Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item A Simple and rapid non-radioactive oligonucleotide based hybridization assay for the detection of Wuchereria bancrofti.(SEAMEO Regional Tropical Medicine and Public Health Project, 1999) Gunawardene, Y.I.N.S.; Wijesundera, W.S.; Karunanayake, E.H.; Chandrasekharan, N.V.; Jayasekara, N.; Siridewa, K.Five biotin labeled oligonucleotides was designed based on a previously cloned and characterized repetitive DNA sequence specific for Wuchereria bancrofti. The oligonucleotide mix (containing five probes) when used in a hybridization assay, detected as little as 100 pg of purified W. bancrofti, microfilarial DNA, a single infective stage larva and a single microfilaria in 50 microl blood sample. A simple protocol was followed for the hybridization assay. Blood samples lysed with sterile distilled water and digested with proteinase K in the presence of a detergent were directly applied on to nylon membranes for dot blot assays. The DNA extract of mosquitos carrying infective stage larvae was eluted through sephadex G-50 minicolumns prior to blotting. The assay was also able to detect DNA extracted from microfilariae infected samples stored over five days at room temperature (28 degrees C). This simple and rapid oligonucleotide hybridization protocol with the highly sensitive chemiluminescent-based detection has significant potential for the development of a field kit to detect W. bancrofti infection.Item Wuchereria bancrofti antigenaemia in Sri Lanka.(Blackwell Scientific Publications, 1999) Itoh, M.; Weerasooriya, M.V.; Gunawardena, N.K.; Mudalige, M.P.; Samarawickrema, W.A.; Kimura, E.The prevalence of Wuchereria bancrofti antigenaemia determined in 353 subjects in Matara, Sri Lanka by Og4C3 ELISA was 20.7%. Positive rates obtained with the same subjects by 1 ml Nuclepore filtration and 60 microl thick blood smear were 11.3% and 7.9%, respectively. Antigen levels were positively associated with microfilaria counts. Two-thirds of antigen-positive and microfilaria-negative (Ag+/Mf-) individuals were > 25-year-old, but younger age groups (< or = 25-year-old) tended to have proportionally more Ag+/Mf- cases. Possible origins of the Ag+/Mf- status are discussedItem The use of whole blood absorbed on filter paper to detect Wuchereria bancrofti circulating antigen(Oxford University Press, 1998) Itoh, M.; Gunawardena, N.K.; Qiu, X.G.; Weerasooriya, M.V.; Kimura, E.The Og4C3 enzyme-linked immunosorbent assay (ELISA) to detect circulating Wuchereria bancrofti antigen uses 50 microL of serum. In this study, a whole blood sample absorbed on filter paper was tested as a substitute for serum. Serum samples were obtained from 60 Sri Lankan subjects by venepuncture and finger-prick blood samples from the same individuals were directly absorbed on filter paper. Og4C3 ELISAs using serum and filter paper blood were compared. Despite the fact that the estimated amount of serum available for the ELISA with filter paper blood was only one-fifth of that available when serum was used, the 2 ELISAs gave almost identical results. Of the 39 positive serum samples, 38 were detected using filter paper blood. Employing the ELISA using filter paper blood, 619 people in Matara, Sri Lanka, were examined for antigenaemia. The positivity rate was 22.5%, 3.1 times higher than the rate of microfilaraemia detected by examination of 60 microL blood filmsItem Efficacy of single dose combinations of albendazole, ivermectin and diethylcarbamazine for the treatment of bancroftian filariasis(Oxford University Press, 1998) Ismail, M.M.; Jayakody, R.L.; Weil, G.J.; Nirmalan, N.; Jayasinghe, K.S.A.; Abeyewickreme, W.; Sheriff, M.M.R.; Rajaratnam, H.N.; Amarasekera, N.; de Silva, D.C.; Michalski, M.L.; Dissanaike, A.S.In a 'blind' trial on 50 male asymptomatic microfilaraemic subjects with Wuchereria bancrofti infection, the safety, tolerability and filaricidal efficacy of a single dose of albendazole (alb) 600 mg alone or in combination with ivermectin (iver) 400 microg/kg or diethylcarbamazine citrate (DEC) 6 mg/kg was compared with a single dose of the combination DEC 6 mg/kg and iver 400 micro g/kg over a period of 15 months after treatment. All but one subject, with 67 micro filariae (mf)/mL, had pre-treatment counts 100 mf/mL. All 4 treatments significantly reduced mf