3,000 mf/ml blood. Severity of adverse reactions was linked to level of parasitaemia before treatment. The critical parasitaemia level which could lead to expect serious adverse effects seems to be 30,000 ml/ml blood. These informations should induce carefulness to carry out large scale treatments against filariosis in endemic areas of Loa loa.
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PMID:[Secondary effects of the treatment of hypermicrofilaremic loiasis using ivermectin]. 855 62

A prospective study was conducted to determine the etiologies of isolated pruritus among out-patients attending a hospital dermatology clinic in Lome. Two hundred and twenty patients (120 men and 100 women) suffering from isolated pruritus were included in the study. The most frequent etiologies were; digestive parasitosis (n = 50), onchocercosis (n = 45), drug allergy (n = 26), food allergy (n = 10), psychological pruritus (n = 25) and hepatitis (n = 13). The etiology was not determined for 29 cases. This study shows the large contribution of parasites to the pathogenesis of pruritus in tropical Africa.
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PMID:[Etiology of isolated pruritus in dermatology consultations at Lome (Togo)]. 861 9

The cultural context of forest onchocerciasis was studied in the Boulou and Baka ethnic communities in the Dja-Lobo Division of southern Cameroon. A 2-day survey used focus group interviews followed by a questionnaire administered to 212 randomly selected individuals in 8 communities (88 male and 124 females heads of household) to assess their knowledge about onchocerciasis. Most people (98%) had some knowledge about the disease. Minak was the term used for filariasis by most people (97%) and people knew (90%) that black fly (nyamendimi) was responsible for its transmission. Other vectors of the illness identified were mosquitoes, dirty water, sorcery, and taboo foods. 81% thought that maternal transmission was possible and 66% indicated that filariasis could be transmitted sexually. Virtually all respondents associated itching and rash with minak (filariasis) and more than 60% also recognized the swelling of the skin and leopard skin as manifestations of filariasis. Filariasis, malaria, worms, and blindness were placed in the middle category when the severity of various diseases was ranked by 20 Boulou adults. In contrast, the Baka did not think that filariasis caused blindness, nor that it is linked to eye-worms. However, the 212 individuals ranked blindness as the most severe among other diseases (filaria, malaria, diarrhea, and intestinal worms). 80% of the Boulou and Baka adults had had filariasis in the previous year, but only 5% of the Boulou children and none of the Baka children had had filariasis during that time period. With respect to intestinal worms, 71% of the Boulou adults and 60% of the Baka adults had had intestinal worms in the previous year, while more than 90% of the Boulou children and all of the Baka children had had intestinal worms. Of the 90% who revealed that they had had filariasis at least once before, 69% sought treatment. 54% had tried traditional treatment, while 50% had tried Notezine, 49% had tried Phenergan, and 38% had tried M.G. Lumiere.
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PMID:Ivermectin distribution and the cultural context of forest onchocerciasis in South Province, Cameroon. 864 8


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