The subject of parasitological surveys were inhabitants of the Kella・Sergent Village in Bouar Area of Savanna Zone in the north of 470 km from Bangui city and M'Banza in M'Baiki Area of Jungle Zone in the west of 130 km from Bangui. At Kella・Sergent Village, a total of 200 inhabitants were examined, and 182 cases who brought their stools in same day, have been done the stool examination using with the methods of cellophane thick smear technique. Among 45 helminths eggs positive cases, treated with Pyrantel pamoate for hookworm positives, Mebendazole for trichiuriasis and Praziquantel for both of schistosomiasis mansoni and hymenolepiasis cases. At M'Banza Villege, a total of 72 inhabitants were examined and all of them received the stool examination with the direct thick smear method, and 29 cases were hookworm egg positive. All cases treated with Pyrantel pamoate after get the results in the same day.

All stools after direct examination were fixed with formalin at the laboratory of Bouar Hospital and/or the village. These fixed specimens were brought back to Japan and examined with MGL centrifugation technique.

The detection of Onchocerca volvulus on 198 inhabitants at Kella・Sergent Village have been done by the skin snips, however all cases were negative.

Two hundred cases of Kella・Sergent Village and 63 cases of M'Banza were made the blood smear for the examinations both of lymphatic filariasis and malaria, and were examined after Giemsa staining in Japan.

However, the urine examinations for detection of Schistosoma haematobium have not done both village in this time, because there is not found in past several years.

　

The applicants for this surveys are exist in a great number and many inhabitants are waiting for our consultation. However, examination time is very limit for our staying terms because of the internal trouble in this country, unfortunately. Moreover direct flight from Paris to Bangui is only once per week at the moment. Then the survey project were decided only two villages of Kella・Sergent and M'Banza which were same places done the surveys from about 20 years over. Methods of examination have been done the stool and blood examinations and also skin snip us usual.

At Kella・Sergent Village, health note check and blood smear preparations were done under the tree in the village because the weather was fine without rainfall, and direct thick smear stool examinations, and the stool treatment of formalin fixation for MGL and making the blood smear specimens to brought back to Japan have been done in Bouar Hospital. At M'Banza Village, direct thick smear stool examinations were done under the tree with microscope, and same time the formalin treatment of stools and blood smear fixation have been done by the reasons of no electricity in this village.

All the fix materials were bought back to Japan and examined. Dr. Yaya who was company with us, done the reception and help as interpreter of traditional language, and also clinical consultation for the patients. Dr. Aoyama who is the Medical Doctor of Japanese Embassy also kindly company with us to go to M'Banza Village, and clinical consultation for several patients.

　

a) Stool examinations

The stool specimens of 182 inhabitants of Kella・Sergent Village and 72 stools of M'Banza Village were examine using with the methods of direct cellophane thick smear technique in locals of each villages. And 182 specimens of of Kella・Sergent Village and 59 specimens of M'Banza Village were fixed with formalin in the nunc tubes.

These fixed specimens were brought back to Japan and examined with MGL methods (formalin-ether centrifugation technique) using iodine staining for the detections of helminthes eggs and protozoan cysts. Thirteen out of 72 stool specimens in M'Banza Village inhabitants were not enough quality of stools, these spedmens were tested with the methods of direct cellophane thick smear technique only for the detections of helminthes eggs.

　

b) Blood Examination

Each blood from 263 persons in total of 200 at Kella・Sergent Village and 63 at M'Banza Village were drawn, and made the both of thick and thin blood smear for the examinations of lymphatic filariasis and malaria. These specimens were dried at locals and brought back to Japan. The thick smears were hemolysis with distilled water, and the both of thin smears and hemolytic thick smears were stained with Giemsa after methyl alcohol fixation in the laboratory in Japan. Finally, the detection of microfilariae and Plasmodium have been done by microscope.

　

c) Skin snip test

For the detection of Onchocerca volvulus, 198 inhabitants at Kella・Sergent Village have been done by the skin snip test. The small pieces of shoulder and hip skin were cut using with luncet and razor blade, and these materials removed on the slide glass with a drop of saline solution and looking for microfilaria of Onchocerca volvulus by microscope. All specimens were brought back to Japan and re-examined after staining in the laboratory.