counts, but alb/iver was the most effective regimen for clearing mf from night blood: 9 of 13 subjects (69 percent) were amicro filaraemic by membrane filtration 15 months after treatment compared to one of 12 (8 percent), 3 of 11 (27 percent), and 3 of 10 (30 percent) in the groups treated with alb, alb/DEC, and DEC/iver, respectively. Filarial antigen tests suggested that all 4 treatments had significant activity against adult W. bancrofti; alb/DEC had the greatest activity according to this test, with antigen levels decreasing by 77percent 15 months after therapy. All 4 regimens were well tolerated and clinically safe, although mild, self-limited systemic reactions were observed in all treatment groups. These results suggest that alb/iver is a safe and effective single dose regimen for suppression of micro filaraemia in bancroftian filariasis that could be considered for control programmes. Additional benefits of this combination are its potent, broad spectrum activity against intestinal helminths and potential relative safety in areas of Africa where DEC cannot be used for filariasis control because of co-endemicity with onchocerciasis or loiasisItem The Treatment and control of helminth infections prevalent in Sri Lanka(The Kandy Society of Medicine, 1997) de Silva, N.R.; Guyatt, H.L.Item Prolonged clearence of microfilaraemia in patients with bancroftian filariasis after multiple high doses of ivermectin of diethylacarbamizine(Oxford University Press, 1996) Ismail, M.M.; Weil, G.J.; Jayasinghe, K.S.A.; Premaratne, U.N.; Abeyewickreme, W.; Rajaratnam, H.N.; Sheriff, M.M.R.; Perera, C.S.; Dissanaike, A.S.In a double-blind trial on 37 asymptomatic microfilaraemic subjects (minimum 400 microfilariae [mf] per mL) with Wuchereria bancrofti infection, the safety, tolerability and macrofilaricidal efficacy of 12 fortnightly doses of ivermectin, 400 microg/kg (ivermectin group), was compared with 12 fortnightly doses of diethylcarbamazine (DEC), 10 mg/kg (DEC group), over a period of 129 weeks after treatment. A control group (LDIC group) was treated with low dose ivermectin to clear microfilaraemia, for ethical reasons. Both ivermectin and DEC in high multiple doses were well tolerated and clinically safe. Macrofilaricidal efficacy was assessed by prolonged clearance of microfilaraemia, appearance of local lesions, and reduction of circulating W. bancrofti adult antigen detected by an antigen capture enzyme-linked immunoassay based on the monoclonal antibody AD12. Mf counts fell more rapidly after ivermectin than after DEC, but low residual mf levels were equivalent in these groups after week 4. Conversely, filarial antigen levels fell more rapidly after DEC than after ivermectin, but low residual antigen levels in these groups were statistically equivalent at all times beyond 12 weeks. Mild, self-limited systemic reactions to therapy were observed in all 3 treatment groups. Local reactions, such as development of scrotal nodules, were observed in several subjects in the DEC and ivermectin groups. These results suggested that high dose ivermectin and DEC both had significant macrofilaricidal activity against W. bancrofti, but neither of these intensive therapeutic regimens consistently produced complete cures. Thus, new drugs or dosing schedules are needed to achieve the goal of killing all filarial parasites in the majority of patients.Item Effect of ivermectin on the development of Wuchereria bancrofti in the vector(Malaysian Society of Parasitology and Tropical Medicine, 1992) Abeyewickreme, W.; Ismail, M.M.; Premaratne, U.N.; Dissanaike, A.S.Item Treatment of bancroftian filariasis with ivermectin in Sri Lanka, evaluation of efficacy and adverse reaction(Malaysian Society of Parasitology and Tropical Medicine, 1991) Ismail, M.M.; Premaratne, U.N.; Abeyewickreme, W.; Jayasinghe, K.S.A.; de Silva, W.A.S.; Atukorala, S.; de Abrew, K.; Dissanaike, A.S.Item Anopheles (Cellia) jamesii: a potential natural vector of Bancroftian filariasis in Sri Lanka(Oxford University Press, 1991) Abeyewickreme, W.; Wanniarachchi, P.No Abstract AvailableItem Anopheles (Cellia) culicifacies: a potential vector of bancroftian filariasis in Sri Lanka(Museum and Reference Centre, SEAMEO-TROPMED National Centre of Thailand, 1987) Abeyewickreme, W.; Hewadikaram, K.A.; Weerasena, K.H.; Premaratne, U.N.; Ismail, M.M.