Lymphatic filariasis

People infected with filariasis who have microfilaraemia or a positive antigen test should receive antifilarial drug treatment to eliminate microfilariae. Unfortunately, the medicines available have limited effect on adult worms. Treatment also involves the management of morbidity and disability prevention (MMDP) that includes simple hygiene measures, such as basic skin care and exercise, to prevent acute attacks and progression of lymphoedema to elephantiasis. For management of hydrocoele, surgery may be appropriate.

Whereas the disease was once thought to affect only adults, it now appears that most infections are acquired in childhood. Initial infection is followed by a long period of subclinical disease, which progresses in later life to clinically manifest disease. Lymphatic filariasis can cause of variety of clinical manifestations, that can be grouped in three categories: acute attacks, lymphoedema/elephantiasis and hydrocoele.

Lymphatic filariasis, commonly known as elephantiasis, is a painful and profoundly disfiguring disease. It is caused by infection with parasites classified as nematodes (roundworms) of the family Filariodidea that are transmitted through the bites of infected mosquitos. Mosquito-transmitted larvae are deposited on the skin from where they can enter the body. The larvae then migrate to the lymphatic vessels where they develop into adult worms, thus continuing a cycle of transmission.