Rifky Faris

Community diagnosis of Bancroftian filariasis

The objective of this study was to find the best tests for efficiently estimating the true prevalence of Bancroftian filariasis in endemic areas. The study population comprised 427 people over 10 years of age in an endemic village in Egypt. Four tests were evaluated; a standardized clinical examination, night blood examinations for microfilariae (50 microL thick films and 1 mL membrane filtration), and a test for circulating filarial antigen. 191 subjects (44.75%) had at least one positive test and were considered to have filariasis. The sensitivities of clinical examination, thick films, membrane filtration and antigen testing for filariasis were 16%, 50%, 64%, and 88%, respectively. Relative to membrane filtration of night blood, the filarial antigen test had a sensitivity of 97.5%, a positive predictive power of 71%, and a negative predictive power of 99%. None of the blood tests was a sensitive indicator of clinical filariasis; 69% of clinical cases were negative in all 3 blood tests and would have been missed if clinical examinations had not been done. Therefore, we recommend a combination of clinical examination and the filarial antigen test (with optional examination for microfilariae of those with positive antigen tests) for community diagnosis of Bancroftian filariasis in endemic areas.

Blood lead level of Cairo traffic policeman

Blood lead level, haemoglobin concentration (Hb) and urinary delta-aminolevulenic acid (ALA) were determined for 126 traffic policemen and a control group of 50 office-based policemen of Cairo city. Mean blood lead level and Hb of traffic policemen were significantly higher than those of the controls; ALA of both groups were similar. The blood lead level of traffic policemen was not related to age, duration of employment or Hb. Although the observed blood lead level of Cairo traffic policemen (29.2 +/- 7.5 microns dl-1) may be considered acceptable for their occupation, it indicates a potential risk from traffic-exhaust-induced air pollution for other groups of the Cairo population such as children and pregnant women.

Efficient assessment of filariasis endemicity by screening for filarial antigenaemia in a sentinel population

We have previously reported that a monoclonal antibody-based antigen detection assay (AD12) is sensitive and specific for Bancroftian filariasis in Egypt. The purpose of the present study was to demonstrate the use of this assay in a sentinel population as a means of efficiently screening for filariasis endemicity. Antigen testing was performed with finger-prick blood collected during the day from 743 schoolchildren (ages 11-16 years). The school draws students from 5 villages in Qalubia Governorate, 35 km north-east of Cairo, Egypt. The prevalence of filarial antigenaemia in the school was 17.2%. Antigenaemia rates in children from the 5 villages were 29, 20, 18, 17, and 10% (non-uniformity significant by chi 2 analysis, P = 0.02). These data agree with Ministry of Health rankings of relative endemicity for these villages based on prior night blood surveys. The village with the highest antigen prevalence in children was surveyed one year before the present study. Prevalence rates of antigenaemia and microfilaraemia at that time for a different sample of children aged 11-16 years were 33% and 22%, respectively. We conclude that antigen detection in schoolchildren of this age group is an efficient means of assessing filariasis endemicity in Egypt.

A Comparative Clinical Evaluation of a New Topical Steroid “Halcinonide” and Hydrocortisone in Steroid-Responsive Dermatoses

Fifty patients with symmetrical, bilateral lesions of psoriasis, eczematous dermatitis, atopic dermatitis, or neurodermatitis participated in a double-blind paired comparison study in which 0·1 % halcinonide (in a cream formulation containing also neomycin and nystatin) was applied to the lesions on one side of the body and 1% hydrocortisone cream to those on the opposite side for two to three weeks. The number of excellent responses to therapy showed the halcinonide combination to be significantly superior (p >0·01) to the control cream in all diagnostic categories if considered collectively, and in psoriasis if the responses were grouped according to diagnosis. No adverse reactions occurred during the trial.

A Double-Blind Comparison of a New Combination (Halcinonide-Neomycin-Amphotericin) and Active Controls in Cutaneous Candidiasis and Steroid-Responsive Dermatoses

One hundred patients participated in the studies of cutaneous candidiasis and steroid-responsive dermatoses. Seventy patients with the former diagnosis were treated with either halcinonide-neomycin-amphotericin or hydrocortisone-iodochiorhydroxyquin ointment combinations on a double-blind parallel comparison basis. Similar results were obtained after both therapies. Thirty patients with symmetrical bilateral lesions of steroid-responsive dermatoses were treated with halcinonide-neomycin-amphotericin cream on the lesions on one side of the body and hydrocortisone-iodochlorhydroxyquin cream on the opposite side. A double-blind design was used in directly comparing the response to each of the two drugs. Considering the results of all dermatoses together the test combination was statistically superior to the control cream (p > 0·05). However, while numerical superiority of good responses to the halcinonide combination was recorded in psoriasis, no statistical significance could be derived due to the limited number of cases. No side-effects occurred with any drug combination used. In the opinion of the authors halcinonide-neomycin-amphotericin cream and ointment are safe and effective in the treatment of cutaneous candiasis and steroid-responsive dermatoses.