The effects of a mass chemotherapy programme using spaced doses of diethylcarbamazine citrate on Wuchereria bancrofti microfilaraemias and vector infection rates were studied in an isolated rural community of 650 people in north Trinidad where a microfilaria rate of 15% had previously been recorded. A single oral dose of 6mg/kg body weight was given at monthly intervals for one year. After 6 months, 79% (52/66) of persons previously microfilaraemic had become negative. After 12 months the negative proportion had increased to 90% (63/70). The geometric mean microfilaria density of those still microfilaraemic was reduced from 19.7 to 4.6 per 100mm3 of blood. Of 147 initially negative persons, none had become positive following treatment. Filarial infection rates in Culex quinquefasciatus from randomly sampled houses fell from 6.4% to zero; in houses where occupants with microfilaraemia had been identified before treatment, the rate was reduced from 15.8% to zero. In a supplementary study, however, weekly collections from one initially positive house showed a rapid decline in the vector infection rate from 43% to 2% after three months but an additional 3 months elapsed before the index reached zero. There was negligible microfilarial uptake by the vectors from residual low-density microfilaraemias (<10 microfilariae per 100mm3 of blood) after chemotherapy.

Mortality follow-up is now complete for 5 years in the 18 403 male civil servants aged 40-64 who were examined between 1967-69 in the Whitehall Study of British civil servants. During this period, 277 of them died of coronary heart-disease (C.H.D.); half of these deaths were in subjects in whom the findings at initial screening had suggested early myocardial ischæmia (angina or history of possible infarction according to standard questionnaire, or electrocardiographic evidence of ischæmia). The finding of suspect ischæmia had greater predictive power than the "primary" coronary risk factors, from which it was generally independent. At each level of the primary risk factors, the risk of death from C.H.D. was much greater in the presence of suspect ischæmia; and, with the possible exceptions of glucose tolerance and physical activity, the main risk factors still operated even at the stage of early ischæmia. These findings have implications for future studies of the effects of intervention.

The examination of 250 cases of onchocerciasis from the Sudan-savanna of northern Cameroon showed a strong association between microfilarial invasion of the eye and microfilarial skin concentrations at the outer canthus. It was also shown that the presence of a head nodule was associated with a high microfilarial skin concentration around the eye. It is suggested that these findings are of practical importance in the field for the early detection of cases at risk of developing serious ocular lesions.

The methods and preliminary results are reported of a screening survey for cardiorespiratory disease and diabetes among 18,403 male Civil Servants aged 40-64 years, representing a 77% response of those eligible. Simplified and standardised techniques were used to obtain as much information as possible from a short examination (average 23 minutes) by specially trained nurses or technicians. Using conventional diagnostic criteria, 2.3% of these men had chronic bronchitis and 15.6% persistent phlegm production in winter; while in 4.1% the ratio of forced expiratory volume in 1 second to forced vital capacity was less than 60%; 0.6 per 1000 had active tuberculosis and 0.4 per 1000 had lung cancer; 11% reported symptoms suggesting coronary or peripheral vascular disease, while 6.3% had electrocardiographic evidence of possible ischæmia; 3.2% had casual blood-pressure above either systolic 200 mm. Hg or diastolic 115 mm. Hg. Newly discovered diabetes was present in 0.3%, while 33% were above the desirable weight for their height. Of those with evidence of cardiovascular disease, for example, most were apparently not under medical care at the time. The value of screening depends on the efficacy of intervention, and two randomised controlled trials of specific preventive measures have been started—one of vigorous antismoking counselling among smokers at high risk of cardiorespiratory disease, and the other on the efficacy of diet and an oral hypoglycæmic drug in " borderline " diabetes.

The results of an onchocerciasis survey of total populations aged 5 years and over in 22 village groups in Cameroon rain-forest and savanna are reported. Using standardized techniques the same observers examined skin and eye lesions in 2,678 persons infected with O. volvulus, and compared them with lesions in 1,156 persons in whom the parasite was not detected.

Journal Article Observer variation in clinical onchocerciasis Get access P. J. S. Hamilton, P. J. S. Hamilton †Tropical Epidemiology Unit, Department of Medical Statistics and Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London WCIE 7HT, UK Search for other works by this author on: Oxford Academic PubMed Google Scholar T. F. De C. Marshall, T. F. De C. Marshall †Tropical Epidemiology Unit, Department of Medical Statistics and Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London WCIE 7HT, UK Search for other works by this author on: Oxford Academic PubMed Google Scholar J. Anderson, J. Anderson *Medical Research Council grantholders, Helminthiasis Research Unit, P.O. Box 55, Kumba, S.W. Province, Cameroon, UK Search for other works by this author on: Oxford Academic PubMed Google Scholar H. Fuglsang H. Fuglsang *Medical Research Council grantholders, Helminthiasis Research Unit, P.O. Box 55, Kumba, S.W. Province, Cameroon, UK Search for other works by this author on: Oxford Academic PubMed Google Scholar Transactions of The Royal Society of Tropical Medicine and Hygiene, Volume 68, Issue 3, 1974, Pages 187–189, https://doi.org/10.1016/0035-9203(74)90115-1 Published: 01 January 1974

The results of an onchocerciasis survey of total populations aged 5 years and over in 16 heavily infected villages in Cameroon rain-forest and savanna zones are reported. Using standardized parasitological and clinical techniques the same observers examined the intensity of infection and clinical manifestations in 1,098 cases in the rain-forest and compared them with those found in 1,128 cases in the savanna.

Journal Article The rôle of malaria, folic acid deficiency and haemoglobin as in pregnancy at Mulago Hospital Get access P.J.S. Hamilton, P.J.S. Hamilton Senior Lecturer in Tropical Epidemiology, London School of Hygiene and Tropical Medicine UK Search for other works by this author on: Oxford Academic PubMed Google Scholar D.A.M. Gebbie, D.A.M. Gebbie Professor of Obstetrics Nairobi Medical School, Nairobi, Kenya Search for other works by this author on: Oxford Academic PubMed Google Scholar N.E. Wilks, N.E. Wilks Walter Reed Hospital, Washington, USA Search for other works by this author on: Oxford Academic PubMed Google Scholar F. Lothe F. Lothe Former Director of Pathology, Uganda Search for other works by this author on: Oxford Academic PubMed Google Scholar Transactions of The Royal Society of Tropical Medicine and Hygiene, Volume 66, Issue 4, 1972, Pages 594–602, https://doi.org/10.1016/0035-9203(72)90305-7 Published: 01 January 1972