The prevalence of onchocerciasis infection was determined in communities on

A retrospective study was performed comparing the number of spontaneous abortions in a hyperendemic area for onchocerciasis in Ecuador before and after invermectin treatment with that of a comparable non-endemic area. The frequency of spontaneous abortions was associated with a change in the community microfilarial load, suggesting that there may be a relationship between spontaneous abortions and infection with Onchocerca volvulus. In the endemic area, a significantly greater rate of spontaneous abortions was seen in the period before ivermectin distribution compared to that after the start of ivermectin treatments every 6 months. In the non-endemic area, no change in the rate of spontaneous abortions was seen over the same time period. In addition to the well-documented improvements in skin and ocular disease, ivermectin may also improve the reproductive health of endemic populations.

The effect of chloroquine phosphate on Onchocerca volvulus in vivo was studied in Ecuadorians undergoing treatment for malaria. All persons with a diagnosis of acute malaria and treated with 2500 mg of chloroquine over 3 d showed a 100% reduction of dermal O. volvulus microfilariae 7 d after treatment. However, 28 d after treatment the microfilarial densities returned to their pre-treatment levels and at 35 d they had increased to 121.6% of their pre-treatment values. Treatment did not appear to have any effect on the adult O. volvulus examined histologically in extirpated nodules. Patients treated for acute malaria and subsequently kept on a prophylactic regimen of 500 mg chloroquine weekly showed a reduction of 56.7% from pre-treatment microfilarial density after 27 weeks. Patients who underwent nodulectomy as well as treatment for acute malaria and were given 500 mg of chloroquine prophylactically for 27 weeks showed a reduction in dermal microfilarial density of 93.6%. Symptoms of onchocerciasis were reduced in the latter group of patients, with the elimination of all acute dermatological changes within 6 weeks. Ocular examination of these surgically and chemotherapeutically treated individuals revealed reductions of 94.9% of microfilariae in the anterior chamber, 95.9% of live microfilariae in the cornea, and 95.1% of dead microfilariae in the cornea. There was a reduction of 69.8% in corneal fluffy opacities. No alteration in the visual acuity or in visible lesions in the posterior segment was recorded. The results suggest that a complex interaction between chloroquine and O. volvulus takes place in vivo, which can be beneficial to the patient over a long period.(ABSTRACT TRUNCATED AT 250 WORDS)

ResumenSe realizó un estudio epidemiológico, clínico y serológico del pian en la cuenca del río Santiago, cantón Eloy Alfaro, provincia de Esmeraldas, el cual demostró una prevalencia del 11,3% con lesiones dérmicas activas y una seropositividad del 94,9%. El área del río Santiago era hiperendémica para el pian (prevalencia 17,9%; seropositividad 98,0%), mientras que el río Zapallito era mesoendémico y los ríos Cayapas y Onzole, hipoendémicos. Se encontró evidencia del pian, activa y latente, solamente en la raza negra. La mayor incidencia de las lesiones clínicas (55,8%) se encontró en los niños de 5-12 años de edad, localizándose el porcentaje superior en las piernas (64,2%). Los papilomas fueron las lesiones más frecuentes (55,4%). Se administró tratamiento masivo con penicilina benzatínica, según las normas de OMS, en todas las comunidades positivas para esta enfermedad. SummaryA clinical and serological epidemiological study in a yaws focus in cantón Eloy Alfaro, in the Santiago basin area of the province of Esmeraldas, showed a prevalence of 11.3% for active skin lesions and seropositivity of 94.9%. The Santiago river was found to be hyperendemic for yaws (prevalence 17.9), while the Zapallito river was rnesoendemic and the Cayapas and Onzole rivers were hypoendemic. Active and latent evidence of yaws was found only in the black race. Children, aged 5-12, were found to have the highest incidence (55.8%) of clinical lesions, the majority being found on the legs (64.2%). The most prevalent lesions (55.4%) were papilloma. Mass treatment of al 1 positive communities, using benzathine penicillin G, was carried out according to WHO recommendations.El pian, una enfermedad contagiosa no lo largo de todo el Africa tropical, Tailandia, Malasia, venérea producida por Treponema perte-Indonesia, Filipinas, Suramérica y las islas del Canue, también llamada buba, bouba o ribe (1). frambesia, está virtualmente confinada a En 1959, se estimaba que la incidencia mundial era las poblaciones tropicales primitivas de las de aproximadamente 50 millones de casos y en áreas rurales en los trópicos medio-algunos países se tuvo la sospecha que existían 20 geográficos. La enfermedad es endémica a a 30

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