　

All helminths eggs positive cases of both villages of Kella Sergent and M'Banza which were recognized with the methods of direct cellophane thick smear were given the anti-helminths drugs at locals in the same day. Namely, hookworm positives treated with Pyrantel pamoate, Mebendazole for trichiuriasis and Praziquantel for both of schistosomiasis mansoni and hymenolepiasis cases. And other helminths positives were treated with each effective drugs according to the results of examinations in last year. Diethykarbamazine for filariasis, Metronidazole for amoebiasis, Chroloquine and Mefloquine for malaria were used. And moreover, several anti-helminths drugs such as Pyrantel pamoate, Thiabendazole, Mebendazole, Prazi-quantel, Chroloquine, Mefloquine and Metronidazole were donated to Doctors and Infirmers of Bouar Hospital and to Infirmers of M'Banza Dispensary, and demand to give to the patients with the individual results data of inhabitants of the subject villages. With many sincere thanks to the members of the Nippon Foundation Delegation, sepecially both Doctors of Dr. Ito who was the staff of Ministry of Health, Labor and Welfare and Dr. Nakai who was the staff of Japan Ground Self Defense Forces to help for the administration of treatments in Kella・Sergent Village with Tsuji. They were canceled their original schedule for helping our activity kindly.

　

a) Results of stool examinations

Stool examinations for helminth eggs were performed with both methods of cellophane thick smear technique (modified Kato-Katz method) and formalin-ether centrifugation technique (MGL method). With the MGL technique, using iodine staining protozoan cysts were also examined after the specimens brought back to Japan. Out of 182 stools at Kella・Sergent Village, 79 (43.4%) were found for helminth eggs as shown in Table 1 and 2 [25.7% in 2001 of last year, 60.8% in before the last year of 2000], 70 (38.5%) of hookworm [21.3% in 2001, 45.7% in 2000], 25 (13.7%) of Schistosoma mansoni [5.1% in 2001, 27.1% in 2000], and 1 (0.5%) of Trichuris trichiura [0.7% in 2001, 1.5% in 2000], 1 (0.5%) of Hymenolepis nana [0.7% in 2001, 0.5% in 2000] were positives.

On the other hand, 40 (55.6%) stools out of 72 at M'Banza Village were detected for helminths eggs [18.4% in 2001, 50.8% in 2000], and 39 (54.2%) hookworm [16.3% in 2001, 50.8% in 2000], 1 case (1.4%) Schistosoma mansoni [1.6% in 2001. 0 in 2000] were positives, however not recognized Ascaris lumbricoides even positives in last year's examination.

Results of the examination for protozoan cysts at Kella・Sergent Village by MGL are shown in Table 3. Out of 182 stools, the protozoan cysts were found in 108 (59.3%) [64.1% in 2001, 63.3% in 2000], Entamoeba histolytica in 27 (14.8%) [17.6% in 2001, 11.1% in 2000], Entamoeba coli in 78 (42.9%) [43.5% in 2001, 47.2% in 2000], Endolimax nana in 65 (35.7%) [50.4% in 2001, 39.2% in 2000], Iodamoeba butshlii in 32 (17.6%) [30.5% in 2001, 20.1% in 2000] and Giardia lambria in 21 (11.5%) [14.5% in 2001, 9.5% in 2000], respectively. Out of 58 stools at M'Banza Village, the protozoan cysts were found in 48 (81.4%) [85.1% in 2001, 42.9% in 2000], and Entamoeba hystolytica in 4 (6.3%) [25.4% in 2001, 17.5% in 2000], Entamoeba coli in 31 (57.6%) [38.6% in 2001, 27.0% in 2000], Endolimax nana in 30 (50.8%) [60.5% in 2001, 17.5% in 2000], Iodamoeba butshlii in 28 (47.5%) [43.0% in 2001, 12.7% in 2000] and Giardia lambria in 3 (5.1%) [17.5% in 2001, 11.1% in 2000]. The prevalence rates of protozoan cysts in both villages were high, as mentioned above.

　

b) Results of skin snip examinations

Results of the examination for Onchocercosis by the detection of Onchocerca volvulus from the skin snip on 198 inhabitants at Kella・Sergent Village, no microfilaria positive cases were found as shown in Table 4.

　

c) Results of blood examinations for lymphatic filariasis

Results of the examination for microfilaria by blood thick and thin smear technique with Giemsa staining specimens are shown in Table 5. Out of 200 cases at Kella・Sergent Village, the microfilaria were detected in 30 cases (15.0%) [7.3% in 2001, 11.3% in 2000]. Among 30 positives, 15 (50.0%) were positive for Acanthocheilonema perstans and 18 (60.0%) were positive for Loa loa. At M'Banza Vilege, 24 cases (38.1%) [42.3% in 2001, 24.7% in 2000] out of 63 inhabitants were positive, and among 24 positives, 17 (70.7%) were Acanthocheilonema perstans cases and 16 (66.7%) were Loa loa cases. There was no significant species difference in positive ratio between Acanthocheibonema perstans and Loa loa.

