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KMID : 0353019680050020103
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Korean Journal of Public Health
1968 Volume.5 No. 2 p.103 ~ p.112
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An Epidemiological Study and Clinical Evaluation on Mass Chemotherapy with Spatonin for Filariasis in Southern Area of Che Ju Do
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Abstract
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Filariasis survey was carried out on 1107 subjects of 3 villages located in southern county of Che Ju Do from June to October of 1968.
Mass chemotherapy with spatonin (Diethylcarbamazine) on 208 microfilaria positive cases was followed after the survey. The summarized results are as follows:
1. Epidemiological characteristics of microfilaria positives and elephantiasis patients.
Microfilaria rates varied by areas with average of 20.9% ranging from 17.3% to 27.1%.
Distribution of microfilaria rate by sex did not show any significant difference, however, the distribution of microfilaria rate by age showed two peaks, one for 21-30 years and the other for 41-50 age group. For the remarkable dropped rate for 31-40 years age group, more studies may be necessary to give explanations.
The range of microfilaria counts per 40㎣ of blood (density) varied widely from 1 to 788, although the most of microfilaria positives (40%) had less than 25 Mf (microfilaria) per unit of blood. Also the microfilaria density showed interesting correlation between Mf. rate and the density by villages; where the rate was high, the density was proportionately high.
The survey by family unit revealed that 40% (average) of total households surveyed had Mf positives, and 80% of positive households had one or two positive family members.
On the survey of clinical filariasis, 41 of 1107 subjects were found to have elephantiasis. Female showed predominantly higher rate (2.2 times) compared with that of male. The distribution by age showed definite tendency of increasing rate by increasing age; in more than 80% of the cases, the elephantiasis appeared after 20 years of age, even though the earlest case was 14 years old girl.
Sites for elephantiasis were found in 75% on lower extremities, 5% on upper extremities and 20% on both extremities. Erythematous swellings of extremities accompanied by fever seemed to occur once or twice annually. Some contributing factors for the episodes seemed to be related to over exhaustion and/or injuries.
2. Mass treatment with spatonin, its efficacy and side reactions.
Mass chemotherapy with spatonin on 208 microfilaria positives gave all excellent efficacy according to the results of blood smear immediately after the last dose of the drug; four experimental groups (by village) treated with 6mg of spatonin/kg body weight every day, every other day for 6 doses, same amount of the drug 6mg/kg of b.w. every other day for first 2 doses and every day for rest of doses, and 3mg/kg of b.w. every other day for 14 doses, showed similar results (92.6%, 91.2% and 88.4% of rate turning to microfilaria negative) for 6mg/kg of b.w. groups regardless of way of administration except 3mg/kg of B.W. group, which had much inferior efficacy than the another groups(only one of five became negative). Six doses of 6mg/kg b.w. spatonin may be enough to turn the positives to negative, although long term follow up study is strongly desired.
The side reactions due to the drug was relatively severe especially after the first and second doses. More frequent symptoms were anorexia, fever, headache, joint pain, and dizziness, which became milder when the drug was administered every other day.
From this study, it was tentatively concluded that filariasis is one of important endemic diseases in the area studied. and spatonin could be a potent drug for control of filariasis when administered properly.
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