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For the past four decades, Belém has been considered to be the largest focus of Bancroftian filariasis in the Amazon region and one of the most important ones in Brazil. In 1952, practically one-fifth of the population was infected and it was estimated that there were 2,500 cases of Bancroftian elephantiasis. The major factor considered to be responsible for this situation was the high density of the main vector species: it was calculated that in April 1943 there was a mean of 67 infected mosquitoes per house. A control campaign was initiated in 1952, involving treatment of patients with diethylcarbamazine, as well as control of the vector. In 1956, vector control was discontinued because of a lack of efficient insecticides and financial limitations. Even so, the campaign was very successful and the incidence was reduced from 19.9% to 0.03%. Total eradication could be achieved if new methods of vector control were introduced, such as the use of Reiter's expanded polystyrene balls in cesspits and pit latrines, biological control using pathogenic bacteria, and improvement of basic sanitation. Há mais de quatro décadas Belém é considerada o maior foco de bancroftose da região amazônica e um dos mais importantes do Brasil. Em 1952, praticamente um quinto de sua população apresentava microfilárias no sangue, estimando-se em 2.500 os casos de elefantíase. O fator considerado o maior condicionante de tão extraordinária freqüência era a alta densidade local do principal vetor, Culex quinquefasciatus. Em abril de 1943 calculava-se uma média de 67 fêmeas da espécie infectadas por domicílio. Uma campanha de controle foi deflagrada em 1952, incluindo busca ativa e tratamento dos casos com dietilcarbamazina, além medidas de combate ao vetor. Estas foram abandonadas em 1956, por força da ineficácia ou do alto custo dos inseticidas. Ainda assim, a campanha foi muito bem sucedida, reduzindo a incidência de 19,9 para 0,03%. Hoje, a erradicação poderia ser de pronto lograda, se novos métodos de combate ao vetor fossem adotados, tais como o emprego das bolinhas expandidas de poliestireno nas fossas sépticas e privadas estanques não-inundáveis e o controle biológico com microrganismos entomopatogênicos nos criadouros naturais, sobretudo se acompanhados de um incremento de obras de saneamento

Bancroftian filariasis in Belém, Pará State: possibilities for eradication by introducing modern methods of control for Culex quinquefasciatus