2020年10月5日 星期一

[全球衛生] 修課筆記20201006

tropical disease:malaria, leishmaniasis, schistosomiasis, onchocerciasis, filariasis, chagas, trypanosomiasis, dengue

ASTMH american society of tropical medicine and hygiene

Eradication: zero disease globally

Elimination: zero case in a defined geographic area

NEJM 2013: disease eradication

Guinea worm eradication program:dog, chimpamzee

MDA Mass drug administration

APOC african programme for onchocerciasis control

Global fund : HIV TB malaria

Clinton Health Access Initiatice CHAI

Gates foundation

GSK malaria vaccine

Wuchereria bancrofti

brugia malayi

brugia timoria

masonella ozzardi

masonella perstans

loa loa:west africa

ochocerca volvuvus

mansonella streptocrca

rhodnius prolixus

tsetse fly

microfilariasis, oviparous

culex quinquefasciatus 南方家蚊

Melanization and excapsulation response

Productio of AMPs

inflmmatory acute stage filariasis

lymphoedema

filarial fever

tropical pulmonary eosinophilia TPE

high IgE, no circulating microfilaria, high eosinophilia

elphantiasis

chyluria

initial acute response, granulomatous reaction(release endo-cytoplasmic bacteria)

daytime occult filariais: malayi, bancrofti

night time good for culex quinquefasciatus (10pm-4am)

diural perodic form: loa loa

Ag detection

molecular diagnosis

Ab detection: not recommended due to cross reactivity

DEC diethylcarbamazine, Hetrazan

Ivermectin: paralyzed microfilaria

albendazole

doxycycline

community based ivermectin or DEC

vector control

GPELF: global programme to eliminate lymphatic filariasis, eliminate filiariasis by 2020

loa loa african eye worm, mango fly chrysops

loa loa:west africa

ochocerca volvuvus

mansonella streptocrca

chrysops silicea, chrysops dimidiata

loa loa, calabar swelling, upper limb swelling

Rapid assessment procedure for loa loa

prophylaxis DEC 300mg/week

treatment DEC 2mg/kg for 21 days(fatal encephalitis, renal lesion); ivermectin

prevention, prophylaxis, community-based control using albendazole have been tried with limited success

river blindness, 2nd commonest filarial infection; onchocerca volvulus; black fly(small)

leuckart(receive sample from Mason)

daytime feeder

high water speed, more ozygen; attach on grass or rock

sowda(seen in sudan and Yemen), darkened skin; edema, thickening of dermis

kidney, lung, liver, other organs

*onchocercomata*

africa: lower trunk and limbs

central america: head thorax neck

erysipela de la costa: face

down regulate Th-1 type mmune response

symbiotic wolbachia

nodding syndrome: neurological disorder in Uganda and its neiboring conuntry, long-term mental disabilities

Mazzotti test, 50mg DEC

Patch test

ivermectin, DEC, doxycycline followed by ivermectin, target wolbachia

malaria: artemisin+quinine

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