　

d) Results of blood examinations for malaria

Results of the examination for Malaria by the detection of Plasmodium from the same blood smear of microfilariae research specimens are as shown in Table 6. Out of 200 cases at Kella・Sergent Village, the total Plasmodium were found in 128 cases (64.0%) [58.3% in 2001, 57.6% in 2000], and 40 cases (70.0%) out of 63 inhabitants at M'Banza Village [64.6% in 2001, 80.8% in 2000] were detected. Positive rate of both villages situated in Savanna (Kella Sergent Villege) and Jungle (M'Banza Villege) was very high.

Among the malaria positive cases, 94 (73.4%) out of 128 positives were found Plasmodium falciparum, and 91 cases (71.1%) were Plasmodium malariae at Kella・Sergent Village, and 28 (70.0%) out of 40 positives were Plasmodium farciparum, and 27 (67.5%) were recognized Plasmodium malariae at M'Banza Village. Plasmodium ovale was found only one case (0.5%) from the inhabitant of Kella・Sergent Village in this time.

No Plasmodium vivax were found in Central African Republique from our past surveys. There was no significant difference in the prevalence rates of Plasmodium infection among both villages. And among the malaria patients, about 45% in Kella・Sergent Village were mixed infection with both species of Plasmodium falciparum and Plasmodium malariae (one case of Plasmodium ovale infection was infected with 3 species), and about 38% in M'Banza Village were mixed infection of both species.

　

e) Results of mixed infections

Results of mixed infections of parasites on the cases who were received all examinations in Kella・Sergent Village are shown in Table 7. Positive rate in this year was 93.4% (170 out of 182 cases). There were little increase compared with the results of recent several years in the same village, such as 88.1% in 2001, 93.0% in 2000 and 89.5% in 1999, but not so significantly. And the average number of species per person was 2.84 species in this time, and the past were 2.81 species in 2001, 2.98 species in 2000 and 3.00 species in 1999, however the average number of species of parasite infections on the Health Note holders who were received already our examinations and treatments in the past was 2.70 species, and shown in little decreased. In M'Banza Village, the average number of species per person was 98.3% in this year as shown in Table 8. and the past were 98.2% in 2001, 93.3% in 2000, 93.8% in 1999. And the average numbers of species per person were 3.60 species in this year, 3.35 species in 2001, 2.87 species in 2000 and 3.26 species in 1999.

　

f) Individual results of the examinations in each case

The individual results of parasitological examinations of Kella・Sergent Village and M'Banza Village are as shown in Table 9 and 10.

The new individuals numbers who were received parasitological and medical consultation by us were increased in each year. It seems to be that the increased reasons may succeed and spread to have the knowledge and interesting on the health problems by our activities such as health education to individuals, and the neighbor villagers were also visit to our consultation and increased every years gradually.

　

Total of the persons who were received all examinations of stools by both methods of cellophane thick smear technique and MGL method, blood smear for lymphatic filariasis and malaria, and skin snip for onchocercosis, were 182 in Kella・Sergent Village and 58 in M'Banza Villege. Among them, 170 cases (93.4%) out of 182 were positive for any parasite in Kella・Sergent Village and 57 cases (98.3%) out of 58 in M'Banza Villege as shown in Table 7 & 8. Namely 12 cases (6.6%) in Kella・Sergent Village were parasites free and one case is negative in M'Banza Villege. This results were compared with the results of recent past several years. In Kella・Sergent Village, positive rate of 2001 were 88.1% (111 out of 128), 93.0% (185 out of 199) in 2000, 89.5% (162 out of 181) in 1999, and 94.5% in 1995, 100% in 1985 which were not described in this Table. In M'Banza village, positive rate of 2001 were 98.2% (112 out of 114), 93.3% (56 out of 60) in 2000 and 93.8% (91 out of 97) in 1999.

The average number of parasites species per person was 2.84 species in this time, and the past average numbers were 2.81 species in 2001, 2.98 species in 2000 and 3.00 species in 1999. However, the average number of species of parasite infections cases on the Health Note holders who were received already our examinations with treatments in the past was 2.70 species in little decreased as shown in Table 7.

In M'Banza Village, the average number of parasites species per person was 3.60 species in this year, and 3.35 species in 2001, 2.87 species in 2000 and 3.26 species in 1999 as shown in Table 8. The reasons of not decreases on both of positive rate and the numbers of species, it seems to be the exist of vector presence by the situation in Jungle areas and many visitors visit in this village because very closed the capitol city.