9. ๏
1.4 billion people live in areas with
risk of infection
Out of them, 120 million
are infected and need
treatment
Out of them, 40 million people are with
overt disease
15 million people with
lymphedema
25 million men with
urogenital swelling
mainly scrotal
hydrocele
11. ๏
Pathogenesis
- Pathogenic effects seen in wuchereriasis are produced
by the adult worm (living/ dead).
- L3 larva & microfilaria are not pathogenic.
- Following stages occur sequentially in the
pathogenesis of lymphatic filariasis:
1.Dilatation of lymphatic vessels.
2.Infecion of the lymphatics ( Lymphangitis).
3. Obstruction of the lymph nodes.
14. ๏
Symptoms
1. Asymptomatic microfilaremia
patients with microfilaria usually
asymptomatic althoughthose with heavy
µfilaria loads may develop acute
chronic inflammatory granulomas
2. Symptomatic
symptoms result from presence of
adult worms in lymphatics
17. ๏
(II(Stage(Stage I)
- Swelling reverses
at night
- Skin folds-absent
- Appearance of skin
((smooth, normal
Stages of LF
- Swelling not
reversible at night
- Skin folds-absent
-Appearance of skin
((smooth, normal
18. Stages of LF
- Swelling not reversible at night
- Skin folds-shallow
- Appearance of skin
(Irregular, knobs, nodules)
(Stage III)
- Swelling not reversible at night
- Skin folds-shallow
- Appearance of skin (smooth,
normal)
(Stage IV)
19. Stages of LF
- Swelling not reversible at night
- Skin folds-deep
- Appearance of skin
(smooth or irregular)
(Stage V) (Stage VI)
- Swelling not reversible at night
- Skin folds-absent, shallow, deep
- Appearance of skin
(mossy lesions on foot or top of
the toes)
20. ๏
Diagnosis
A. Clinical :
signs of lymphatic obstruction & history of visiting endemic
area
B. Laboratory
1. Direct:
Detection of microfilaria in blood or Adults in biopsy (rare)
- Wet drop
- thick, thin film
- Concentration methods: Knott's, membrane filtration
21. ๏
- Detection of circulating antigens (ICT)
( advantage: +ve even in amicrofilaremia
therefore samples collected any time , sensitive )
(By (PCR- Detection of parasite DNA
2. Indirect: limited
3. Serology: CBC
C. Imaging : Ultrasound
Diagnosis
22. ๏
1- Personal Protection:
sleep in an air-conditioned room
sleep under a mosquito net
wear long sleeves and trousers
use mosquito repellent on exposed skin.
Prevention & Control
23. ๏
:2-large scale annual treatment
includes giving entire communities
Medicine that kills the microscopic
worms and controlling mosquitoes.
Single dose of : ( albendazole 400 mg ) ( ivermectin 150-200 mg
/kg ) or ( diethylcarbamazine citrate 6mg /kg )
For 4 : 6 years
3-morbidity management
Prevention & Control
24. ๏
The Medical Management of FILARIASIS Infection Should
:be specific
diethylcarbamazine โdrug of choiceโ
ivermectin / albendazole
doxycycline
Surgery
Diet and activity
NO FILARIASIS VACCINE IS CURRENTLY
AVAILABLE
Treatment
25. ๏
๏ Nobel Prize in Physiology or Medicine 2015 went for William C.
Campbell, Satoshi ลmura for
discovering ivermectin in
treatment of filariasis
๏ WHO launched the Global Programme to Eliminate Lymphatic Filariasis
(GPELF) in 2000
๏ Preventive chemotherapy is still required in 54 countries but has not
been delivered to all endemic areas as of the end of 2015. Enhanced
strategies are called for in about 29 countries to achieve the elimination
targets and stop treatment by 2020
Recent
26. ๏
๏ The Filariasis Test Strip (FTS) is a new point-of-care
rapid diagnostic test designed to detect in human
blood the antigen of the major species of filarial
worm (Wuchereria bancrofti) that causes LF
๏ the global number of people requiring treatment reduced from 1.4
billion in 2011 to 946 million in 2015.
it is common in developing countries but rare in developed
countries
๏ More than 556 million people receive treatment for lymphatic
filariasis in 2015
Recent
