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Bockarie MJ et al Efficacy of single-dose diethylcarbamazine compared with diethylcarbamazine combined with albendazole against Wuchereria bancrofti infection in Papua New Guinea Am J Trop Med Hyg 2007 Jan;76(1):62 6 [PMID: 17255231] Johnston KL et al Wolbachia in filarial parasites: targets for filarial infection and disease control Curr Infect Dis Rep 2007 Jan;9(1):55 9 [PMID: 17254505] Ramzy RM et al Effect of yearly mass drug administration with diethylcarbamazine and albendazole on bancroftian filariasis in Egypt: a comprehensive assessment Lancet 2006 Mar 25;367(9515):992 9 [PMID: 16564361] Tisch DJ et al Mass chemotherapy options to control lymphatic filariasis: a systematic review Lancet Infect Dis 2005 Aug; 5(8):514 23 [PMID: 16048720]

keratitis and blindness Iridocyclitis, glaucoma, choroiditis, and optic atrophy may also lead to vision loss The likelihood of blindness after infection varies greatly based on geography, with the risk greatest in savanna regions of West Africa

Severe pruritus, skin excoriations, pigment changes, nodules, and thickening Conjunctivitis progressing to severe eye disease and blindness Microfilariae in skin snips and on slit-lamp examination; adult worms in subcutaneous nodules

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// publish how many strings you hold public int GetNumEntries( ) { return ctr; } } public class Tester { static void Main( ) { // create a new ListBox and initialize ListBoxTest lbt = new ListBoxTest("Hello", "World"); // add a few strings lbt.Add("Proust"); lbt.Add("Faulkner"); lbt.Add("Mann"); lbt.Add("Hugo"); // test the access string subst = "Universe"; lbt[1] = subst; lbt["Hel"] = "GoodBye"; // lbt["xyz"] = "oops"; // access all the strings for (int i = 0; i < lbt.GetNumEntries( ); i++) { Console.WriteLine("lbt[{0}]: {1}", i, lbt[i]); } } } }

The diagnosis is made by identifying microfilariae in skin snips, by visualizing microfilariae in the cornea or anterior chamber by slit-lamp examination, by identification of adult worms in a biopsy or aspirate of a nodule or, uncommonly, by identification of microfilariae in urine Skin snips from the iliac crest (Africa) or scapula (Americas) are allowed to stand in saline for 2 4 hours or longer, and then examined microscopically for microfilariae Deep punch biopsies are not needed, and if suspicion persists after a skin snip is negative, the procedure should be repeated Ultrasound may identify characteristic findings suggestive of adult worms in skin nodules When the diagnosis remains difficult, the Mazzoti test can be used In this test, a 50-mg dose of diethylcarbamazine is given A positive test, with exacerbation of skin rash and pruritus, usually within 3 hours, is highly suggestive of the diagnosis This test should only be used in suspected lightly infected patients (after other tests are negative), as this treatment can elicit severe skin and eye reactions in heavily infected individuals A related and safer test using topical diethylcarbamazine is available in some areas Eosinophilia is a common, but inconsistent finding Serologic tests are poorly standardized, nonspecific, and generally unhelpful, as in endemic areas positivity is not indicative of acute disease

Onchocerciasis, or river blindness is caused by Onchocerca volvulus An estimated 18 million persons are infected, of whom 3 4 million have skin disease, 500,000 have severe visual impairment, and 300,000 are blinded Over 99% of infections are in subsaharan Africa, especially the West African savanna, with about half of cases in Nigeria and Congo In some hyperendemic African villages, close to 100% of individuals are infected, and 10% or more of the population is blind The disease is also prevalent in the southwestern Arabian peninsula and Latin America, including southern Mexico, Guatemala, Venezuela, Colombia, Ecuador, and northwestern Brazil Onchocerciasis is transmitted by simulium flies (blackflies) These insects breed in fast-flowing streams and bite during the day After the bite of an infected blackfly, larvae are deposited in the skin, where adults develop over 6 12 months Adult worms live in subcutaneous connective tissue or muscle nodules for a decade or more Microfilariae are released from the nodules and migrate through subcutaneous and ocular tissues Disease is due to responses to worms and to intracellular Wolbachia bacteria

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