Commonly known as elephantiasis, lymphatic filariasis is a tropical disease which has been neglected for a long time. Mosquitos transmit this disease to humans, and infection occurs when filarial parasites are transmitted to humans. Childhood infection is mostly common, causing damage to the lymphatic system.

This damage is hardly noticeable during childhood but becomes severe later in life. The severity is always a visible scrotal swell, painful and profound disfiguring. Elephantiasis and lymphedema are other major sign that will be manifested later in life, this can lead to permanent disability. This disease can lead to social sigmatisation of patients which can cause psychological pains. Most patients also suffer from financial losses during management of this disease.

Causes and Transmission of Lymphatic Filariasis

Parasites called nematodes (roundworm) of the family filariodidea are the main causes of this disease. There are 3 major types of this tread-like worms (filarial) and they include:

  • Wuchereria Bancroft (accounts for 90% of the cases)
  • Brugai malayi
  • Brugai timori
These worms can live for approximately 6-8years and during there lifetime, they can produce millions of immature larvae that circulate in the blood of the patient.

Immature larvae are ingested by mosquitoes after biting an infected host. Then it matures into infective larvae within the mosquito. The infective larvae is deposited on the skin of the patient by the mosquito, the skin is where the infective larvae gain entrance to the body. The  final part is that, the larvae migrates to the lymphatic vessels where it develops into adult worms and then continues the transmission circle.

Symptoms 

There are three major stages on the signs and symptoms of this infection, this involves asymptomatic, acute and chronic conditions.

Asymptomatic stage

The majority of infection is asymptomatic, they show little or no external signs of the infection while contribution internally to the transmission of the disease. This can cause damage to the lymphatic system, kidney and alteration of the immune system.

Acute stage

In actute stage of Lymphatic Filariasis, inflammation of the skin, lymph nodes and lymphatic vessels normally accompany chronic elephantiasis. This may be caused by the body's  immune system response against parasites. In most cases, due to underlying lymphatic damage the normal defence system may be partially lost and may result to secondary bacterial skin infection. Weekends of the body is another symptom of during the acute stage of this infection, this may last for weeks or months.

Chronic stage

When this condition develops to chronic stage, it leads to tissue swelling or tissue thickening of limbs and hydrocele (scrotal swelling). It is also common when breasts and genital are involved. At this stage the body becomes really deformed and this deformity may lead to poor mental health and societal stigmatization.

W.H.O -Lymphatic filariasis patient with visible enlargement of left foot, India.


Treatment

According to WHO, preventive chemotherapy is the most appropriate method for prevention and stopping lymphatic filariasis. This can be achieved through mass drug administration by healthcare professionals. It is recommended to see a doctor for proper management and preventive care. Although the drugs may have limited effect on adult, it has been proven to effectively reduce mirofilarie in the blood stream and also prevent the spread of these parasites to mosquitos.

Prevention and control 

It is important to know that the best way to stay healthy is to apply preventive and control measures. Mosquito control is one strategy used to reduce transmission of all mosquito-borne infections including Lymphatic Filariasis. It is always advisable to use insecticide treated nets and insecticide spray in areas where mosquitoes (Anopheles) are present to control and prevent possible tramission. This control measure is more effective during and after mass drug administration.


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